摘要
目的评价骨肉瘤患者的系统免疫炎症指数(systemic immune inflammatory index,SII)与临床特征和预后之间的关系。方法回顾性收集2012年1月—2017年12月福州市第二医院行骨肉瘤手术患者的临床资料,计算术前SII数值,定义为血小板计数×中性粒细胞计数/淋巴细胞计数。采用受试者操作特征曲线分析确定SII的最佳临界值,采用χ2检验分析SII与患者临床特征的关系,采用Kaplan-Meier法和Cox比例风险模型研究SII对总生存期的影响。根据患者预后的独立危险因素建立列线图预测模型。结果共纳入108例行骨肉瘤手术患者。术前高SII与肿瘤直径、Enneking分期、局部复发和转移相关(P<0.05)。中位随访时间为62个月;低SII组1、3、5年生存率高于高SII组(100.0%、96.4%、85.1%vs.95.4%、73.7%、30.7%),两组总体生存率差异有统计学意义(P<0.05)。单因素Cox回归分析结果显示肿瘤直径、Enneking分期、局部复发、转移以及SII与总生存期有关(P<0.05)。在多因素Cox回归分析中,Enneking分期(P=0.031)、局部复发(P=0.035)以及SII(P=0.001)为总生存期的独立危险因素。根据Cox回归模型筛选出来的独立危险因素构建的列线图具有较好的区分度和一致性(C指数=0.774),且校准曲线显示该列线图与实际结果具有较高的吻合度,受试者操作特征曲线提示该列线图具有较好的预测效能(曲线下面积=0.880)。结论术前SII水平有望成为骨肉瘤患者的重要预后参数,越高的SII水平代表患者预后越差;以术前SII、Enneking分期和局部复发为基础构建的列线图预测模型有较好的预测效能,可指导临床骨肉瘤的诊疗。
Objective To evaluate the relationship of systemic immune inflammatory index(SII)with the clinical features and prognosis of osteosarcoma patients.Methods The clinical data of patients with osteosarcoma surgically treated in Fuzhou Second Hospital between January 2012 and December 2017 were retrospectively collected.The preoperative SII value was calculated,which was defined as platelet×neutrophil/lymphocyte count.The best critical value of SII was determined by receiver operating characteristic(ROC)curve analysis,and the relationship between SII and clinical features of patients was analyzed byχ2 test.Kaplan-Meier method and Cox proportional hazard model were used to study the effect of SII on overall survival(OS).The nomogram prediction model was established according to the independent risk factors of patients’prognosis.Results A total of 108 patients with osteosarcoma were included in this study.Preoperative high SII was significantly correlated with tumor diameter,Enneking stage,local recurrence and metastasis(P<0.05).The median follow-up time was 62 months.The 1-,3-,5-year survival rates of the low SII group were significantly higher than those of the high SII group(100.0%,96.4%,85.1%vs.95.4%,73.7%,30.7%),and the survival of the two groups were statistically different(P<0.05).Univariate Cox regression analyses showed that tumor diameter,Enneking stage,local recurrence,metastasis and SII were associated with OS(P<0.05).Multiple Cox regression analysis showed that Enneking stage(P=0.031),local recurrence(P=0.035)and SII(P=0.001)were independent risk factors of OS.The nomogram constructed according to the independent risk factors screened by the Cox regression model had good discrimination and consistency(C-index=0.774),and the calibration curve showed that the nomogram had a high consistency with the actual results.In addition,the ROC curve indicated that the nomogram had a good prediction efficiency(area under the curve=0.880).Conclusions The preoperative SII level is expected to become an important prog
作者
吴叶欣
陈小彬
施腾飞
WU Yexin;CHEN Xiaobin;SHI Tengfei(Department of Clinical Laboratory,Fuzhou Second Hospital,Fuzhou,Fujian 350025,P.R.China;Department of General Surgery,the 900th Hospital of Joint Logistics Support Force of People’s Liberation Army of China,Fuzhou,Fujian 350025,P.R.China)
出处
《华西医学》
CAS
2023年第10期1468-1473,共6页
West China Medical Journal
基金
福建省科技创新平台项目(2020Y2014)
福州市级科技计划项目(2021-S-163)
联勤保障部队第九〇〇医院训练伤防治专项研究项目(2023XL02)。
关键词
骨肉瘤
系统免疫炎症指数
预后
列线图
总生存期
Osteosarcoma
systemic immune inflammatory index
prognosis
nomogram
overall survival
