术前系统免疫炎症指数和反应蛋白/血清白蛋白比值与非小细胞肺癌预后的相关性
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摘要
目的探讨术前系统免疫炎症指数(SII)和C-反应蛋白/血清白蛋白比值(CRP/Alb)与非小细胞肺癌(NSCLC)预后的相关性。方法回顾性分析2012年1月-2015年12月本院收治的124例NSCLC手术患者的临床资料,分析术前SII和CRP/Alb与临床病理特征及预后之间的关系。结果 SII低水平组与高水平组在性别、年龄、病理分型上差异无统计学意义(P>0.05),但SII高水平组的TNM分期、T分期及N分期均较晚,KPS评分也较低(P<0.05)。与CRP/Alb低水平组比较,CRP/Alb高水平组的TNM分期、T分期、N分期和KPS评分亦较晚或较低(P<0.05),2组患者之间的其他病理特征比较差异无统计学意义(P>0.05)。SII低水平组和高水平组的中位生存时间分别为38.2个月和21.0个月,差异有统计学意义(P=0.01)。CRP/Alb组低水平组和高水平组的中位生存时间分别为43.5个月和19.6个月,差异有统计学意义(P<0.01)。Cox多因素分析结果显示,TNM分期、KPS评分、术前SII和CRP/Alb是NSCLC预后的独立危险因素(P<0.05)。结论术前SII和CRP/Alb均是影响NSCLC预后的独立危险因素,SII和CRP/Alb升高提示预后不良。
Objective To investigate the prognostic values of preoperative systematic immue-inflammation index(SII) and C-reactive protein/albumin ratio(CRP/Alb) in non-small cell lung cancer patients(NSCLC). Methods The clinical data of 124 cases with NSCLC were reviewed. The relationship of preoperative SII and CRP/Alb with clinicopathological features and prognosis was analyzed during January 2012-December 2015. Results There was no statistical significance on the differences in gender, age and pathological classification between low SII group and high SII group(P>0.05). However, the TNM stage, T stage and N stage of high SII group were relatively later, and KPS score was also lower(P<0.05). Compared with low CRP/Alb group, TNM stage, T stage, N stage and KPS score of high CRP/Alb group were also later or lower(P<0.05). The difference in other clinicopathological features between low CRP/Alb group and high CRP/Alb group was not statistically significant(P>0.05). The median overall survival time of low SII group and high SII group were respectively 38.2 and 20.0 per month, with the differences statistically significant(P<0.05). Meanwhile, the median overall survival time of low CRP/Alb group and high CRP/Alb group were respectively 43.5 and 19.6 per month, with the differences statistically significant(P<0.05). Cox multivariate analysis showed that TNM staging, KPS score, preoperative SII and CRP/Alb were independent risk factors for NSCLC(P<0.05). Conclusion High level of preoperative SII and CRP/Alb were independent risk factors for poor prognosis of NSCLC.
Objective To investigate the prognostic values of preoperative systematic immue-inflammation index(SII) and C-reactive protein/albumin ratio(CRP/Alb) in non-small cell lung cancer patients(NSCLC). Methods The clinical data of 124 cases with NSCLC were reviewed. The relationship of preoperative SII and CRP/Alb with clinicopathological features and prognosis was analyzed during January 2012-December 2015. Results There was no statistical significance on the differences in gender, age and pathological classification between low SII group and high SII group(P>0.05). However, the TNM stage, T stage and N stage of high SII group were relatively later, and KPS score was also lower(P<0.05). Compared with low CRP/Alb group, TNM stage, T stage, N stage and KPS score of high CRP/Alb group were also later or lower(P<0.05). The difference in other clinicopathological features between low CRP/Alb group and high CRP/Alb group was not statistically significant(P>0.05). The median overall survival time of low SII group and high SII group were respectively 38.2 and 20.0 per month, with the differences statistically significant(P<0.05). Meanwhile, the median overall survival time of low CRP/Alb group and high CRP/Alb group were respectively 43.5 and 19.6 per month, with the differences statistically significant(P<0.05). Cox multivariate analysis showed that TNM staging, KPS score, preoperative SII and CRP/Alb were independent risk factors for NSCLC(P<0.05). Conclusion High level of preoperative SII and CRP/Alb were independent risk factors for poor prognosis of NSCLC.
