摘要
目的探讨全身免疫炎症指数(SII)和中性粒细胞和淋巴细胞比值(NLR)在脑胶质瘤患者临床预后预测中的应用。方法回顾性分析2015年1月至2020年12月我院神经外科收治的脑胶质瘤患者151例临床资料,采用ROC曲线探讨相关指标预测患者预后的曲线下面积和最佳截断值,Kaplan-Meier法绘制生存曲线,Log-rank检验和Cox回归分析患者预后的影响因素。结果中位随访时间13个月,平均生存周期21.9个月,随访期内患者死亡率66.9%,患者术后6个月和1年生存率分别为88.1%和53.6%。SII和NLR预测患者预后的最佳截断值分别为477×10^(9)/L和2.05。单因素分析显示,WHO分级、术式、术前KPS评分、ALB、LYM、BMI、SII和NLR等8个因素与患者预后有关(P<0.05)。Cox多因素分析显示,SII≥477×10^(9)/L和NLR≥2.05是患者预后的危险因素,其HR(95%CI)分别为2.158(1.432~3.252)和2.929(1.773~4.841);术前KPS评分≥60分及WHO分级为II级和III级(相对于IV级)是患者预后的保护因素,其HR(95%CI)分别为0.472(0.313~0.713)、0.096(0.041~0.227)和0.483(0.314~0.742)。SII≥477×10^(9)/L和<477×10^(9)/L的患者1年生存率分别为25.45%和65.26%,NLR≥2.05和<2.05的患者1年生存率分别为29.76%和77.27%,WHO分级II级、III级和IV级患者1年生存率分别为85.37%、50.75%和16.28%,术前KPS<60分和≥60分组患者1年生存率分别为30.23%和58.88%。结论脑胶质瘤临床预后较差,SII、NLR、术前KPS评分及WHO分级与患者临床预后有关。
Objective To discuss the application of systemic immune-inflammation index(SII)and neutrophils to lymphocyte ratio in predicting the prognosis of patients with glioma.Methods From January 2015 to December 2020,151 patients with glioma admitted to the neurosurgery department of Yibin First People's Hospital were selected to collect relevant clinical data and follow up until December 30,2022.The ROC curve was used to explore the area under the curve(AUC)and the best cut-off value of the relevant indicators to predict the prognosis,Kaplan-Meier method was used to draw the survival curve,Log-rank test and Cox regression were used to analyze the influecing factors of prognosis among patients.Results The median follow-up duration was 13 months,and the average survival period was 21.9 months.The death rate during the follow-up period was 66.9%with 6-month and 1-year survival rates at 88.1%and 53.6%,respectively.The best cutoff values of SII and NLR to predict the prognosis of patients were 477×10^(9)/L and 2.05 respectively.Univariate analysis showed that WHO grade,operation mode,preoperative KPS score,albumin,lymphocyte,body mass index(BMI),SII and NLR were related with the prognosis of patients with glioma(P<0.05).COX multivariate analysis showed that SII≥477×10^(9)/L and NLR≥2.05 were risk factors of prognosis with HR(95%CI)at 2.158(1.432~3.252)and 2.929(1.773~4.841),respectively.Preoperative KPS≥60 and WHO grade II and III(compared with grade IV)were the protective factors for prognosis of patients with HR at 0.472(0.313~0.713),0.096(0.041~0.227)and 0.483(0.314~0.742),respectively(P<0.05).The one-year survival rates of patients with SII≥477×10^(9)/L and<477×10^(9)/L were 25.45%and 65.26%,NLR≥2.05 and<2.05 were 29.76%and 77.27%,WHO grade II,III and IV were 85.37%,50.75%and 16.28%,respectively.And preoperative KPS<60 and≥60 were 30.23%and 58.88%,respectively.Conclusion The clinical prognosis of glioma would be poor.SII,NLR,preoperative KPS score and WHO grade would be related to clinical prognosis of patients with glioma.
作者
连治琼
段晓洪
卢睿
张睿
刘娟
Lian Zhiqiong;Duan Xiaohong;Lu Rui(Department of No.1 Neurosurgery,Department of Orthopaedics,Department of No.2 Neurosurgery,The First Peoples’Hospital of Yibin,Yibin,Sichuan 644000,China.)
出处
《四川医学》
CAS
2023年第8期794-800,共7页
Sichuan Medical Journal
基金
四川省卫健委普及科研项目(编号:18PJ541)。
