系统免疫炎症指数联合糖类抗原199在胆囊癌预后评估中的作用  

Role of Systemic Immune Inflammation Index Combined with Carbohydrate Antigen 199 in Prognostic Evaluation of Patients with Gallbladder Cancer

作　　者：任国亮[1] 李连生[1] 苏伟 丰帆[2] REN Guo-liang;LI Lian-sheng;SU Wei;FENG Fan(Department of Hepatobiliary and Pancreatic Surgery&Hernia Surgery,Qinghai Red Cross Hospital,Xining 810000,China;Department of Radiology,Qinghai Red Cross Hospital,Xining 810000,China)

机构地区：[1]青海红十字医院肝胆胰及疝外科,西宁810000 [2]青海红十字医院放射科,西宁810000

出　　处：《临床误诊误治》2021年第10期48-53,共6页Clinical Misdiagnosis & Mistherapy

基　　金：青海省自然科学基金资助项目(2018-N-316)。

摘　　要：目的探讨术前系统免疫炎症指数(SII)联合糖类抗原199(CA199)在胆囊癌患者预后评估中的作用。方法回顾性分析2006年5月—2020年2月手术治疗278例胆囊癌的临床资料。收集术前SII、CA199及肿瘤病理特征等临床资料。随访1~60个月,根据末次随访时的生存情况分为存活组42例和死亡组236例。分析术前SII联合CA199预测胆囊癌患者死亡的效能,以及影响患者死亡的危险因素。结果术前SII联合CA199预测胆囊癌患者死亡的曲线下面积高于SII或CA199单独预测(P<0.05)。多因素Cox回归分析显示,姑息手术、SII>635.38、CA199>116.25 U/ml、临床分期Ⅲ~Ⅳ期、有淋巴结转移是胆囊癌患者死亡的独立危险因素(P<0.05,P<0.01)。Kaplan-Meier生存曲线显示,SII高表达组(>635.38)和CA199高表达组(>116.25 U/ml)的5年生存率分别低于SII低表达组和CA199低表达组(P<0.05)。结论术前SII、CA199升高是胆囊癌患者死亡的独立危险因素,二者联合检测用于患者死亡评估具有较高的临床价值。Objective To explore the role of preoperative systemic immune inflammation index(SII)combined with carbohydrate antigen 199(CA199)in prognostic evaluation of patients with gallbladder cancer.Methods Clinical data of 278 patients with gallbladder cancer treated by surgery between May 2006 and February 2020 was retrospectively analyzed.Preoperative clinical data such as SII,CA199 and tumor pathological characteristics was collected.The patients were followed up for 1 to 60 months,and were divided into survival group(n=42)and death group(n=236)according to their survival conditions at the last follow-up.The efficacy of preoperative SII combined with CA199 in predicting the death and the risk factors influencing the death of patients with gallbladder cancer were analyzed.Results The area under the receiver operating curve(ROC)of preoperative SII combined with CA199 in predicting the death of patients with gallbladder cancer was significantly higher than those by SII or CA199 alone(P<0.05).Multivariate Cox regression analysis showed that palliative surgery,SII more than 635.38,CA199 more than 116.25 U/ml,clinical stageⅢtoⅣand having lymph node metastasis were independent risk factors for death in patients with gallbladder cancer(P<0.05,P<0.01).Kaplan-Meier survival curve showed that the 5-year survival rates of SII high expression group and CA199 high expression group were significantly lower than those of SII low expression group and CA199 low expression group respectively(P<0.05).Conclusion The preoperative increase of SII and CA199 levels are independent risk factors for the death of patients with gallbladder cancer.The combined detection of the two indexes is of good clinical value in predicting the death of patients with gallbladder cancer.

关 键 词：胆囊肿瘤 系统免疫炎症指数 糖类抗原199 预后 危险因素 

分 类 号：R735.8[医药卫生—肿瘤]