SII-N评分模型预测老年食管癌预后的初步探讨

目的 评价TNM分期联合系统免疫炎症指数(SII)对老年食管癌是否具有更好的预测价值。方法 回顾性分析 118例接受放化疗的老年食管癌患者的临床资料,计算SII值。将SII及临床病理特征纳入Cox模型分析,得出预后指数(PI)方程。应用Kaplan-Meier法生存分析,根据PI分组预测患者生存并比较PI和TNM的预测价值。结果 单因素分析显示SII、N分期、TNM分期均与总生存率密切相关(均 P<0.01),多因素分析结果显示SII、N分期是影响总生存率的因素。根据Cox分析结果得出PI=0.961×SII分组+0.523×N分期。根据PI及总生存期绘制受试者工作特征(ROC)曲线,得出临界值并分组。低危组1、2、3年总生存率明显高于高危组(HR=0.365,95%CI:0.221~0.604,P<0.001)。SII-N预测总生存ROC曲线下面积优于TNM分期(0.707:0.560,P<0.001)。结论 初步证明SII-N预后评分模型优于传统TNM分期,可能对老年食管癌治疗策略选择具有指导意义,值得进一步研究。

Preliminary study of SII-N scoring model in predicting the prognosis of elderly patients with esophageal cancer

Objective To investigate whether TNM staging combined with systemic immune inflammation index (SII) has a high predictive value for the clinical prognosis of elderly patients with esophageal cancer. Methods Clinical data of 118 elderly patients with esophageal cancer who received radiotherapy and chemotherapy were retrospectively analyzed, and the SII was calculated. SII and clinicopathological features were included in the Cox proportional risk model, and the prognostic index (PI) equation was obtained. Kaplan-Meier survival analysis was adopted. According to PI, the survival of patients was predicted and the predictive values of PI and TNM were statistically compared. Results Univariate analysis showed that SII, N staging and TNM staging were closely correlated with the overall survival (all P<0.01). Cox multivariate analysis revealed that SII and N staging were the independent risk factors for overall survival. According to the results of Cox analysis, the equation of PI=0.961 × SII grouping+ 0.523 × N staging was obtained. The receiver operating characteristic (ROC) curve was drawn according to PI and overall survival, and the critical value was obtained and divided into different groups. The 1-, 2-and 3-year survival rates in the low-risk group were significantly higher than those in the high-risk group (HR=0.365, 95%CI:0.221-0.604, P<0.001). The prediction of overall survival by SII-Narea under curve (AUC)=0.707] was significantly better than that by TNM staging (AUC=0.560, P<0.001). Conclusion This study preliminarily proves that the SII-N prognosis score model is better than the traditional TNM staging, which may have guiding significance for the selection of therapeutic strategies for elderly patients with esophageal cancer, and is worthy of further study.