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- Title
多种免疫炎症指标对肝内胆管癌患者根治性切除术后 预后的预测价值.
- Authors
马炳奇; 孟慧娟; 张伟; 董小锋; 王蒙; 窦杰; 吴雨宁; 李世平
- Abstract
Objective To investigate the value of different immune and inflammatory indices in predicting the survival outcome of patients with intrahepatic cholangiocarcinoma(ICC) after curative-intent resection. Methods A retrospective analysis was performed for the case data of 122 patients with ICC who underwent curative-intent resection in Affiliated Hospital of Weifang Medical University and Tianjin Medical University Cancer Institute and Hospital from January 2012 to December 2017 to analyze the correlation of neutrophil-lymphocyte ratio(NLR), lymphocyte-monocyte ratio(LMR), systemic immune-inflammation index(SII), prognostic inflammation index(PII), inflammation score(IS), and systemic inflammation score(SIS) with the disease-free survival(DFS) and overall survival of ICC patients after surgery, and the value of the above indices in predicting prognosis was evaluated. The chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. The Kaplan-Meier method was used to plot survival curves, and the Log-rank test was used for comparison between groups; the Cox regression model was used for univariate and multivariate analyses, and hazard ratio(HR) and 95% confidence interval [CI] were calculated. Results The univariate survival analysis showed that NLR(HR=2.212, P=0.004), LMR(HR=0.403, P=0.012), PII(HR=3.013, P<0.001), prognostic nutritional index(PNI)(HR=0.530, P=0.019), IS(HR=1.809, P=0.001), SII(HR=2.107, P=0.002), and SIS(HR=2.225, P<0.001) were predictive factors for postoperative DFS of patients with ICC, and NLR(HR=2.416, P=0.009), LMR(HR=0.297, P=0.008), PII(HR=3.288, P<0.001), PNI(HR=0.292, P=0.003), IS(HR=2.048, P=0.002), SII(HR=1.839, P=0.049), and SIS(HR=2.335, P<0.001) were predictive factors for postoperative OS of patients with ICC. The multivariate survival analysis showed that high levels of PII(HR=2.146, P=0.035) and SIS(HR=2.511, P<0.001) were independent influencing factors for postoperative DFS of ICC patients, and high levels of PII(HR=2.981, P=0.009), PNI(HR=0.261, P=0.002), and SIS(HR=2.294, P=0.010) were independent influencing factors for postoperative OS. The patients with a high level of PII tended to have advanced tumor T stage(χ~²=8.777, P=0.003) and M stage(P=0.029), and the patients with high-grade SIS tended to have advanced N stage(χ~²=9.985, P=0.030) and M stage(χ~²=8.574, P=0.012). Conclusion Among the various inflammation indices, PII and SIS are recommended for preoperative stratification and prediction of the outcome of ICC patients after curative-intent resection.
- Publication
Journal of Clinical Hepatology / Linchuang Gandanbing Zazhi, 2022, Vol 38, Issue 9, p2061
- ISSN
1001-5256
- Publication type
Article
- DOI
10.3969/j.issn.1001-5256.2022.09.021