高级别胶质瘤患者免疫炎症指数和白球比预后价值分析  

Analysis of prognostic value of immune inflammation index and white ball ratio in patients with high-grade glioma

作　　者：曹佳超 董博[1] 蒋天伟 CAO Jia-chao;DONG Bo;JIANG Tian-wei(Department of Neurosurgery jThird Affiliated Hospital of Soochovu University,First Peoples Hospital of Changzhou,Changzhou 213000,China)

机构地区：[1]苏州大学附属第三医院·常州市第一人民医院神经外科,江苏常州213000

出　　处：《中华肿瘤防治杂志》2021年第16期1215-1219,1225,共6页Chinese Journal of Cancer Prevention and Treatment

基　　金：国家自然科学基金(31800745)。

摘　　要：目的探讨术前全身免疫炎症指数(SII)和白球比(A/G)对高级别胶质瘤(HGG)患者的预后预测价值。方法选取2016-01-01-2018-01-31苏州大学附属第三医院初诊的100例HGG患者纳入数据分析。收集患者临床资料、血常规、治疗情况及预后等信息。根据中性粒细胞计数、淋巴细胞计数、血小板计数计算SII和A/G。患者均进行随访,末次随访时间2019-08-20,中位随访时间23个月。计算SII和A/G预测患者预后的最佳临界值,并分析不同SII和A/G水平患者的临床特征差异,Cox回归分析影响HGG患者预后的影响因素。结果A/G和SII预测患者预后的最佳临界值分别为1.41和315.60×109 L-1。SII在不同肿瘤分级(χ^(2)=4.128,P=0.042)、中性粒细胞计数(χ^(2)=21.227,P<0.001)、淋巴细胞计数(χ^(2)=6.947,P=0.008)、血小板计数(χ^(2)=3.907,P=0.048)患者中差异有统计学意义。A/G在不同血小板计数(χ^(2)=11.891,P=0.007)、白蛋白(χ^(2)=11.524,P=0.003)、球蛋白(χ^(2)=5.391,P=0.026)患者中差异有统计学意义。SII与A/G呈负相关,r=-0.183,P=0.017。高SII和低SII患者中位总生存期(OS)分别为9.60和17.00个月,差异有统计学意义,χ^(2)=10.157,P=0.002。高A/G和低A/G患者中位OS分别为11.10和5.10个月,差异有统计学意义,χ^(2)=6.372,P=0.012。Cox回归分析显示,肿瘤分级(HR=2.792,95%CI为1.126~7.855,P<0.001)和SII(HR=1.306,95%CI为1.063~2.519,P=0.031)为HGG患者预后的危险性因素,而手术切除范围(HR=0.657,95%CI为0.143~0.866,P<0.001)和A/G(HR=0.173,95%CI为0.131~0.559,P<0.001)是患者预后的保护性因素。结论SII和A/G是HGG患者预后危险因素,高SII和低A/G值可以作为诊断HGG患者预后的预测指标。Objective To explore the preoperative systemic immune inflammation index(SII)and white/bulb ratio(A/G)in predicting the prognosis of patients with high-grade glioma(HGG).Methods A total of 100newly diagnosed HGG patients from January 1,2016to January 31,2018in Third Affiliated Hospital of Soochow University were finally included.Clinical data,routine blood analysis,treatment status and prognosis of patients were collected.SII and A/G were calculated based on neutrophil count,lymphocyte count and platelet count.All patients were followed up by phone or in person.The last follow-up time was August 20,2019,and the median follow-up time was 23months.X-tile software was used to calculate the optimal threshold for predicting the prognosis of patients with SII and A/G,and the clinical characteristics of patients with different levels of SII and A/G were analyzed.Cox regression analysis was used to determine prognostic factors in HGG patients.Results The optimal cutoffs for A/G and SII in predicting patient prognosis were 1.41and 315.60×109 L-1,respectively.SII was significantly different in patients with tumor grades(χ^(2)=4.128,P=0.042),neutrophil counts(χ^(2)=21.227,P<0.001),lymphocyte counts(χ^(2)=6.947,P=0.008),and platelet counts(χ^(2)=3.907,P=0.048).A/G was significantly different in patients with platelet counts(χ^(2)=11.891,P=0.007),albumin(χ^(2)=11.524,P=0.003),and globulin(χ^(2)=5.391,P=0.026).In addition,there was a negative correlation between SII and A/G(r=-0.183,P=0.017).The median overall survival(OS)of patients with high SII and low SII was 9.60 months and 17.00months,respectively,the difference was statistically significant(χ^(2)=10.157,P=0.002).The median OS of patients with high A/G and low A/G was 11.10months and 5.10months,respectively,the difference was statistically significant(χ^(2)=6.372,P=0.012).Cox regression analysis showed that tumor grade(HR=2.792,95%CI:1.126-7.855,P<0.001)and SII(HR=1.306,95%CI:1.063-2.519,P=0.031)were prognostic risk factors for HGG patients.The range of surgica

关 键 词：全身免疫炎症指数 白球比 高级别胶质瘤 手术 预后 

分 类 号：R739.41[医药卫生—肿瘤]