系统免疫炎症指数与肝门部胆管癌患者术后预后的关系  

Relationship between systemic immune inflammation index and postoperative prognosis of patients with hilar cholangiocarcinoma

作　　者：李健[1] 孟赛赛 柏凯 朱荣涛[1] 王维杰[1] 梁若鹏[1] 张弛弦 马秀现[1] Li Jian;Meng Saisai;Bo Kai;Zhu Rongtao;Wang Weijie;Liang Ruopeng;Zhang Chixuan;Ma Xiuxian(Department of Hepatobiliary Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院肝胆外科,450052

出　　处：《中华肝胆外科杂志》2021年第2期106-109,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：河南省医学科技攻关计划联合共建项目(LHGJ20190138)。

摘　　要：目的探讨系统免疫炎症指数(SII)与接受外科手术治疗的肝门部胆管癌患者预后的关系。方法回顾性分析2012年1月至2016年12月在郑州大学第一附属医院行外科手术治疗的181例肝门部胆管癌患者临床资料,其中男性119例,女性62例,平均年龄62.4岁。根据患者术前血常规计算SII。采用受试者工作特征(ROC)曲线确定SII预测术后生存的最佳界值。Kaplan-Meier法绘制生存曲线,生存率比较采用log-rank检验。采用Cox比例风险模型进行多因素分析。结果术前SII预测患者术后生存的ROC曲线下面积为0.749(95%CI:0.641~0.858),最佳界值为412.6。依据最佳界值分为低SII组(SII≤412.6,n=80)和高SII组(SII>412.6,n=101)。低SII组患者术后1、3、5年累积生存率分别为87.5%、57.5%、26.3%,优于高SII组的71.3%、39.6%、9.9%,差异有统计学意义(P<0.05)。多因素分析表明术前SII>412.6(HR=2.887,95%CI:2.256~7.903,P<0.05)是肝门部胆管癌患者术后生存的独立危险因素。结论术前SII对肝门部胆管癌患者术后生存有一定预测价值,SII>412.6是患者术后生存的独立危险因素。Objective To study the correlation between systemic immune inflammation index(SII)and prognosis of patients with hilar cholangiocarcinoma after surgical treatment.Methods The clinical data of 181 patients with hilar cholangiocarcinoma treated by surgery at the First Affiliated Hospital of Zhengzhou University from January 2012 to December 2016 were retrospectively analyzed.There were 119 men and 62 women,with an average age of 62.4 years.SII was calculated using preoperative routine blood tests.Receiver operating characteristic(ROC)curve was used to obtain the optimal cutoff value of SII.The Kaplan-Meier method was used to draw survival curves and survival rates were compared by log-rank test.The Cox proportional risk model was used to analyze single and multiple factors.Results The SII area under the ROC curve in predicting postoperative survival was 0.749(95%CI:0.641-0.858),the optimal threshold was 412.6.Using this threshold,patients were divided into the low SII group(SII≤412.6,n=80)and the high SII group(SII>412.6,n=101).The 1,3,and 5-year cumulative survival rates of patients in the low SII group were 87.5%,57.5%,and 26.3%,which were significantly better than those of the high SII group of 71.3%,39.6%,and 9.9%respectively(P<0.05).Multivariate analysis showed that SII>412.6(HR=2.887,95%CI:2.256-7.903,P<0.05)was an independent risk factor for overall survival of patients with hilar cholangiocarcinoma.Conclusion Preoperative SII had predictive values for postoperative survival of patients with hilar cholangiocarcinoma,SII>412.6 was an independent risk factor for postoperative survival.

关 键 词：Klatskin肿瘤 系统免疫炎症指数 预后 

分 类 号：R735.8[医药卫生—肿瘤]