| 术前SII-PNI评分与老年胃癌患者临床病理特征及预后关系的研究 |
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| 引用本文： | 吕景霞,丁平安,张志栋,王冬,赵雪峰,檀碧波,刘羽,范立侨,李勇,赵群.术前SII-PNI评分与老年胃癌患者临床病理特征及预后关系的研究[J].中国肿瘤临床,2022,49(8):384-389. |
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| 作者姓名： | 吕景霞 丁平安 张志栋 王冬 赵雪峰 檀碧波 刘羽 范立侨 李勇 赵群 |
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| 作者单位： | 河北医科大学第四医院外三科（石家庄市050011） |
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| 基金项目： | 本文课题受河北卫健委县级公立医院适宜卫生技术推广入库项目（编号:2019024）、政府资助临床医学优秀人才培养项目（编号:2019012）和河北省医学科学研究重点课题计划（编号:20160170）资助 |
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| 摘 要： | 目的 基于外周血中性粒细胞、淋巴细胞及血小板计数的系统性炎症反应指数（systemic immune-inflammation index，SII）以及根据血清白蛋白水平和外周血淋巴细胞计数确定的预后营养指数（prognostic nutritional index，PNI），探讨术前SII-PNI评分在预测老年胃癌患者根治术后预后中的临床价值。 方法 回顾性分析2012年1月至2015年1月于河北医科大学第四医院行根治性手术治疗的327例老年胃癌患者（年龄≥70岁）临床资料，分别计算术前SII及PNI值。利用ROC曲线确定SII、PNI的最佳cut-off值，根据评分将患者分为3组，比较各组患者之间的临床病理特征及生存预后。 结果 术前SII-PNI不同评分患者中，肿瘤直径、肿瘤浸润程度（pT分期）、淋巴结是否转移、pTNM分期、脉管浸润与神经受侵发生率以及Ki-67阳性比例比较，差异均具有统计学意义（均P<0.05）。Cox多因素分析显示，肿瘤组织学类型（P=0.023）、肿瘤浸润深度pT分期（P=0.016）、存在淋巴结转移（P=0.014）、肿瘤pTNM分期（P=0.001）和术前SII-PNI评分（P=0.001）是影响老年胃癌患者预后的独立危险因素。 结论 术前SII-PNI评分与老年胃癌患者的临床病理特征密切相关，同时评分越高患者术后易出现并发症，而且预后越差。
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| 关 键 词： | 胃肿瘤 系统性炎症反应指数 预后营养指数 危险因素 |
| 收稿时间： | 2021-11-12 |
Relationship between preoperative SII-PNI score and clinicopathological features and prognosis of elderly patients with gastric cancer |
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| Affiliation: | Department of Surgery, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China |
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| Abstract: | Objective To investigate the clinical value of the preoperative systemic immune-inflammation index (SII)–prognostic nutritional index (PNI) score in predicting the prognosis of elderly patients with gastric cancer after radical surgery based on SII values derived from peripheral blood neutrophil, lymphocyte, and platelet counts and PNI values determined based on serum albumin levels and peripheral blood lymphocyte counts. Methods Elderly patients with gastric cancer (aged ≥70 years) treated with radical surgery from January 2012 to January 2015 at Fourth Hospital of Hebei Medical University were retrospectively analyzed, and preoperative SII and PNI values were calculated. The optimal cut-off values of SII and PNI were determined using ROC curves, and patients were assigned into three groups based on SII and PNI scores to compare clinicopathological characteristics and survival prognosis between the groups. Results Patients with different preoperative SII-PNI scores were compared in terms of tumor diameter, degree of tumor infiltration (pT stage), lymph node metastasis rate, pTNM stage, incidence of vascular infiltration, and nerve invasion. Cox multifactorial analysis showed that tumor histological type (P=0.023), depth of tumor infiltration (pT stage) (P=0.016), presence of lymph node metastasis (P=0.014), tumor pTNM stage (P=0.001), and preoperative SII-PNI score (P=0.001) were independent risk factors that affected the prognosis of elderly patients with gastric cancer. Conclusions The preoperative SII-PNI score correlates closely with the clinicopathological characteristics of elderly patients with gastric cancer, while higher scores predispose patients to postoperative complications and poorer prognosis. |
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