基于术前SIRI、HELPP评分及CONUT评分的胰头癌根治术预后列线图模型构建  

Construction and evaluation of a prognostic column chart model for radical resection of pancreatic head cancer based on preoperative SIRI,HELPP,and CONUT

作　　者：宋健 石慧 杨帆[2] 王万祥[2] SONG Jian;SHI Hui;YANG Fan;WANG Wanxiang(Department Of Emergency Critical Care Medicine,Inner Mongolia Autonomous Region People′s Hospital,Hohhot,Inner Mongolia 010000,China;Department of Hepatopancreatobiliary Surgery,Affiliated Hospital of Inner Mongolia Medical University,Hohhot,Inner Mongolia 010000,China)

机构地区：[1]内蒙古自治区人民医院急诊重症医学科,内蒙古呼和浩特010000 [2]内蒙古医科大学附属医院肝胆胰脾外科,内蒙古呼和浩特010000

出　　处：《国际检验医学杂志》2025年第1期96-101,共6页International Journal of Laboratory Medicine

摘　　要：目的探讨全身炎症反应指数(SIRI)、海德堡胰腺癌预后(HELPP)评分、控制营养状态(CONUT)评分与胰头癌根治术后患者的相关临床病理特征及生存预后的关系,构建术后生存预测模型并进行效能评价。方法回顾性分析2011年1月1日至2021年6月30日于内蒙古医科大学附属医院肝胆胰脾外科诊断为胰头癌并行根治性胰十二指肠切除术的169例患者的临床病理资料。采用COX比例风险回归模型分析影响胰头癌术后患者总生存期的预后因素,采用R4.2.2构建预后列线图。结果169例患者的中位生存时间为20.8个月,术后1、2、3年累积生存率分别为71.6%、38.5%、15.4%;SIRI≥1.74、HELPP评分>3分、CONUT评分≥3分患者预后更差;COX回归分析发现,TNM分期、肿瘤最大径、糖类抗原(CA)19-9、SIRI、HELPP评分和CONUT评分均为影响预后的独立危险因素(P<0.05);据此构建的预后列线图具有较好的预测效能。结论SIRI、HELPP评分和CONUT评分有望成为预测胰头癌根治性切除后患者预后的潜在指标,TNM分期、肿瘤最大径、CA19-9、SIRI、HELPP评分及CONUT评分是影响胰头癌预后的独立危险因素,以此构建胰头癌患者预后的列线图模型可对患者的长期生存做出预测。Objective To explore the relationship between systemic inflammatory response index(SIRI),Heidelberg pancreatic cancer prognosis(HELPP)score,controlled nutritional status(CONUT)score and the related clinicopathological characteristics and survival prognosis of patients after radical resection of pancreatic head cancer,and to build a survival prediction model and evaluate its efficacy.Methods A retrospective analysis was conducted on the clinical and pathological data of 169 patients diagnosed with pancreatic head cancer and undergoing radical pancreaticoduodenectomy at the Department of Hepatobiliary Pancreatic Spleen Surgery in Inner Mongolia Medical University Affiliated Hospital from January 1,2011 to June 30,2021.Multivariate COX regression analysis was used to conduct a proportional hazards model for univariate and multivariate analysis of prognostic factors affecting the overall survival of patients with pancreatic head cancer after surgery.A prognostic column chart was constructed using R4.2.2.Results The median survival time of 169 patients was 20.8 months,and the cumulative survival rates at 1,2,and 3 years after surgery were 71.6%,38.5%,and 15.4%,respectively.Patients with SIRI≥1.74,HELPP score>3,and CONUT score≥3 had worse prognosis.Multivariate COX regression analysis revealed that TNM staging,tumor maximum diameter,carbohydrate antigen(CA)19-9,SIRI,HELPP score,and CONUT score were all independent risk factors affecting prognosis(P<0.05).The prognostic column chart constructed based on this had good predictive performance.Conclusion SIRI,HELPP score and CONUT score are potential indicators for predicting the prognosis of patients after radical resection of pancreatic head cancer.TNM staging,maximum tumor diameter,CA19-9,SIRI,HELPP score,and CONUT score are independent risk factors affecting the prognosis of pancreatic head cancer.The established nomogram model can predict the long-term survival of patients with pancreatic head cancer.

关 键 词：胰头癌 全身炎症反应指数 海德堡胰腺癌预后评分 控制营养状态评分 列线图 预后 

分 类 号：R759.3[医药卫生—皮肤病学与性病学]