术前系统性炎症反应指数-预后营养指数评分对结肠癌根治术后患者预后的影响

Effect of systemic immune inflammation index-prognostic nutritional index score on the prognosis of patients with colon cancer after radical surgery

目的评价系统性炎症反应指数(SII)-预后营养指数(PNI)评分对结肠癌根治术后患者预后的预测价值。方法选择2015年1月—2016年12月徐州医科大学附属医院收治的144例结肠癌根治术后患者,收集临床资料,进行回顾性分析。采用受试者工作特征(ROC)曲线确定SII和PNI的最佳截断值,并根据截断值将SII-PIN评分赋值对患者进行分组,分析不同分组与结肠癌根治术后患者临床病理特征及预后的关系。结果SII与PNI的ROC曲线下面积分别为0.695、0.754,最佳截断值分别为658、48.95。根据最佳截断值,SII-PNI评分分组为:SII<658且PNI>48.95为0分(61例);SII≥658或PNI≤48.95为1分(41例);SII≥658且PNI≤48.95为2分(42例)。COX多因素回归分析显示,肿瘤的分化程度、浸润程度、TNM分期及SII-PNI评分是影响结肠癌患者无病生存期(DFS)的独立危险因素(P<0.05),肿瘤的分化程度、TNM分期及SII-PNI评分2分是影响结肠癌患者总生存期(OS)的独立危险因素(P<0.05)。生存曲线显示,SII-PNI评分0分组的生存率显著高于1分组和2分组(P<0.05)。结论术前SII-PNI评分是影响结肠癌患者预后的独立危险因素,可用于结肠癌根治术后患者预后评估,评分越高,预后越差。

Objective To evaluate the predictive value of the systemic immune inflammatory index(SII)-prognostic nutritional index(PNI)score for the prognosis of patients with colon cancer after radical surgery.Methods A retrospective analysis was conducted using clinical data from 144 patients with colon cancer who underwent radical surgery in the Affiliated Hospital of Xuzhou Medical University from January 2015 to December 2016.The optimal cutoff values for SII and PNI were determined using the receiver operating characteristic(ROC)curve.The patients were grouped based on the cutoff values and assigned SII-PIN score.The relationships between different groupings and the clinicopathological characteristics and prognosis of patients with colon cancer after radical surgery were analyzed.Results The area under the ROC curves of SII and PNI was 0.695 and 0.754,respectively,with the optimal cutoff values of 658 and 48.95.According to the cutoff values,the SII-PNI score was divided as follows:SII<658 and PNI>48.95 were 0 point(61 cases);SII≥658 or PNI≤48.95 was 1 point(41 cases);SII≥658 and PNI≤48.95 were 2 points(42 cases).COX multivariate regression analysis showed that the degree of tumor differentiation,infiltration,TNM stage,and SII-PNI score were the independent risk factors affecting DFS in colon cancer patients(P<0.05),while the degree of tumor differentiation,TNM stage,and SII-PNI score(2 points)were the independent risk factors affecting OS in colon cancer patients(P<0.05).The survival curve showed that the survival rate of group 0 point with SII-PNI score was significantly higher than those of group 1 point and group 2 points(P<0.05).Conclusions The preoperative SII-PNI score is an independent risk factor affecting patients with colon cancer,and can be used to evaluate the prognosis of patients after radical resection of colon cancer.