引文
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[12] 张文, 张鹏, 徐雪莹, 等. 中性粒细胞在肿瘤中作用的研究进展[J]. 肿瘤, 2017, 37(1): 96-100.
[13] 高瑞, 骆玉霜, 尹晓菊, 等. C反应蛋白对恶性肿瘤的意义[J]. 实用肿瘤学杂志, 2016, 30(1): 84-87.
[14] 黄丽, 王晴美, 胡建, 等. C反应蛋白与恶性肿瘤关系的研究进展[J]. 转化医学电子杂志, 2017, 4(2): 65-70.
[15] 陈英英, 张佳和, 张湾, 等. C反应蛋白/白蛋白比率预测结直肠癌病人预后关系[J]. 南方医科大学学报, 2017, 37(5): 622-627.
[16] Mocellin MC, Camargo CQ, Nunes EA, et al. A systematic review and meta-analysis of the n-3 polyunsaturated fatty acids effects on inflammatory markers in colorectal cancer[J]. Clin Nutr, 2016, 35(2): 359-369.
[2] Revesz D, Engelhardt EG, Tamminga JJ, et al. Decision support systems for incurable non-small cell lung cancer: a systematic review[J]. BMC Med Inform Decis Mak, 2017, 17(1): 144.
[3] 周文杰, 吴骏, 王琦, 等. 评估术前系统免疫炎症指数与贲门癌患者预后的相关性[J]. 中国医药生物技术, 2016, 11(6): 510-514.
[4] 李嫚, 张鹏. C反应蛋白与白蛋白比值对原发性肝癌患者预后的判断价值[J]. 肿瘤防治研究, 2016, 43(7): 598-601.
[5] 陈英英, 张佳和, 张湾, 等. C反应蛋白/白蛋白比率预测结直肠癌病人预后关系[J]. 南方医科大学学报, 2017, 37(5): 622-627.
[6] 王鑫, 支修益. 国际肺癌研究协会(IASLC)第八版肺癌TNM分期解读[J]. 中华胸部外科电子杂志, 2016, 3(2): 70-76.
[7] Hong X, Cui B, Wang M, et al. Systemic immune-inflammation index, based on platelet counts and neutrophil-lymphocyte ratio, is useful for predicting prognosis in small cell lung cancer[J]. Tohoku J Exp Med, 2015, 236(4): 297-304.
[8] Yang Z, Zhang J, Lu Y, et al. Aspartate aminotransferase-lymphocyte ratio index and systemic immune-inflammation index predict overall survival in HBV-related hepatocellular carcinoma patients after transcatheter arterial chemoembolization[J]. Oncotarget, 2015, 6(40): 43090-43098.
[9] 陈罗军, 田景媛, 李娜, 等. 血小板在促进肿瘤进展中的作用[J]. 国际肿瘤学杂志, 2018, 45(2): 103-106.
[10] 胡波, 王道义. 血小板和血浆纤维蛋白原水平与非小细胞肺癌转移及进展的相关研究[J]. 国际检验医学杂志, 2015, 36(2): 200-202.
[11] 高肇妤, 梁迪, 靳晶, 等. 中性粒细胞在肺癌发展及预后中的作用[J]. 肿瘤, 2017, 37(8): 889-894.
[12] 张文, 张鹏, 徐雪莹, 等. 中性粒细胞在肿瘤中作用的研究进展[J]. 肿瘤, 2017, 37(1): 96-100.
[13] 高瑞, 骆玉霜, 尹晓菊, 等. C反应蛋白对恶性肿瘤的意义[J]. 实用肿瘤学杂志, 2016, 30(1): 84-87.
[14] 黄丽, 王晴美, 胡建, 等. C反应蛋白与恶性肿瘤关系的研究进展[J]. 转化医学电子杂志, 2017, 4(2): 65-70.
[15] 陈英英, 张佳和, 张湾, 等. C反应蛋白/白蛋白比率预测结直肠癌病人预后关系[J]. 南方医科大学学报, 2017, 37(5): 622-627.
[16] Mocellin MC, Camargo CQ, Nunes EA, et al. A systematic review and meta-analysis of the n-3 polyunsaturated fatty acids effects on inflammatory markers in colorectal cancer[J]. Clin Nutr, 2016, 35(2): 359-369.