术前炎症相关指标与可切除胃癌患者预后的相关性

目的 探讨术前外周血系统性免疫炎症指数(Systemic immune-inflammation index,SII)、中性粒细胞与淋巴细胞比值(Neutrophil to lymphocyte ratio,NLR)、血小板与淋巴细胞比值(Platelet to lymphocyte radio,PLR)与可切除胃癌患者预后的相关性及其临床意义。方法 回顾性分析2013年10月—2015年2月哈尔滨医科大学附属肿瘤医院收治的226例经手术治疗胃癌患者的临床病理资料。评估并比较SII、NLR、PLR在可切除胃癌患者中的预后价值。结果 胃癌组SII、NLR、PLR显著高于健康对照组,差异均有统计学意义(P＜0.05)。多因素Cox回归分析结果显示SII高(HR=2.947,95% CI:1.345~6.454,P=0.007)、NLR高(HR=2.876,95% CI:1.445~5.724,P=0.003)、T分期越高(HR=5.885,95% CI:1.641~21.099,P=0.007)、有远处转移(HR=3.010,95% CI:1.472~6.154,P=0.003)是影响可切除胃癌患者预后的独立危险因素。SII预测可切除胃癌患者结局的ROC曲线下面积为0.840,灵敏度为86.6%,特异度为68.0%,高于NLR、PLR及CA199,且差异有统计学意义(P＜0.05)。结论 SII对可切除胃癌患者生存结局的评估价值优于NLR和PLR。

Relationship between preoperative inflammation-related indicators and prognosis of patients with resectable gastric cancer

Objective The aim of this study was to investigate the correlation among systemic immune-inflammation indexes(SII),neutrophils to lymphocytes ratio(NLR),platelets to lymphocytes ratio(PLR),prognosis of patients with resectable gastric cancer,and their clinical significance. Methods Clinicopathological data of 226 patients with gastric cancer treated in the Affiliated Cancer Hospital of Harbin Medical University from October 2013 to February 2015 were retrospectively analyzed.The prognostic values of SII,NLR and PLR in patients with resectable gastric cancer were evaluated and compared. Results The SII,NLR and PLR of the gastric cancer group were significantly higher than those of the healthy control group,and the differences were statistically significant(P＜0.05).Multivariate Cox regression analysis showed that high SII(HR=2.947,95% CI:1.345~6.454,P=0.007),high NLR(HR=2.876,95% CI:1.445~5.724,P=0.003),high T staging(HR=5.885,95% CI:1.641~21.099,P=0.007)and presence of distant metastasis(HR=3.010,95% CI:1.472~6.154,P=0.003)were independent risk factors affecting the prognosis of patients with resectable gastric cancer.The area under the ROC curve of SII predicting the outcome of resectable gastric cancer patients was 0.840,the sensitivity was 86.6%,and the specificity was 68.0%,which was higher than NLR,PLR and CA199,and the difference was statistically significant(P＜0.05). Conclusion SII is better than NLR and PLR in evaluating the survival outcomes of patients with resectable gastric cancer.