系统免疫-炎症指数与晚期非小细胞肺癌预后的关系

目的 探讨系统免疫-炎症指数（system immune-inflammation index，SII）对晚期非小细胞肺癌患者预后的评估价值。方法 收集2013年10月至2018年12月于承德医学院附属医院就诊的300例晚期非小细胞肺癌患者的临床资料。通过 ROC 曲线计算SII最佳截点值，并根据最佳截点值分为高SII组（SII≥767.24×10⁹，n=168）和低SII组（SII＜767.24×10⁹，n=132），比较两组患者的临床病理特征及总生存期，并采用Cox回归分析SII与患者预后的关系。结果 SII与晚期非小细胞肺癌患者临床分期、KPS评分有关（P＜0.05）。低 SII 组中位生存期高于高 SII 组（21个月 vs 13个月，χ²=16.824，P<0.001）。单因素Cox回归结果显示，病理类型、临床分期、吸烟情况、KPS评分、SII、血红蛋白水平和治疗方案均与晚期非小细胞肺癌患者预后有关（P＜0.05）；多因素Cox回归显示，SII≥767.24×109是晚期非小细胞肺癌患者总生存期的独立危险因素（HR=1.416，95%CI：1.039~1.930，P=0.028）。结论 高SII是晚期非小细胞肺癌患者总生存期的独立危险因素，SII可作为预后评估指标。

Relationship between system immune-inflammation indexand prognosis of advanced non-small cell lung cancer

Objective To investigate the value of system immune-inflammation index（SII） in the prognosis of patients with advanced non-small cell lung cancer（NSCLC）. Methods Clinical data of 300 patients with advanced NSCLC who were admitted to the Chengde Medical College Affiliated Hospital from October 2013 to December 2018 were collected. ROC curve was used to calculate the best SII cutoff value，and patients were divided into high SII group（SII≥767.24×10⁹，n=168） and low SII group（SII＜767.24×10⁹，n=168）according to the best cutoff value . The clinicopathological characteristics and overall survival of the two groups of patients were compared，and the relationship between SII and prognosis was analyzed by Cox regression. Results SII was associated with clinical staging and KPS score（P<0.05）. The median survival in the low SII group was higher than that in the high SII group（21 months vs 13 months，χ²=16.824，P<0.001）.Univariate Cox regression showed that pathological type，clinical stage，smoking，KPS score，SII，Hb level and treatment regimen were all associated with the prognosis of advanced NSCLC patients（P<0.05）. Multivariate Cox regression showed that SII≥767.24×109 was an independent risk factor for the overall survival of advanced NSCLC patients（HR=1.416，95%CI：1.039-1.930，P=0.028）. Conclusion High SII is an independent risk factor for the overall survival of patients with advanced NSCLC，which can be used as a prognostic indicator.