俞璐莎, 高丽渊, 黄应亮. 基于系统免疫炎症指数和预后营养指数预测喉癌患者预后[J]. 疾病监测, 2024, 39(1): 108-114. DOI: 10.3784/jbjc.202303180111
引用本文: 俞璐莎, 高丽渊, 黄应亮. 基于系统免疫炎症指数和预后营养指数预测喉癌患者预后[J]. 疾病监测, 2024, 39(1): 108-114. DOI: 10.3784/jbjc.202303180111
Yu Lusha, Gao Liyuan, Huang Yingliang. Study of relationship between systemic immune inflammatory index, prognostic nutritional index and prognosis of patients with laryngeal cancer[J]. Disease Surveillance, 2024, 39(1): 108-114. DOI: 10.3784/jbjc.202303180111
Citation: Yu Lusha, Gao Liyuan, Huang Yingliang. Study of relationship between systemic immune inflammatory index, prognostic nutritional index and prognosis of patients with laryngeal cancer[J]. Disease Surveillance, 2024, 39(1): 108-114. DOI: 10.3784/jbjc.202303180111

基于系统免疫炎症指数和预后营养指数预测喉癌患者预后

Study of relationship between systemic immune inflammatory index, prognostic nutritional index and prognosis of patients with laryngeal cancer

  • 摘要:
    目的  分析基于术前系统免疫炎症指数(SII)、预后营养指数(PNI)的喉癌患者预后列线图预测模型的建立与预测效能。
    方法  选取2016年2月至2020年2月于浙江大学医学院附属第二医院临平院区行手术治疗的喉癌患者168例为研究对象。 采用受试者工作特征(ROC)曲线分析术前SII、PNI预测喉癌患者术后发生死亡的最佳截断值,并以最佳截断值进行分组。 绘制生存曲线,分析患者生存情况。 确定影响喉癌患者预后的危险因素,并根据此结果构建预后列线图。 列线图模型的内部验证采用Bootstrap法。 列线图模型预测效能和区分度分别采用ROC曲线下面积(AUC)检验和一致性指数(C指数)评价。
    结果 全组患者的中位总生存期(OS)为29个月[95%置信区间(CI):23~36],1、2、3年生存率分别为96.20%、80.38%、71.52%。 生存曲线显示,与高SII组相比,低SII组喉癌患者的生存率更高(χ2=30.231,P<0.001),与低PNI组相比,高PNI组喉癌患者的生存率更高(χ2=28.347,P<0.001)。 Cox回归分析显示T分期、T3期、肿瘤分化程度、淋巴结转移、SII、PNI是影响喉癌患者术后发生死亡的危险因素。 根据Cox回归分析结果构建喉癌患者预后列线图预测模型,Bootstrap法结果与C指数表明模型校准度与区分度良好。 ROC曲线结果显示该预测模型AUC为0.852(95%CI:0.682~0.983)(P<0.001)。
    结论  术前SII、PNI、T分期、肿瘤分化程度、淋巴结转移与喉癌患者术后预后关系密切,基于SII、PNI、T分期、肿瘤分化程度、淋巴结转移构建的列线图模型具有良好的准确度、区分度和临床预测效能。

     

    Abstract:
    Objective To analyze the establishment and predictive effectiveness of prognostic graph prediction model of laryngeal cancer patients based on systemic immune inflammation index (SII) and prognostic nutrition index (PNI).
    Methods A total of 168 patients with laryngeal cancer who underwent surgical treatment in our hospital from January 2016 to January 2020 were selected as the study subjects. Receiver operating characteristic (ROC) curve was used to analyze the optimal truncation values of preoperative SII and PNI in predicting postoperative death of laryngeal cancer patients, and the optimal truncation values were used for grouping. The survival curve was drawn to analyze the survival of the patients and determine the risk factors affecting the prognosis of the patients, and the prognosis histogram was constructed according to the results. Bootstrap method was used for internal verification of the line graph model. The prediction efficiency and differentiation of the graph model were evaluated by area test under receiver operating curve (ROC) and consistency index (C index), respectively.
    Results The median overall survival (OS) of the laryngeal cancer patients was 29 months [95% confidence interval (CI) : 23–36], and the 1-year, 2-year, and 3-year survival rates were 96.20%, 80.38%, and 71.52%, respectively. The survival curve showed that compared with high SII group, the laryngeal cancer patients in low SII group had a higher survival rate (χ2=30.231, P<0.001) and compared with low PNI group, the laryngeal cancer patients in high PNI group had a higher survival rate (χ2=28.347, P<0.001). Cox regression analysis showed that T stage, T3 stage, tumor differentiation degree, lymph node metastasis, SII and PNI were risk factors for postoperative death in the patients with laryngeal cancer. According to the results of Cox regression analysis, the prognosis prediction model of the laryngeal cancer patients was constructed. The results of Bootstrap method and C-index showed that the model had good calibration and differentiation efficacies. ROC curve results showed that the area under ROC curve (AUC) of the model was 0.852 (95%CI: 0.682–0.983) (P<0.001).
    Conclusion Preoperative SII, PNI, T stage, tumor differentiation degree and lymph node metastasis are closely related to postoperative prognosis of laryngeal cancer patients. The column graph model constructed based on SII, PNI, T stage, tumor differentiation degree and lymph node metastasis has high accuracy, and good differentiation and clinical predictive efficacies.

     

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