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Abstract：
BACKGROUND: The prognosis nutritional index (PNI) and the systemic inflammatory immunological index (SII) are characteristic indicators of the nutritional state and the systemic inflammatory response, respectively. However, there is an unknown combined effect of these indicators in the clinic. Therefore, the practicality of using the SII-PNI score to predict prognosis and tumor response of locally advanced gastric cancer (LAGC) following chemotherapy was the main focus of this investigation.
METHODS: We retrospectively analyzed 181 patients with LAGC who underwent curative resection after neoadjuvant chemotherapy in a prospective study (NCT01516944). We divided these patients into tumour regression grade(TRG) 3 and non-TRG3 groups based on tumor response (AJCC/CAP guidelines). The SII and PNI were assessed and confirmed the cut-off values before treatment. The SII-PNI values varied from 0 to 2, with 2 being the high SII (≥ 471.5) as well as low PNI (≤ 48.6), a high SII or low PNI is represented by a 1 and neither is represented by a 0, respectively.
RESULTS: 51 and 130 samples had TRG3 and non-TRG3 tumor responses respectively. Patients with TRG3 had substantially higher SII-PNI scores than those without TRG3 (p < 0.0001). Patients with greater SII-PNI scores had a poorer prognosis (p < 0.0001). The SII-PNI score was found to be an independent predictor of both overall survival (HR = 4.982, 95%CI: 1.890-10.234, p = 0.001) and disease-free survival (HR = 4.763, 95%CI: 1.994-13.903, p = 0.001) in a multivariate analysis.
CONCLUSIONS: The clinical potential and accuracy of low-cost stratification based on SII-PNI score in forecasting tumor response and prognosis in LAGC is satisfactory.
METHODS: We retrospectively analyzed 181 patients with LAGC who underwent curative resection after neoadjuvant chemotherapy in a prospective study (NCT01516944). We divided these patients into tumour regression grade(TRG) 3 and non-TRG3 groups based on tumor response (AJCC/CAP guidelines). The SII and PNI were assessed and confirmed the cut-off values before treatment. The SII-PNI values varied from 0 to 2, with 2 being the high SII (≥ 471.5) as well as low PNI (≤ 48.6), a high SII or low PNI is represented by a 1 and neither is represented by a 0, respectively.
RESULTS: 51 and 130 samples had TRG3 and non-TRG3 tumor responses respectively. Patients with TRG3 had substantially higher SII-PNI scores than those without TRG3 (p < 0.0001). Patients with greater SII-PNI scores had a poorer prognosis (p < 0.0001). The SII-PNI score was found to be an independent predictor of both overall survival (HR = 4.982, 95%CI: 1.890-10.234, p = 0.001) and disease-free survival (HR = 4.763, 95%CI: 1.994-13.903, p = 0.001) in a multivariate analysis.
CONCLUSIONS: The clinical potential and accuracy of low-cost stratification based on SII-PNI score in forecasting tumor response and prognosis in LAGC is satisfactory.
摘要：
背景：预后营养指数（PNI）和全身炎症免疫指数（SII）是营养状态和全身炎症反应的特征性指标，分别。然而,这些指标在临床上的联合作用未知。因此,使用SII-PNI评分预测化疗后局部进展期胃癌(LAGC)的预后和肿瘤反应的实用性是本研究的主要重点.
方法：我们在一项前瞻性研究（NCT01516944）中回顾性分析了181例LAGC患者在新辅助化疗后接受根治性切除术。我们根据肿瘤反应（AJCC/CAP指南）将这些患者分为肿瘤消退等级（TRG）3和非TRG3组。在治疗前评估SII和PNI并确认截止值。SII-PNI值在0到2之间变化，其中2为高SII（≥471.5）和低PNI（≤48.6），高SII或低PNI分别由1表示,并且两者都不由0表示。
结果:51和130个样品分别具有TRG3和非TRG3肿瘤反应。TRG3患者的SII-PNI评分明显高于无TRG3患者(p<0.0001)。SII-PNI评分较高的患者预后较差(p<0.0001)。在多变量分析中发现SII-PNI评分是总生存期(HR=4.982,95CI:1.890-10.234,p=0.001)和无病生存期(HR=4.763,95CI:1.994-13.903,p=0.001)的独立预测因子。
结论：基于SII-PNI评分的低成本分层在预测LAGC肿瘤反应和预后方面的临床潜力和准确性令人满意。
方法：我们在一项前瞻性研究（NCT01516944）中回顾性分析了181例LAGC患者在新辅助化疗后接受根治性切除术。我们根据肿瘤反应（AJCC/CAP指南）将这些患者分为肿瘤消退等级（TRG）3和非TRG3组。在治疗前评估SII和PNI并确认截止值。SII-PNI值在0到2之间变化，其中2为高SII（≥471.5）和低PNI（≤48.6），高SII或低PNI分别由1表示,并且两者都不由0表示。
结果:51和130个样品分别具有TRG3和非TRG3肿瘤反应。TRG3患者的SII-PNI评分明显高于无TRG3患者(p<0.0001)。SII-PNI评分较高的患者预后较差(p<0.0001)。在多变量分析中发现SII-PNI评分是总生存期(HR=4.982,95CI:1.890-10.234,p=0.001)和无病生存期(HR=4.763,95CI:1.994-13.903,p=0.001)的独立预测因子。
结论：基于SII-PNI评分的低成本分层在预测LAGC肿瘤反应和预后方面的临床潜力和准确性令人满意。
