系统免疫炎症指数联合临床分期对食管癌患者预后的预测价值

目的:探讨系统免疫炎症指数(SII)与接受根治性放疗的食管癌患者预后的关系，并联合TNM分期预测患者预后。方法:回顾分析河北医科大学第四医院放疗科2014年至2016年收治的248例食管癌患者临床资料，其中，男146例，女102例；中位年龄67岁；同期化疗134例，单纯放疗114例。计算患者放疗前SII，运用受试者工作...

Predictive value of systemic immune-inflammation index combined with clinical staging for prognosis of esophageal cancer patients

Objective To investigate the relationship between systemic immune-inflammation index(SII)and the prognosis of esophageal cancer patients treated with radical radiotherapy and to predict the prognosis of the patients using the SII combined with clinical staging.Methods A retrospective analysis was conducted for 248 patients with esophageal cancer who were admitted to the Department of Radiotherapy in the Fourth Hospital of Hebei Medical University between 2014 and 2016.These patients included 146 males and 102 females,with a median age of 67 years.Among them,134 patients received concurrent chemotherapy and 114 patients received radiotherapy alone.The SII before radiotherapy was defined as platelet count×neutrophil count/lymphocyte count.The patients were divided into a low-SII group and a high-SII group according to the optimal cutoff value of pretreatment SII determined by the receiver operating characteristics(ROC)curve.Survival analysis was calculated using the Kaplan-Meier method,and the Cox proportional hazards model was used for multivariate analysis.For these patients,the prognosis effects and the predictive value for survival of different SII levels combined with TNM staging were compared.Results According to the ROC curves,the optimal cutoff value of SII before radiotherapy was 740.80.Based on this number,the patients were divided into a low-SII group(<740.80,150 cases)and a high-SII group(≥740.80,98 cases).The objective response rate of the low-SII group was significantly higher than that of the high-SII group(86.0%vs 75.5%,χ²=4.39,P=0.036).The 1-,3-,and 5-year overall survival(OS)rates of the low-SII group were 78.6%,45.6%,and 32.3%,respectively.These rates were significantly higher than the corresponding rates of the high-SII group,which were 71.0%,28.3%,and 16.4%(χ²=11.22,P=0.001),respectively.Moreover,the 1-,3-and 5-year progression-free survival(PFS)rates of the low-SII group were 67.0%,36.9%,and 32.0%,respectively.Again,these rates were significantly higher than those of the high-SII group,which were 45.5%,17.5%,and 12.5%(χ²=15.38,P<0.001),respectively.Multivariate analysis showed that TNM staging,treatment method,and SII were independent prognostic factors for OS and PFS(HR=1.39-1.60,P<0.05).Patients with low SII and early clinical staging had a better prognosis than other subgroups(χ²=13.68,13.43,P=0.001).The area under curve(AUC)of SII combined with TNM staging(0.70)was higher than that of SII(0.63)and TNM staging(0.62)(Z=2.48,2.57,P<0.05).Conclusions Pretreatment SII has a high predictive value for the prognosis of esophageal cancer after radiotherapy,and higher SII indicates a worse prognosis.Thus,combining SII with TNM staging can improve the prediction accuracy of the prognosis of esophageal cancer patients.