术前全身炎症反应指数及预后营养指数对表浅型食管鳞癌患者预后的预测价值

Value of preoperative systemic inflammatory response index and prognostic nutritional index in predicting prognosis of patients with superficial esophageal squamous cell carcinoma

背景表浅型食管鳞癌(superficial esophageal squamous cell carcinoma,SESCC)患者的治疗以内镜和外科手术为主.对于部分患者来说,单一的手术治疗预后欠佳.如何筛选出预后不良的患者并给予适当的干预是临床医生面临的难题.因此,寻找更便利更有效的预后预测指标对于患者的生存期和指导进一步治疗至关重要.目的探讨术前外周血全身炎症反应指数(systemic inflamma-tion response index,SIRI)及预后营养指数(prognostic nutritional index,PNI)对SESCC患者预后的预测价值.方法回顾性分析122例SESCC患者的临床、影像及病理等资料.通过ROC曲线确定SIRI及PNI的最佳截断值,将其分为低SIRI组和高SIRI组,低PNI组和高PNI组,Kaplan-Meier法分析生存曲线,Log-rank法比较验证组间生存差异.COX单因素和多因素回归分析SESCC患者术后预后的影响因素.结果低SIRI组的总生存时间高于高SIRI组,差异具有统计学意义(P=0.001);高PNI组的总生存时间高于低PNI组,差异具有统计学意义(P=0.014).术前SIRI、PNI是影响患者总生存期的独立危险因素.结论术前SIRI和PNI是预测SESCC患者预后简单可靠的生物标志物.

BACKGROUND The treatment of superficial esophageal squamous cell carcinoma(SESCC)is mainly based on endoscopic and surgical procedures.For some patients,surgical treatment alone is associated with a poor prognosis.How to screen out patients with poor prognosis and give appropriate intervention is a challenge for clinicians.Therefore,it is very important to find more convenient and effective prognostic indicators for the survival of patients to guide further treatment.AIM To evaluate the prognostic value of peripheral blood systemic inflammatory response index(SIRI)and prognostic nutritional index(PNI)in patients with SESCC.METHODS The clinical,biochemical,and pathological data of 122 patients with SESCC were retrospectively analyzed.The optimal cut-off values of SIRI and PNI were determined using the receiver operating characteristic(ROC)curve.According to the optimal cut-off values of SIRI and PNI,the patients were divided into a low SIRI group and a high SIRI group,and a low PNI group and a high PNI group.The Kaplan-Meier(K-M)method was used for survival analysis,and the Log-rank method was used to evaluate the difference between groups.COX univariate and multivariate regression analyses were performed to determine the predictive factors for the prognosis of patients with SESCC.RESULTS The overall survival time of patients in the low SIRI group was significantly longer than that of patients in the high SIRI group(P=0.001).The overall survival time of patients in the high PNI group was significantly longer than that of patients in the low PNI group(P=0.014).Preoperative SIRI and PNI were identified to be independent risk factors for the overall survival of patients with SESCC.CONCLUSION Preoperative SIRI and PNI are simple and reliable biomarkers for predicting the prognosis of patients with SESCC.