术前系统免疫炎症指数和γ-谷氨酰转肽酶与肝癌患者临床病理特征及预后的相关性  

Correlation of preoperative systemic immune inflammation index andγ-glutamyl transpeptidase with clinicopathological features and prognosis in patients with hepatocellular carcinoma

作　　者：刘迪[1] 柳科军 卜阳 LIU Di;LIU Kejun;BO Yang(Department of Hepatobiliary Surgery,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Department of Hepatobiliary Surgery,People’s Hospital of Ningxia Hui Autonomous Region Yinchuan 750002,China)

机构地区：[1]宁夏医科大学总医院肝胆外科,宁夏银川750004 [2]宁夏回族自治区人民医院肝胆外科,宁夏银川750002

出　　处：《宁夏医学杂志》2023年第8期699-703,F0003,共6页Ningxia Medical Journal

基　　金：宁夏回族自治区科技基础条件建设计划创新平台基金项目(2020CXPT0007);宁夏回族自治区科技惠民项目(2021CMG03017)。

摘　　要：目的探讨术前系统免疫炎症指数(SII)和γ-谷氨酰转肽酶(γ-GGT)与肝癌患者临床病理特征及预后的关系。方法回顾性分析213例病理诊断为肝细胞癌的患者临床资料,采用受试者工作特征(ROC)曲线确定术前SII和γ-GGT的临界值,分析SII和γ-GGT与肝癌患者临床病理特征及预后的相关性。结果ROC曲线分析显示SII和γ-GGT评估患者生存预后的临界值分别为194.38和40.50。与同指标低水平组比较,SII和γ-GGT高水平组的TNM分期更晚,且患者术后肝内肿瘤复发率高,差异有统计学意义(P<0.05)。Spearman秩相关分析显示,术前SII与T分期、N分期及肝内早期复发呈正相关关系(P<0.05);术前γ-GGT与吸烟、饮酒、T分期及肝内早期复发呈正相关关系。术前SII>194.38或γ-GGT>40.50均预测肝癌患者术后生存预后不良,此外,SII联合γ-GGT的预测效能更为敏感。Cox回归分析显示术前SII和γ-GGT是影响肝癌患者术后生存预后的独立因素。结论术前SII和γ-GGT是影响肝癌患者生存预后的独立危险因素,高水平组的SII联合γ-GGT对于预测肝癌患者的不良预后具有较好的临床应用价值。Objective To explore the correlation of preoperative systemic immune inflammation index(SII)andγ-glutamyl transpeptidase(γ-GGT)with clinicopathological features and prognosis in patients with hepatocellular carcinoma(HCC).Methods The clinical data of 213 HCC patients were retrospectively analyzed.Receiver operating characteristic(ROC)curve analysis was performed to determine the cut-off value of preoperative SII andγ-GGT.The correlation of SII andγ-GGT with clinical pathological characteristics and prognosis of patients with hepatocellular carcinoma was analyzed.Results Receiver operating characteristic(ROC)curve showed the recommended cut-off values of SII andγ-GGT for evaluating cancer-specific survival were194.38 and 40.50.Compared with the low level group of the same indicator,TNM clinical stage was later and the rate of postoperative intrahepatic tumor recurrence was higher,the difference was statistically significant(P<0.05).Spearman rank correlation analysis showed that SII was positively correlated with T stage,N stage,and early intrahepatic tumor recurrence.Preoperativeγ-GGT was positively correlated with smoking,drinking,T stage and early intrahepatic tumor recurrence(P<0.05).Preoperative SII>194.38 orγ-GGT>40.50 predicted poor survival prognosis in patients with hepatoma.Moreover,the predictive efficacy of SII combined withγ-GGT was more sensitive.Cox regression analysis showed that preoperative SII andγ-GGT were independent factors affecting the postoperative prognosis of HCC patients.Conclusion Preoperative SII andγ-GGT could independently predict poor survival of HCC patients.The combination of SII andγ-GGT in the high-grade group has been shown to have good clinical utility in predicting poor prognosis in HCC patients.

关 键 词：肝癌 系统免疫炎症指数 Γ-谷氨酰转肽酶 预后 

分 类 号：R574[医药卫生—消化系统]