系统免疫炎症指数对非小细胞肺癌患者预后的预测作用

Role of Systemic Immune-inflammatory Index in Prognostic Prediction of Patients with Non-small Cell Lung Cancer

目的探讨系统免疫炎症指数(systemic immune-inflammation index,SII)在非小细胞肺癌(non-small cell lung cancer,NSCLC)预后预测中的临床价值。方法回顾性分析2013-01/2015-12月作者医院诊治的396例行手术治疗NSCLC患者临床资料。通过电子病历系统收集术前资料,记录患者总生存期(overall survival,OS)。多因素Cox回归分析NSCLC患者预后的危险因素。结果396例患者中位随访43个月,死亡312例(78.79%),生存84例(21.21%)。受试者工作特征(receiver operating characteristic,ROC)曲线分析显示,中性粒细胞/淋巴细胞比值(neutrophils to lymphocytes ratio,NLR)预测NSCLS患者5年生存状况的曲线下面积(area under the curve,AUC)为0.723(95%CI:0.647~0.799),最佳临界值为2.58。SII预测NSCLS患者5年生存状况的AUC为0.807(95%CI:0.741~0.843),最佳临界值为635.17。高SII组TNM分期Ⅲ期、有淋巴结转移比例高于低SII组(P<0.05),OS、5年生存率低于低SII组(P<0.05)。多因素Cox回归分析显示,TNM分期Ⅲ期(HR=1.71,95%CI:1.24~2.83,P<0.001)、有淋巴结转移(HR=1.71,95%CI:1.13~2.76,P=0.015)、SII>635.17(HR=2.04,95%CI:1.37~5.25,P=0.009)、NLR>2.58(HR=1.29,95%CI:1.06~2.54,P=0.032)是NSCLC患者预后的独立危险因素。结论SII>635.17是NSCLC患者预后的独立危险因素,可预测其远期生存状况。

Objective To investigate the clinical value of systemic immune-inflammation index(SII)in the prognosis of non-small cell lung cancer(NSCLC).Methods The clinical data of 396 NSCLC patients diagnosed and treated in author′s hospital from January 2013 to December 2015 was retrospectively analyzed.Preoperative data was collected by the electronic medical record system,and the overall survival(OS)of the patients were recorded,and the risk factors for the prognosis of NSCLC patients were analyzed by multivariate Cox regression.Results There were 396 patients with a median follow-up of 43 months,among them,312 cases(78.79%)died and 84 cases(21.21%)survived.receiver operating characteristic(ROC)curve analysis showed that the neutrophils to lymphocytes ratio(NLR)predicted that the 5-year survival status of NSCLS patients with area under the curve(AUC)was 0.723(95%CI:0.647-0.799),and the best cut-off value was 2.58.SII predicted that the 5-year survival status of NSCLS patients with AUC was 0.807(95%CI:0.741-0.843),and the best cut-off value was 635.17.TNM stageⅢ,the proportion of lymph node metastasis in high SII group were higher than those in the low SII group(P<0.05),and the OS and 5-year survival rate were lower than those of the low SII group(P<0.05).Multivariate Cox regression analysis showed that TNM stageⅢ(HR=1.71,95%CI:1.24-2.83,P<0.001),lymph node metastasis(HR=1.71,95%CI:1.13-2.76,P=0.015),SII>635.17(HR=2.04,95%CI:1.37-5.25,P=0.009),NLR>2.58(HR=1.29,95%CI:1.06-2.54,P=0.032)were independent risk factors for prognosis of NSCLC patients.Conclusion SII>635.17 is an independent risk factor for the prognosis of NSCLC patients and it can predict their long-term survival.