系统免疫炎症指数对放化疗老年食管癌患者预后的预测作用  

The predictive effect of systemic immune-inflammation index on the prognosis of elderly patients with esophageal cancer with radiotherapy and chemotherapy

作　　者：张春艳[1] 刘明珠[2] 侯宁[3] 何海航 ZHANG Chun-yan;LIU Ming-zhu;HOU Ning;HE Hai-hang(Day Ward,Comprehensive Ward,Jilin Cancer Hospital,Changchun 130012;Internal Medicine Department,Jilin Cancer Hospital,Changchun 130012;Radiotherapy Room,Jilin Cancer Hospital,Changchun 130012;Otorhinolaryngology,Brain,and Abdominal Department,Jilin Cancer Hospital,Changchun 130012)

机构地区：[1]吉林省肿瘤医院日间病房、综合病区,130012 [2]吉林省肿瘤医院内二科,130012 [3]吉林省肿瘤医院放射治疗室,130012 [4]吉林省肿瘤医院耳鼻咽喉、脑、腹三科,130012

出　　处：《现代消化及介入诊疗》2021年第3期314-318,共5页Modern Interventional Diagnosis and Treatment in Gastroenterology

基　　金：吉林省科技发展计划项目(20150204076SF)。

摘　　要：目的探讨系统免疫炎症指数(SⅡ)对放化疗老年食管癌患者预后的影响。方法回顾性分析2015年5月至2018年5月吉林省肿瘤医院放化疗的328例老年食管癌患者的临床资料。根据治疗前SⅡ分为低SⅡ组(≤737.65) 108例和高SⅡ组(> 737.65) 220例。对所有患者随访,记录生存状况,多因素Cox回归分析食管癌患者死亡的危险因素。结果 ROC曲线分析显示,治疗前SⅡ预测老年食管癌患者死亡的AUC为0.793(95%CI:0.719~0.868,P=0.000)。与低SⅡ组比较,高SⅡ组TNM分期Ⅲ期、肿瘤最大径> 3.5 cm、低分化及NLR> 2.32比例更高,差异有统计学意义(P <0.05)。高SⅡ组中位生存期(29个月)较低SⅡ组(38个月)短(P <0.05)。多因素Cox回归分析结果显示,低分化、NLR> 2.32、SⅡ> 737.65是老年食管癌患者死亡的独立危险因素。结论 SⅡ能有效预测放疗老年食管癌患者的生存状况,其值升高提示患者死亡风险增高。Objective To investigate the effect of systemic immune-inflammation index( SⅡ) on the prognosis of elderly patients with esophageal cancer. Methods Retrospectively collected and analyzed the clinical data of 328 elderly patients with esophageal cancer who received radiotherapy and chemotherapy in Jilin Cancer Hospital from May 2015 to May 2018. According to SⅡ before treatment,108 cases were divided into low SⅡ group( ≤737. 65) and 220 cases in high SⅡ group( > 737. 65). All patients were followed up,survival status was recorded,multivariate Cox regression analysis of risk factors for death of esophageal cancer patients.Results ROC curve analysis showed that the AUC of SⅡ predicting death in elderly patients with esophageal cancer before treatment was 0. 793( 95% CI: 0. 719 to 0. 868,P = 0. 000). Compared with the low-SⅡ group,the high-SⅡ group had a higher proportion of TNM stage Ⅲ,tumor diameter > 3. 5 cm,poor differentiation and NLR > 2. 32,and the difference was statistically significant( P <0. 05). The median survival time in the high SⅡ group( 29 months) was shorter in the lower SⅡ group( 38 months)( P < 0. 05).Multivariate Cox regression analysis showed that poorly differentiated,NLR > 2. 32,SⅡ > 737. 65 are independent risk factors for death in elderly patients with esophageal cancer. Conclusion SⅡ can effectively predict the survival status of elderly patients with esophageal cancer after radiotherapy,and an increase in its value indicates an increased risk of death in patients.

关 键 词：食管癌 老年 系统免疫炎症指数 放化疗 

分 类 号：R735.1[医药卫生—肿瘤]