引用本文:刘子豪,陆锡燕,靳晓伟,江 凡,吴瑶瑶,黄栎有.炎性指标预测食管鳞癌根治性同步放化疗患者生存预后的价值研究[J].中国临床新医学,2022,15(10):970-975.
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炎性指标预测食管鳞癌根治性同步放化疗患者生存预后的价值研究
刘子豪,陆锡燕,靳晓伟,江 凡,吴瑶瑶,黄栎有
223800 江苏,徐州医科大学附属宿迁医院,南京鼓楼医院集团宿迁医院肿瘤科
摘要:
[摘要] 目的 探讨炎性指标对食管鳞癌根治性同步放化疗患者预后的预测价值。方法 回顾性分析2016年1月至2017年12月于徐州医科大学附属宿迁医院肿瘤科行根治性同步放化疗的154例食管癌患者的临床资料。采用受试者工作特征(ROC)曲线分析治疗前系统免疫炎症指数(SII)、预后营养指数(PNI)、中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)和淋巴细胞-单核细胞比值(LMR)对患者总生存期的预测效能。采用Kaplan-Meier法绘制生存曲线,比较不同组别的生存期。采用Cox回归分析影响患者生存预后的因素,并将筛得指标通过R语言软件建立列线图预测模型。结果 ROC曲线分析结果显示,治疗前SII、NLR、PLR、LMR及PNI水平均能有效预测患者的生存预后情况(P<0.05)。Kaplan-Meier生存曲线分析结果显示,SII≤794.8组的生存预后优于SII>794.8组(P<0.05),NLR≤3.25组的生存预后优于NLR>3.25组(P<0.05),PLR≤125.65组的生存预后优于PLR>125.65组,差异均有统计学意义(P<0.05)。多因素Cox回归分析结果显示,美国东部肿瘤协作组(ECOG)评分(HR=1.774)、T分期(HR=1.749)、淋巴结转移(HR=2.147)、SII(HR=2.513)是影响患者生存预后的独立因素(P<0.05)。由此建立的列线图预测模型的C-index为0.796(95%CI:0.757~0.871),具有良好的精准度。结论 SII是影响食管鳞癌根治性放化疗患者生存预后的独立因素。基于SII等指标建立的预测模型具有良好的精准度,可供临床参考、使用。
关键词:  炎性指标  食管鳞癌  根治性放疗  预后
DOI:10.3969/j.issn.1674-3806.2022.10.15
分类号:R 735.1
基金项目:宿迁市科技计划项目(编号:S201808)
A study on the value of inflammatory indicators in predicting survival and prognosis of patients with esophageal squamous cell carcinoma undergoing radical concurrent chemoradiotherapy
LIU Zi-hao, LU Xi-yan, JIN Xiao-wei, et al.
Department of Oncology, Suqian Hospital Affiliated to Xuzhou Medical University, Suqian Hospital of Nanjing Drum Tower Hospital Group, Jiangsu 223800, China
Abstract:
[Abstract] Objective To explore the predictive value of inflammatory indicators on the prognosis of patients with esophageal squamous cell carcinoma undergoing radical concurrent chemoradiotherapy. Methods The clinical data of 154 patients with esophageal cancer who underwent radical concurrent chemoradiotherapy in the Department of Oncology of Suqian Hospital Affiliated to Xuzhou Medical University from January 2016 to December 2017 were retrospectively analyzed. The receiver operating characteristic(ROC) curve was used to analyze the predictive efficacy of systemic immune inflammation index(SII), prognostic nutritional index(PNI), neutrophil to lymphocyte ratio(NLR), platelet to lymphocyte ratio(PLR) and lymphocyte to monocyte ratio(LMR) on the overall survival of the patients before treatment. Survival curves were drawn by using Kaplan-Meier method to compare the survival of different groups. Cox regression was used to analyze the factors affecting the survival and prognosis of the patients, and the screened indicators were used to establish a nomogram prediction model through R language software. Results The results of ROC curve analysis showed that the levels of SII, NLR, PLR, LMR and PNI before treatment could effectively predict the survival and prognosis of the patients(P<0.05). The results of Kaplan-Meier survival curve analysis showed that the survival prognosis of the SII≤794.8 group was better than that of the SII>794.8 group(P<0.05); the survival prognosis of the NLR≤3.25 group was better than that of the NLR>3.25 group(P<0.05), and the survival prognosis of the PLR≤125.65 group was better than that of the PLR>125.65 group, and the differences were statistically significant(P<0.05). The results of multivariate Cox regression analysis showed that Eastern Cooperative Oncology Group(ECOG) score(HR=1.774), T stage(HR=1.749), lymph node metastasis(HR=2.147), and SII(HR=2.513) were independent factors affecting the survival and prognosis of the patients(P<0.05). The C-index of the nomogram prediction model established based on these indicators was 0.796(95%CI: 0.757-0.871), which had good accuracy. Conclusion SII is an independent factor affecting the survival and prognosis of the patients with esophageal squamous cell carcinoma undergoing radical chemoradiotherapy. The prediction model established based on SII and other indicators has good accuracy and can be used for clinical reference.
Key words:  Inflammatory indicator  Esophageal squamous cell carcinoma  Radical radiotherapy  Prognosis