摘要
目的:探讨全身免疫炎症指数(systemic immune-inflammation index,SII)和预后营养指数(prognostic nutritional index,PNI)在晚期前列腺癌病人预后预测中的价值。方法:回顾2013—2018年温江区人民医院收治的96例晚期前列腺癌病人,收集病人病历资料并随访其生存情况[总生存时间(OS)和无进展生存时间(PFS)],采用受试者工作特征(ROC)曲线分析全身免疫炎症指数和预后营养指数预测病人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回归分析病人总生存时间和无进展生存时间的影响因素。结果:96例晚期前列腺癌病人随访时间为54(38,62)个月,随访期内死亡54例(56.25%),中位总生存时间为50(33,61)个月,3年和5年总生存时间生存率分别为70.83%和45.83%,中位无进展生存时间为45.00(27.25,56.75)个月,3年和5年无进展生存时间生存率分别为61.46%和43.75%。全身免疫炎症指数和预后营养指数预测病人预后的ROC曲线下面积分别为0.699和0.904,其最佳截断值分别为671.70和46.35。全身免疫炎症指数≥671.70组实际生存时间短于<671.70组,预后营养指数≥46.35组实际生存时间长于<46.35组(P<0.05)。多因素Cox回归显示,美国癌症联合委员会(AJCC)分期为Ⅲ期是病人总生存时间的保护因素[HR=0.562,95%CI(0.349,0.748),P=0.011],全身免疫炎症指数≥671.70[HR=2.427,95%CI(1.731,6.109),P<0.001]和预后营养指数<46.35[HR=10.869,95%CI(5.311,22.244),P<0.001]是病人总生存时间的危险因素;AJCC分期Ⅳ期[HR=2.035,95%CI(1.404,5.072),P=0.014]和预后营养指数<46.35[HR=10.344,95%CI(5.080,21.062),P<0.001]是病人无进展生存时间的危险因素。结论:预后营养指数、全身免疫炎症指数和AJCC分期是晚期前列腺癌病人总生存时间的预测因子,预后营养指数和AJCC分期也是病人无进展生存时间的预测因子。
Objective:To explore the value of systemic immune⁃inflammation index(SII)and prognostic nutritional index(PNI)in predicting the prognosis of advanced prostate cancer patients.Methods:A retrospective study was conducted on 96 patients with advanced prostate cancer admitted to People's Hospital of Wenjiang from 2013 to 2018.Patient medical records were collected and their survivals were followed up,including overall survival(OS)and progression free survival(PFS).Receiver operating characteristic(ROC)curves were used to analyze the area under the curves(AUC)and the optimal cutoff value of SII and PNI predicting patient prognosis.The Kaplan⁃Meier method was used to draw survival curves,Log⁃rank test and Cox regression analysis were used to investigate the influencing factors of patient OS and PFS.Results:The median follow⁃up time was 54(38,62)months in 96 objects,with 54 deaths(56.25%)during the follow⁃up period.The median overall survival was 50(33,61)months with the 3⁃year and 5⁃year OS survival rates at 70.83%and 45.83%,respectively.The median progression free survival was 45.00(27.25,56.75)months with the 3⁃year and 5⁃year PFS survival rates at 61.46%and 43.75%,respectively.The AUC for predicting patient prognosis using SII and PNI were 0.699 and 0.904,with the optimal cutoff values at 671.70 and 46.35.The actual survival time of the SII≥671.70 group was shorter than that of the<671.70 group,while the actual survival time of the PNI≥46.35 group was longer than that of the<46.35 group(P<0.05).Multivariate Cox regression showed that AJCC stage atⅢwas a protective factor for patients'OS(HR=0.562,95%CI 0.349⁃0.748,P=0.011),SII≥671.70(HR=2.427,95%CI 1.731⁃6.109,P<0.001)and PNI<46.35(HR=10.869,95%CI 5.311⁃22.244,P<0.001)were risk factors for patients'OS.AJCC stageⅣ(HR=2.035,95%CI 1.404⁃5.072,P=0.014)and PNI<46.35(HR=10.344,95%CI 5.080⁃21.062,P<0.001)were risk factors for patients'PFS.Conclusion:PNI,SII,and AJCC staging are predictive factors for OS in advanced prostate cancer patients,and PNI and AJCC staging are also predictive factors for PFS in patients.
作者
江琴
周敏
王媛
尹丹
张馨月
JIANG Qin;ZHOU Min;WANG Yuan;YIN Dan;ZHANG Xinyue(Chengdu Wenjiang District People's Hospital,Sichuan 611130 China;Sichuan Academy of Medical Sciendes&Sichuan Provincial People's Hospital(Affiliated Hospital of University of Electronic Science and Technology of China))
出处
《护理研究》
北大核心
2025年第3期353-360,共8页
Chinese Nursing Research
基金
2021年四川省卫生和计划生育委员会科研课题,编号:21PJ026。
