纤维蛋白原联合全身炎症反应指数对食管鳞癌术后患者预后生存的评估

Evaluation of fibrinogen combined with systemic inflammatory response index on the prognosis and survival of patients with esophageal squamous cell carcinoma after surgery

目的探讨术前纤维蛋白原(FIB)联合全身炎症反应指数(SIRI)(简称F-SIRI)对可行手术切除的食管鳞癌(ESCC)患者的预后价值,为延长患者的生存提供参考依据。方法分析2016年1月-2020年12月在徐州医科大学附属医院行根治术治疗的198例ESCC患者的临床数据,记录FIB、SIRI数值,采用受试者工作特征(ROC)曲线取最佳截断值,根据截断值将F-SIRI评分分为0、1、2组。评估F-SIRI评分与临床病理特征的关系,探讨F-SIRI评分对ESCC术后患者预后生存的影响。结果FIB、SIRI最佳截断值分别为2.955和0.979。F-SIRI评分与肿瘤直径、浸润深度、组织分化程度、TNM分期、淋巴结转移、脉管浸润有关(F=8.447、7.319、13.669、31.496、28.938、5.350,P均<0.05)。Cox回归分析显示,分化程度、浸润深度、TNM分期及F-SIRI评分是影响ESCC患者5年内死亡的独立危险因素(HR=3.251、1.566、4.375、1.917、3.054,P均<0.05),分化程度、浸润深度、TNM分期及F-SIRI评分是影响ESCC患者5年内出现进展的独立危险因素(HR=1.990、1.707、4.291、1.181、1.722,P均<0.05)。F-SIRI 0分、1分、2分的5年无复发生存期分别为31.3%、11.8%、1.5%(P<0.05),5年总生存期分别为68.0%、28.8%、13.5%(P<0.05)。结论术前F-SIRI评分是食管鳞癌术后患者预后的独立危险因素,评分越高,预后越差。

Objective To discuss the prognostic value of preoperative fibrinogen(FIB)and systemic inflammatory response index(FIRI)(F-SIRI)in patients with operable esophageal squamous cell carcinoma(ESCC).Methods The clinical data of 198 ESCC patients who underwent radical surgery in the Affiliated Hospital of Xuzhou Medical University from January 2016 to December 2020 were analyzed,and the FIB and SIRI values were recorded.The receiver operating characteristic(ROC)curve was used to obtain the optimal cutoff value,and the F-SIRI score was divided into groups 0,1,and 2 according to the cutoff value.The relationship between the F-SIRI score and clinical pathological characteristics was evaluated,and the effect of the F-SIRI score on the prognosis and survival of patients after ESCC surgery was explored.Results The optimal cutoff values of FIB and SIRI were 2.955 and 0.979,respectively.The F-SIRI score was associated with tumor diameter,invasion depth,TNM stage of tissue differentiation,lymph node metastasis,and vascular invasion(F=8.447,7.319,13.669,31.496,28.938,5.350;all P<0.05).Cox regression analysis showed that differentiation,invasion depth,TNM stage and F-SIRI score were independent risk factors for ESCC patients'mortality within 5 years(HR=3.251,1.566,4.375,1.917,3.054;all P<0.05),and differentiation,invasion depth,TNM stage and F-SIRI score were independent risk factors for ESCC patients'progression within 5 years(HR=1.990,1.707,4.291,1.181,1.722;all P<0.05).The 5-year recurrence-free survival of patients with F-SIRI score of 0,1 and 2 was 31.3%,11.8%and 1.5%,respectively(P<0.05),and the 5-year overall survival was 68.0%,28.8%and 13.5%,respectively(P<0.05).Conclusion Preoperative F-SIRI score was an independent risk factor for prognosis of patients with ESCC after surgery,and the higher the score,the worse the prognosis.