趋化因子受体4、系统性免疫炎症评分联合癌胚抗原对胆囊癌根治术后患者预后的评估价值  

The value of chemokine receptor 4,systemie immune inflammation score combined with carcinoembryonic antigen in evalua-ting the prognosis of gallbladder cancer patients after radical cholecystectomy

作　　者：苏比江·苏里堂江 季学闻 李涛 马利兵 谷申森 SUBIJIANG Sulitangjiang;JI Xuewen;LI Tao(Digestive Vascular Surgery Center Liver Laparoscopic Surgery,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830000,China)

机构地区：[1]新疆医科大学第一附属医院消化血管外科中心肝脏腹腔镜外科,乌鲁木齐830000

出　　处：《肝胆外科杂志》2025年第1期51-57,共7页Journal of Hepatobiliary Surgery

基　　金：新疆维吾尔自治区自然科学基金资助项目(2021D01C304)。

摘　　要：目的探讨趋化因子受体4(CXCR4)、系统性免疫炎症评分(SII)联合癌胚抗原(CEA)对胆囊癌根治术后患者预后的评估价值。方法纳入2020年1月~2021年6月在我院收治的114例胆囊癌患者作为研究对象,均接受根治性手术切除,术后均随访3年,记录患者术后3年内生存情况和相应生存时间。多因素Cox回归分析获得影响胆囊癌患者根治术后3年内死亡的独立预测因素,重点分析CXCR4、SI以及CEA与胆囊癌患者临床病理特征以及根治术后3年内死亡的关系,构建预测胆囊癌患者根治术后3年生存率的列线图模型,计算区分度评价指标C指数(C-index)评估列线图模型预测胆囊癌患者根治术后3年生存率的准确度和预测效能。结果分化程度、TNM/T分期、TNM/N分期、脉管侵犯以及SI在CXCR4阳性组和CXCR4阴性组两组患者中的差异,具有统计学意义(P<0.05);分别以SI以及CEA作为因变量,各临床病理指标作为自变量,结果显示,胆囊癌患者SII与TNM/T分期、TNM/N分期、脉管侵犯、CXCR4以及肿瘤最大直径呈正相关(P<0.05);胆囊癌患者CEA与TNM/T分期、TNM/N分期、脉管侵犯以及肿瘤最大直径呈正相关(P<0.05);多因素Cox回归分析结果显示,TNM/T分期、TNM/N分期、CEA、CXCR4以及SII为影响胆囊癌患者根治术后3年内死亡的独立预测因素(P<0.05);TNM/T分期、TNM/N分期、CEA、CXCR4以及SII结合其影响权重构建预测胆囊癌患者根治术后3年生存率的列线图模型;列线图模型的区分度评价指标C-Index为0.869(95%CI:0.821~0.923),H-L检验结果显示,胆囊癌患者根治术后3年生存率的预测值与实际观测值符合度良好(P>0.05)。结论基于TNM/T分期、TNM/N分期、CEA、CXCR4以及SI构建的列线图模型预测胆囊癌患者根治术后3年生存率具有较高的价值。Objective To explore the prognostic value of chemokine receptor 4(CXCR4),systemic immune inflammatory score(SIl),and carcinoembryonic antigen(CEA)in evaluating gallbladder cancer patients undergoing radical cholecystectomy.Methods A total of 114 gallbladder cancer patients admited to our hospital from January 2020 to June 2021 were included as the study subjects.All patients underwent radical surgical resection and were followed up for 3 years after surgery.The survival status and corresponding survival time of patients within 3 years after surgery were recorded.Variables with statistical significance in univariate a-nalysis were included in multivariate Cox regression analysis to obtain independent predictive factors affecting the mortality of gallblad-der cancer patients within 3 years after radical surgery.The focus was on analyzing the relationship between CXCR4,SII,CEA and the mortality of clinical pathological characteristics of gallbladder cancer patients within 3 years after radical surgery.A column chart model was constructed to predict the 3-year survival rate of gallbladder cancer patients after radical surgery based on the independent predic-tive factors.The samples were recombined using Bootstrap method and repeated 1000 times for internal validation of the column chart model.The discrimination evaluation index C index(C-index)was calculated,and the accuracy and predictive effectiveness of the pre-diction model were evaluated through goodness of fit(H-L)test.Results The differences in differentiation degree,TNM/T staging,TNM/N staging,vascular invasion,and SII of patients between the CXCR4 positive and CXCR4 negative groups were statistically significant(P<0.05);SII and CEA as dependent variables and various clinical pathological indicators as independent variables,the results showed that SIl in gallbladder cancer patients was positively correlated with TNM/T staging,TNM/N staging,vascular invasion,CXCR4 and maximum tumor diameter(P<0.05);CEA in gallbladder cancer patients was positively correlated w

关 键 词：胆囊癌 趋化因子受体4 系统性免疫炎症评分 癌胚抗原 

分 类 号：R735.8[医药卫生—肿瘤]