系统性炎症反应指数在胆囊癌预后预测中的作用及模型建立  

Role of Systemic Inflammatory Response Index in Predicting Prognosis of Gallbladder Carcinoma and Establishment of Predictive Model

作　　者：郑林林 邱模竞 章小明 潘希望 郑张耀 李太原[1] 胡家平[1] ZHENG Lin-lin;QIU Mo-jing;ZHANG Xiao-ming;PAN Xi-wang;ZHENG Zhang-yao;LI Tai-yuan;HU Jia-ping(Department of General Surgery,the First Affiliated Hospital,the Second Affiliated Hospital,Nanchang University,Nanchang 330006,China;Department of Urological Surgery,the Second Affiliated Hospital,Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院普通外科,南昌330006 [2]南昌大学第二附属医院泌尿外科,南昌330006

出　　处：《南昌大学学报（医学版）》2022年第5期38-45,共8页Journal of Nanchang University：Medical Sciences

基　　金：江西省自然科学基金(20202BABL206082)。

摘　　要：目的探讨基于外周血中淋巴细胞、中性粒细胞、单核细胞计数的系统性炎症反应指数(SIRI)在胆囊癌(GBC)患者预后预测中的价值。方法选取169例接受根治性切除术的GBC患者,收集分析其包括术前血液生化检查报告在内的临床病理资料。使用ROC曲线获得SIRI,中性粒细胞/淋巴细胞比率(NLR),血小板/淋巴细胞比率(PLR),单核细胞/淋巴细胞比率(MLR)的最佳分界值,依据SIRI的最佳分界值将纳入患者分为高SIRI组(>1.19)和低SIRI组(≤1.19)。通过生存分析及Cox比例风险回归模型分析影响患者预后的独立因素并建立预测模型,并通过倾向性评分法比较组间差异。结果高SIRI组患者的总生存期(OS)显著低于低SIRI组(P<0.001),且SIRI的预后预测价值较NLR,PLR,MLR更强。Cox多因素分析得出TNM分期、肿瘤分化程度、糖类抗原19-9(CA19-9)、癌胚抗原(CEA)、NLR、SIRI是GBC患者OS的独立危险因素。由临床病理因素和SIRI构成的列线图可以有效地预测GBC患者的预后。结论SIRI是有效的根治性切除术后GBC患者的独立预后指标,其预测效能优于NLR、PLR、MLR。Objective To investigate the value of systemic inflammation response index(SIRI)based on peripheral lymphocyte,neutrophil and monocyte counts in predicating the prognosis of patients with gallbladder cancer(GBC).Methods The clinicopathological data including preoperative blood biochemical examination reports were collected from 169 patients undergoing radical resection for GBC.The optimal cut-off values of SIRI,neutrophils/lymphocytes ratio(NLR),platelets/lymphocytes ratio(PLR),and monocytes/lymphocytes ratio(MLR)were obtained by using ROC curve analysis.According to the optimal cut-off value of SIRI,these patients were divided into high SIRI group(>1.19)and low SIRI group(≤1.19).Survival analysis and Cox regression model were used to explore the independent factors affecting the prognosis and to establish the predictive model.Furthermore,propensity scoring was used to eliminate the differences between groups.Results The overall survival(OS)in high SIRI group was shorter than that in low SIRI group(P<0.001).Moreover,the prognostic value of SIRI is higher than that of NLR,PLR or MLR.Cox multivariate analysis showed that TNM stage,tumor differentiation degree,carbohydrate antigen 19-9(CA19-9),carcinoembryonic antigen(CEA),NLR and SIRI were independent risk factors for OS in GBC patients.The nomogram composed of clinicopathological factors and SIRI could effectively predict the prognosis of GBC patients.Conclusion SIRI is an independent prognostic indicator for GBC patients after radical resection,and it is superior to PLR,MLR and NLR for predicting the prognosis.

关 键 词：胆囊癌 系统性炎症反应指数 预后 列线图 

分 类 号：R735.8[医药卫生—肿瘤]