术前免疫炎症指数和列线图对腺样囊性癌患者预后的预测价值  

Prognostic Prediction Value of Systemic Immune Inflammation Index and Nomogram in Patients with Adenoid Cystic Carcinoma

作　　者：宗颖睿 秦红霞[1] 候珍珍 李晓娜 胡文彬 张晨[1] ZONG Yingrui;QIN Hongxia;HOU Zhenzhen;LI Xiaona;HU Wenbin;ZHANG Chen(Department of Preventive Dentistry,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China;Department of Esthetic Dentistry,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口腔预防科,河南郑州450052 [2]郑州大学第一附属医院口腔美容科,河南郑州450052

出　　处：《口腔医学研究》2022年第12期1128-1133,共6页Journal of Oral Science Research

摘　　要：目的:探讨术前免疫炎症指数(SII)与腺样囊性癌(ACC)患者根治性手术后无复发生存期(RFS)的关系,并构建可靠的预后列线图模型。方法:根据2013年1月~2020年1月在郑州大学第一附属医院接受根治性切除手术的ACC患者的临床资料计算术前SII。通过受试者工作特征曲线(ROC)得到术前SII的最佳截断值(将患者分为高SII组和低SII组),运用Kaplan-Meier法与Cox风险比例回归模型对其进行生存分析,同时绘制森林图。根据结果构建列线图,并采用C统计量(ROC曲线下面积AUC)和校正曲线验证一致性。结果:共纳入119例患者,中位生存时间为45个月,平均生存时间为49.34个月。SII的最佳截断值为691.900。低SII组RFS率高于高SII组(χ^(2)=19.487,Log-rank:P<0.001)。神经侵犯(HR=2.150,95%CI:1.027~4.500,P=0.042)、淋巴结转移(HR=3.572,95%CI:1.705~7.480,P<0.001)和高SII(HR=2.386,95%CI:1.048~5.480,P<0.038)为ACC患者RFS的独立危险指标。C统计量为0.732(95%CI:0.627~0.837)。结论:术前SII越低,患者预后越好,基于SII的列线图预测ACC预后是可靠的。Objective:To explore the association between systemic immune inflammation(SII)and recurrence-free survival(RFS)of adenoid cystic carcinoma(ACC)cancer,and to propose a reliable prognostic nomogram model.Methods:The preoperative SII was computed using clinical data from ACC patients who had radical resection at Zhengzhou University's First Affiliated Hospital between January 2013 and January 2020.The best cut-off value in the receiver operating characteristic curve(ROC)was used to compute SII for all patients,who were then divided into two groups:low SII and high SII.The Kaplan-Meier technique and the Cox proportional hazards regression model were employed by the Forest Plot to undertake survival analysis.On the basis of multivariate analysis,the nomogram was suggested.The C statistic(Area Under Curve,AUC)and Calibration Plots were used to assess the nomogram's consistency.Results:The research comprised a total of 119 patients.The average RFS duration was 49.34 months,while the median follow-up period was 45 months.ROC analysis determined the optimal SII cutoff value of 691.900.The high-SII cohort had significantly shorter RFS(χ^(2)=19.487,Log-rank:P<0.001)than the low-SII cohort.The factors selected as predicting RFS were nerve invasion(HR=2.150,95%CI:1.027-4.500,P=0.042),and lymph node metastasis(HR=3.572,95%CI:1.705-7.480,P<0.001)and high SII(HR=2.386,95%CI:1.048-5.480,P=0.038).C statistics was 0.732(95%CI:0.627-0.837).Conclusion:The lower the preoperative SII,the better the prognosis.The consistency of the nomogram revealed good predictive ability based on SII.

关 键 词：腺样囊性癌 免疫炎症指数 列线图 无复发生存 

分 类 号：R739.91[医药卫生—肿瘤] R739.87[医药卫生—临床医学]