PNI和SII对Ⅲ、Ⅳ期结直肠癌患者预后的预测价值

Predictive value of PNI and SII for prognosis of colorectal cancer patients with stageⅢandⅣ

目的评价预后营养指数(PNI)和免疫炎症指数(SII)对Ⅲ、Ⅳ期结直肠癌患者预后的预测价值。方法回顾性分析2019年1月至2020年12月我院收治的108例Ⅲ、Ⅳ期结直肠癌患者的临床资料,采用受试者工作特征(ROC)曲线计算PNI和SII的截断值,并且根据截断值将患者分为PNI高水平组和PNI低水平组。采用Kaplan-Meier法计算总生存时间(OS),多因素分析采用Cox比例风险回归模型。结果PNI、SII的ROC曲线下面积分别为0.862和0.756。PNI和SII的截断值分别为45.6和862.4。将PNI>45.6设为PNI高水平组,PNI≤45.6为PNI低水平组;将SII≥862.4设为SII高水平组,SII<862.4为SII低水平组。PNI和SII水平与TNM分期有关(P<0.05)。PNI低水平和PNI高水平组的中位OS分别为28.7个月和61.7个月(P=0.003),SII低水平组和SII高水平组的中位OS分别为43.2个月和28.7个月(P=0.033)。单因素分析显示,TNM分期、SII、PNI和手术史与OS有关(P<0.1);Cox多因素分析显示,PNI和手术史是影响OS的独立因素(P<0.05)。结论高水平PNI、低水平SII的Ⅲ、Ⅳ期结直肠癌患者的OS相对较好,PNI和手术史是预测Ⅲ、Ⅳ期结直肠癌患者预后的重要指标。

Objective To evaluate the prognostic value of prognostic nutritional index(PNI)and immune-inflammatory index(SII)in colorectal cancer patients with stageⅢandⅣ.Methods The general clinical data of 108 colorectal cancer patients with stageⅢandⅣin our hospital from January 2019 to December 2020 were retrospectively analyzed,and the receiver operating characteristic(ROC)curve was used to calculate the optimal PNI and SII cutoff.According to the critical value of PNI and SII,they were divided into PNI high-level group and PNI low-level group,respectively.Kaplan-Meier survival curve was used to calculate overall survival(OS),and multivariate Cox proportional hazards models was used to analyze various factors affecting OS.Results The areas under the ROC curves of PNI and SII were 0.862 and 0.756,respectively.The cut-off values for PNI and SII were 45.6 and 862.4,respectively.PNI>45.6 was defined as PNI high-level group,and PNI≤45.6 was defined as PNI low-level group;SII≥862.4 was defined as SII high-level group,and SII<862.4 was defined as SII low-level group.PNI and SII levels correlated with TNM staging(P<0.05).The median OS of low-level PNI and high-level PNI groups was 28.7 months and 61.7 months,respectively(P=0.003),and the median OS of SII low-level and SII high-level groups was43.2 months and 28.7 months,respectively(P=0.033).Regression analysis of factors showed that TNM stage,SII,PNI and surgical history were closely related to OS(P<0.1).Multivariate Cox regression analysis showed that PNI and surgical history were the important factors affecting the prognosis(P<0.05).Conclusion The OS ofⅢandⅣcolorectal cancer patients with high level of PNI and low level of SII is significantly prolonged.PNI and surgical history are important indicators for predicting the prognosis of colorectal cancer patients with stageⅢandⅣ.