系统免疫炎症指数、预后营养指数对老年食管癌根治性放疗后死亡的预测价值  

Predictive value of systemic immune-inflammation index and prognostic nutritional index for the death of elderly patients with esophageal cancer after radical radiotherapy

作　　者：李东辉[1] 李杰[1] 王艳伟[1] LI Donghui;LI Jie;WANG Yanwei(Department of General Surgery,Handan First Hospital(Textile Hospital District),Handan 056004,China)

机构地区：[1]邯郸市第一医院(纺医院区)综合外科,056004

出　　处：《浙江医学》2023年第15期1621-1625,共5页Zhejiang Medical Journal

摘　　要：目的探讨放疗前系统免疫炎症指数(SII)和预后营养指数(PNI)对老年食管癌根治性放疗后死亡的预测价值。方法选取2013年1月至2017年1月在邯郸市第一医院接受根治性放疗的219例老年食管癌患者为研究对象,采用ROC曲线分析放疗前SII、PNI及两者联合对老年食管癌患者接受根治性放疗后死亡的预测效能。同时以ROC曲线分析所得的SII、PNI最佳截断值为界分组,分析老年食管癌患者临床指标对放疗前SII、PNI的影响。结果219例老年食管癌患者中位随访时间为39.1个月。1、3、5年总体生存率分别为72.6%、32.9%、24.2%,中位生存期为21.4个月。放疗前SII、PNI以及两者联合预测老年食管癌患者接受根治性放疗后死亡的AUC、灵敏度、特异度分别为0.723、0.585、0.825,0.704、0.642、0.771和0.812、0.736、0.849。两者联合检测的预测效能明显高于单一指标(均P<0.05)。放疗前SII≥651.38与<651.38、放疗前PNI≥49.24与<49.24患者性别、年龄、BMI、肿瘤位置、肿瘤直径、TNM分期、分化程度、处方剂量、是否同期化疗以及放疗前SII或PNI等临床指标比较,差异均无统计学意义(均P>0.05)。结论放疗前SII与PNI联合检测对老年食管癌根治性放疗后死亡具有较高的预测价值。Objective To explore the predictive value of systemic immune-inflammation index(SII)and prognostic nutritional index(PNI)before radiotherapy for the death of elderly patients with esophageal cancer after radical radiotherapy.Methods A total of 219 elderly patients with esophageal cancer who received radical radiotherapy in Handan First Hospital from January 2013 to January 2017 were selected as the research objects.The ROC curve was used to analyze the predictive performance of SII,PNI and their combination before radiotherapy on the death of elderly patients with esophageal cancer after radical radiotherapy.At the same time,the best cut-off value of SII and PNI obtained from ROC curve analysis was used as the reference of grouping to analyze the impact of clinical indicators of elderly patients with esophageal cancer on SII and PNI before radiotherapy.Results The median follow-up time of 219 elderly patients was 39.1 months.The overall survival rates at 1-,3-and 5-year were 72.6%,32.9%,and 24.2%,respectively,with a median survival period of 21.4 months.The AUC,sensitivity,and specificity of SII,PNI,and their combination before radiotherapy in predicting mortality of elderly esophageal cancer patients receiving radical radiotherapy were 0.723,0.585,0.825;0.704,0.642,0.771;and 0.812,0.736,0.849,respectively.The predictive performance of the combined SII and PNI was significantly higher than that of any of them(both P<0.05).There were no statistically significant differences in clinical indicators such as gender,age,BMI,tumor location,tumor diameter,TNM staging,differentiation degree,prescription dose,concurrent chemotherapy or not,and preradiotherapy SII or PNI between patients with SII≥651.38 and<651.38 before radiotherapy,and between patients with PNI≥49.24 and<49.24 before radiotherapy(all P>0.05).Conclusion The combination of SII and PNI before radiotherapy has a high predictive value for the death of elderly patients with esophageal cancer after radical radiotherapy.

关 键 词：系统免疫炎症指数 预后营养指数 根治性放疗 老年人 食管癌 

分 类 号：R735.1[医药卫生—肿瘤]