术前全身免疫炎症指数评价上尿路上皮癌患者术后膀胱复发风险的价值

Preoperative systemic immune-inflammation index to evaluate intravesical recurrence of upper urinary tract urothelial carcinoma treated with radical nephroureterectomy

目的探讨术前全身免疫炎症指数(SII)对上尿路上皮癌(UTUC)根治术后膀胱复发的预测价值。方法收集宁夏医科大学总医院泌尿外科收治的110例UTUC患者临床资料。采用ROC曲线确定SII预测膀胱内复发风险的截断值,比较不同SII患者的临床病理资料及无复发生存期(RFS)。采用Cox比例风险回归分析影响UTUC术后膀胱复发的影响因素。结果ROC曲线显示,SII对UTUC患者RFS评价的曲线下面积为0.688,最佳截断值为410.3×10^(9)。肿瘤T分期、淋巴结转移是影响UTUC患者SII的主要危险因素(P<0.05)。SII<410.3×10^(9)组与SII≥410.3×10^(9)组的膀胱内复发率分别为10.5%、41.5%,Kaplan-Meier生存曲线显示,SII≥410.3×10^(9)组患者RFS显著差于SII<410.3×10^(9)组(P=0.000)。Cox比例风险回归显示术前肾积水、术前SII是影响UTUC患者术后膀胱复发的独立危险因素。结论术前SII作为一种炎症指标,可用于评价UTUC根治术后膀胱内复发的风险。

Objective To explore the significance of systemic immune-inflammation index(SII)to evaluate intravesical recurrence of upper urinary tract urothelial carcinoma(UTUC)treated with radical nephroureterectomy.Methods A total of 110 UTUC patients were collected as the study subjects.Receiver operating characteristic(ROC)curve was drawn to determine the cut-off value of SII for predicting intravesical recurrence.The clinicopathological data and recurrence-free survival(RFS)of different SII patients were compared.Factors affecting intravesical recurrence were analyzed with univariate and multivariate Cox proportional hazards model regression analyses.Results ROC curve showed that the area under the curve of SII for RFS evaluation was 0.688,and the cut-off value was 410.3×10^(9).SII was related to pathological T stage and lymph node metastasis(P<0.05).The intravesical recurrence rates of SII≥410.3×10^(9) group and SII<410.3×10^(9) group were 10.5%and 41.5%,respectively.Kaplan-Meier survival curve showed the RFS of SII≥410.3×10^(9) group was significantly shorter than that of SII<410.3×10^(9) group(P=0.000).Cox proportional hazard regression analyses showed that preoperative hydronephrosis and SII were independent risk factors of intravesical recurrence.Conclusion Preoperative SII is a useful biomarker to evaluate intravesical recurrence of UTUC treated with radical nephroureterectomy.