系统免疫炎症指数在输尿管尿路上皮癌中的预后价值

Prognostic value of systemic immune-inflammatory index in ureteral urothelial carcinoma

目的探讨术前系统免疫炎症指数(SII)对输尿管尿路上皮癌患者的预后风险分层评估价值。方法回顾性分析2005年1月至2019年12月河北北方学院附属第一医院泌尿外科收治的202例输尿管尿路上皮癌患者的临床资料。整理分析患者术前血液SII,以最高约登指数值确定SII的最佳切点值为580,并进行Cox回归分析。采用一致性指数和决策曲线分析评估预测模型。结果共有55例(27%)患者的SII达高水平(SII>580)。在多变量分析中,高SII与PFS(风险比=1.75,95%CI=1.21~2.65,P=0.002)和CSS(风险比=2.23,95%CI=1.38~4.25,P=0.002)的进展相关。结论术前SII可以确定疾病和预后较差的输尿管尿路上皮癌患者。这种比较容易获得的生物标志物可能有助于输尿管尿路上皮癌患者辅助治疗的决策。

Objective To investigate the value of preoperative systemic immune-inflammation index(SII)in prognostic risk stratification evaluation of patients with ureteral urothelial carcinoma.Methods The clinical data of 202 patients with ureteral urothelial carcinoma admitted to the Department of Urology,the First Affiliated Hospital of Hebei North University from January 2005 to December 2019 were retrospectively analyzed.The preoperative blood SII of patients was sorted out and analyzed,and the best cut value of SII was determined as 580 by using the highest Youden index value.Cox regression analysis was then performed.Concordance indices and decision curve analysis were used to assess the discrimination of the predictive models.Results A total of 55 patients(27%)had high levels of SII(SII>580).In multivariate analysis,high SII was associated with progression to PFS(hazard ratio=1.75,95%CI=1.21-2.65,P=0.002)and CSS(hazard ratio=2.23,95%CI=1.38-4.25,P=0.002).Conclusion Preoperative SII can identify patients with poor disease and prognosis of ureteral urothelial carcinoma.This more readily available biomarker may aid decision making regarding adjuvant therapy for patients with ureteral urothelial carcinoma.