系统性免疫炎症指数对晚期非小细胞肺癌患者预后的预测价值

The predictive value of systemic immune inflammation index for prognosis of advanced non-small cell lung cancer patients

目的探讨系统性免疫炎症指数(SII)对晚期非小细胞肺癌患者预后的预测价值。方法自2019年1月至2022年6月,回顾性收集新疆医科大学附属肿瘤医院收治的晚期非小细胞肺癌患者143例,对患者随访1年,观察患者是否发生肿瘤特异性死亡,将患者分为死亡组(n=67)和对照组(n=76),比较两组患者系统性免疫炎症指数和其他临床特征差异,分析晚期非小细胞肺癌死亡的危险因素,同时分析系统性免疫炎症指数对肿瘤特异性死亡的预测价值。结果与对照组比较,死亡组原发肿瘤最大径增大(5.66±2.53 cm vs.4.79±1.91 cm,P=0.020);SII水平显著增高(522.44±242.98 vs.277.84±100.67,P<0.001);TNM分期为Ⅳ期的患者比例增高(76.12%vs.55.26%,P=0.011);合并胸腔积液的患者比例增高(92.54%vs.68.42%,P<0.001)。SII和原发肿瘤最大径对晚期非小细胞肺癌患者肿瘤特异性死亡均有一定预测价值,曲线下面积分别为0.849(95%可信区间:0.790~0.909,P<0.001)和0.598(95%可信区间:0.503~0.693,P=0.044)。原发肿瘤最大径、胸腔积液和SII是晚期非小细胞肺癌患者肿瘤特异性死亡的独立影响因素(P<0.05)。结论晚期非小细胞肺癌患者系统性炎症指数增高与肿瘤特异性死亡有关,可以作为预后的预测指标。

Objective To explore the predictive value of systemic immune inflammation index on the prognosis of advanced non-small cell lung cancer patients.Methods From January 2019 to June 2022,143 patients with advanced non-small cell lung cancer admitted to our hospital were retrospectively collected.Patients were followed up for 1 year to observe whether they had experienced tumor specific death or not.The patients were divided into a death group(n=67)and a control group(n=76).The differences in systemic immune inflammation index and other clinical features between the two groups were compared,and the risk factors for death in advanced non-small cell lung cancer were analyzed.The predictive value of systemic immune inflammation index for tumor specific death was also analyzed.Results Compared with the control group,the maximum diameter of the primary tumor in the death group increased(5.66±2.53 cm vs 4.79±1.91 cm,P=0.020);the level of SII significantly increased(522.44±242.98 vs 277.84±100.67,P<0.001);the proportion of patients with TNM stage IV increased(76.12%vs 55.26%,P=0.011);and the proportion of patients with pleural effusion increased(92.54%vs 68.42%,P<0.001).Both SII and the maximum diameter of the primary tumor were valuable in predicting the tumor specific death in advanced non-small cell lung cancer patients,with areas under the curve of 0.849(95%confidence interval:0.749~0.909,P<0.001)and 0.598(95%confidence interval:0.503~0.693,P=0.044).The maximum diameter of the primary tumor,pleural effusion and SII were independent influencing factors for tumor specific mortality in advanced non-small cell lung cancer patients(P<0.05).Conclusion The elevated systemic inflammatory index in advanced non-small cell lung cancer patients is associated with tumor specific mortality and can serve as a predictive indicator for prognosis.