术前SII/ALB比值与胃癌患者预后的相关性  

Correlation between preoperative SII/ALB ratio and prognosis of patients with gastric cancer

作　　者：王杨 杨芳 成兴真 聂微 王黔 严芝强 WANG Yang;YANG Fang;CHENG Xingzhen;NIE Wei;WANG Qian;YAN Zhiqiang(Department of Gastrointestinal Surgery,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China;Department of Surgery,School of Clinical Medical,Guizhou Medical University,Guiyang 550004,Guizhou,China;Clinical Laboratory Center,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China)

机构地区：[1]贵州医科大学附属医院胃肠外科,贵州贵阳550004 [2]贵州医科大学临床医学院外科教研室,贵州贵阳550004 [3]贵州医科大学附属医院临床检验中心,贵州贵阳550004

出　　处：《贵州医科大学学报》2024年第10期1521-1527,共7页Journal of Guizhou Medical University

基　　金：贵州省科技计划项目学术新苗(19NSP015)。

摘　　要：目的探讨胃癌患者术前全身免疫炎症指数/血清白蛋白(SII/ALB)比值对术后患者预后的评估价值。方法收集171例胃癌患者的临床资料,采用受试者工作特征曲线(ROC)检测SII/ALB比值是否与患者预后相关;根据SII/ALB比值将患者分为高SII/ALB组(n=96)和低SII/ALB组(n=85),比较两组患者临床病理资料,Kaplan-Meier生存分析所有患者总生存率(OS率),Cox回归模型行单因素及多因素分析,列线图(nomogram)和校正图建立患者OS率的预测模型。结果ROC曲线的AUC为0.618,95%CI为0.535~0.702,P=0.008,提示SII/ALB比值与胃癌患者预后有较好的相关性;高SII/ALB组和低SII/ALB组患者间年龄、肿瘤标志物CA199、肿瘤分期和肿瘤大小及中性粒细胞计数、淋巴细胞计数、血红蛋白、血小板计数的差异有统计学意义(P<0.05);术前高SII/ALB水平的患者预后较差(P=0.042);单因素分析结果显示患者的年龄、淋巴细胞计数、血红蛋白、肿瘤标志物CEA、肿瘤标志物CA199、肿瘤分期、肿瘤大小、SII/ALB比值与患者的预后相关(P<0.05);多因素分析结果显示,淋巴细胞计数、肿瘤标志物CEA、肿瘤分期是影响胃癌患者预后的独立危险因素(P<0.05);列线图及校正曲线图构建的OS率预测模型,对胃癌患者术后1年、3年、5年OS的评估准确性较好。结论术前行SII/ALB比值评估对术后胃癌患者的预后具有一定的价值。Objective To investigate the value of preoperatively systemic immune-inflammation index/albuminemia(SII/ALB)ratio in evaluating the prognosis in patients with gastric cancer.Methods Clinical data of 171 patients with gastric cancer were collected.Receiver operating characteristic(ROC)curve was applied to examine whether SII/ALB ratio correlated with the prognosis of the patients.According to the SII/ALB ratio value,the patients were divided into high SII/ALB group(n=96)and low SII/ALB group(n=85).Clinical and pathological data were compared between two groups.Kaplan Meier survival analysis was performed to determine the overall survival(OS)rate of all patients.Cox regression models were used for univariate and multivariate analysis.Nomograms and calibration curves were used to establish a predictive model for the patient OS rate.Results The AUC of the ROC curve was 0.618,with 95%CI(0.535-0.702,P=0.008),indicating a good correlation between the SII/ALB ratio and the prognosis of the patients with gastric cancer.There were statistically significant differences in age,tumor marker CA199,tumor stage,tumor size,neutrophil count,lymphocyte count,hemoglobin,and platelet count between high SII/ALB and low SII/ALB groups(P<0.05).The patients with high SII/ALB levels before surgery had a poor prognosis(P=0.042).Univariate analysis showed that the patients'age,lymphocyte count,hemoglobin,tumor markers CEA and CA199,tumor stage,tumor size,and SII/ALB ratio were correlated with the prognosis of the patients(P<0.05).Multivariate analysis showed that lymphocyte count,tumor marker CEA grouping and tumor stage were independent risk factors affecting the prognosis of the patients with gastric cancer(P<0.05).OS rate prediction model constructed by nomograms and calibration curves had good accuracy in evaluating 1-,3-and 5-year OS of the patients with gastric cancer after surgery.Conclusion Preoperative evaluation of SII/ALB ratio has certain value for predicting the prognosis of patients with gastric cancer after surgery.

关 键 词：胃肿瘤 血常规 系统免疫炎症指数 血清白蛋白 预后 

分 类 号：R656[医药卫生—外科学]