术前SII、PNI对子宫颈癌淋巴结转移的预测价值

Prognostic Value of Preoperative SII and PNI in Cervical Cancer with Lymph Node Metastasis

目的:探究术前全身免疫炎症指数(SII)和预后营养指数(PNI)对子宫颈癌淋巴结转移的预测价值。方法:回顾性收集2021年1月—2023年1月连云港市第一人民医院收治的131例子宫颈癌患者的临床资料。根据术后病理结果是否伴有盆腔淋巴结转移分为淋巴结转移组(n=42)和淋巴结未转移组(n=89),收集两组的临床资料及相关指标(术前SII、PNI等),进行单因素及多因素logistic回归分析影响子宫颈癌淋巴结转移的危险因素,使用受试者操作特征(ROC)曲线分析SII、PNI水平对子宫颈癌淋巴结转移的预测价值。结果:淋巴结转移组SII、中性粒细胞/淋巴细胞比率(NLR)、血小板/淋巴细胞比率(PLR)、糖类抗原125(CA125)、糖类抗原153(CA153)水平及肿瘤低分化占比均高于淋巴结未转移组,而PNI低于淋巴结未转移组,差异均有统计学意义(P<0.05)。两组血小板含量、血红蛋白含量、是否绝经、是否脉管浸润、是否宫体侵犯、是否人乳头瘤病毒(HPV)感染、病理分型比较,差异均无统计学意义(P>0.05)。SII、PNI、CA153、分化程度是子宫颈癌患者淋巴结转移的独立影响因素(P<0.05);SII、PNI联合预测子宫颈癌淋巴结转移的曲线下面积为0.898,敏感度为80.65%,特异度为91.03%,有良好的临床诊断价值。结论:SII与PNI是影响子宫颈癌淋巴结转移的独立影响因素,且术前SII、PNI联合检测可有效帮助临床医生判断子宫颈癌淋巴结转移结果。

Objective:To explore the predictive value of preoperative systemic immunoinflammatory index(SII)and prognostic nutritional index(PNI)in cervical cancer with lymph node metastasis.Method:Clinical data of 131 patients with cervical cancer treated in Lianyungang First People's Hospital from January 2021 to January 2023 were retrospectively collected.The patients were divided into lymph node metastasis group(n=42)and lymph node non-metastatic group(n=89)according to the pathological results after surgery.Clinical data and related indicators(preoperative SII,PNI,etc.)of the two groups were collected,and univariate and multivariate logistic regression analysis was performed to analyze the risk factors affecting cervical cancer lymph node metastasis.Receiver operating characteristic(ROC)curve was used to analyze the predictive value of SII and PNI levels in cervical cancer with lymph node metastasis.Result:The levels of SII,neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR),carbohydrate antigen 125(CA125),carbohydrate antigen 153(CA153)and low tumor differentiation ratio in lymph node metastasis group were higher than those in lymph node non-metastasis group,while PNI was lower than that in lymph node non-metastasis group,the differences were statistically significant(P<0.05).There were no significant differences in platelet content,hemoglobin content,whether menopause,whether vascular invasion,whether uterine body invasion,whether human papillomavirus(HPV)infection and pathological classification between the two groups(P>0.05).SII,PNI,CA153 and differentiation classification were the independent influencing factors of lymph node metastasis in patients with cervical cancer(P<0.05).The area under the curve of the combined prediction of SII and PNI was 0.898,the sensitivity was 80.65%,and the specificity was 91.03%,which had good clinical diagnostic value.Conclusion:SII and PNI are independent factors affecting cervical cancer with lymph node metastasis,and the combined detection of SII and PNI before surgery can effectively help clinicians judge the results of lymph node metastasis of cervical cancer.