全身免疫-炎症指数(SII)用于评估许多癌症的存活率。SII已在胰头单独检查,壶腹,和远端胆总管癌,并发现了不同的临界值。在手术前检测壶腹周围癌的位置可能很困难或具有误导性。这项研究旨在研究SII在预测壶腹周围癌患者的总体生存率(OS)中的应用,无论肿瘤位置如何。
■在2010年1月至2020年1月期间,对163例因壶腹周围肿瘤而接受胰十二指肠切除术的患者进行了评估。应用排除标准后,本研究纳入了116例接受胰十二指肠切除术的癌症患者的数据.
■使用Kaplan-Meier曲线比较OS。使用Cox比例风险回归模型在单变量和多变量分析中评估基线SII和其他因素的预后意义。单变量分析表明年龄≥60.5岁(风险比[HR]:2.042,95%CI:[1.355-3.078];p=0.001),男性(HR:1.863,95%CI:[1.231-2.821];p=0.003),胰头肿瘤vs.壶腹(HR:2.150,95%CI:[1.364-3.389];p=0.001),胰头肿瘤vs.远端胆总管(HR:1.945,95%CI:[1.091-3.472];p=0.024),N(+)阶段(HR:1.868,95%CI:[1.223-2.854];p=0.004),总胆红素水平>0.35(HR:2.131,95%CI:[1.245-3.649];p=0.006),NLR>2.13(HR:1.911,95%CI:[1.248-2.925];p=0.003),SII>704(HR:1.966,95%CI:[1.310-2.950];p=0.001)与OS显著相关。多变量分析显示SII>704(HR:2.375;p<0.001),年龄≥60.5岁(HR:2.728;p<0.001),N期阳性(HR:3.431;p<0.001),胰头肿瘤与壶腹(HR:2.801;p<0.001)与低生存率独立相关.就SII而言,肿瘤位置之间没有差异(p=0.206)。
■SII是独立的预后危险因素,可能是预测壶腹周围癌患者OS的标志物。就SII而言,肿瘤位置之间没有统计学差异。SII的单个截止值可用于壶腹周围癌的存活,而不需要病理样本。
The systemic immune-inflammation index (SII) is used to assess survival in many cancers. SII has been examined separately in pancreatic head,
ampulla, and distal choledochus cancers, and different cut-off values were found. Detecting the location of periampullary cancer before surgery may be difficult or misleading. This study aimed to investigate the use of SII in predicting overall survival (OS) with periampullary cancers regardless of tumor location.
Between January 2010 and January 2020, 163 patients who underwent pancreaticoduodenectomy for periampullary tumors were assessed. After applying the exclusion criteria, data from 116 patients with cancer who underwent pancreaticoduodenectomy were included in the study.
OS was compared using Kaplan-Meier curves. The prognostic significance of baseline SII and other factors were assessed in univariate and multivariate analyses using the Cox proportional hazard regression model. Univariate analysis demonstrated that age ≥60.5 years (hazard ratio [HR]: 2.042, 95% CI: [1.355-3.078]; p = 0.001), male sex (HR: 1.863, 95% CI: [1.231-2.821]; p = 0.003), tumor in the pancreatic head vs.
ampulla (HR: 2.150, 95% CI: [1.364-3.389]; p = 0.001), tumor in the pancreatic head vs. distal choledochus (HR: 1.945, 95% CI: [1.091-3.472]; p = 0.024), N (+) stage (HR: 1.868, 95% CI: [1.223-2.854]; p = 0.004), total bilirubin level >0.35 (HR: 2.131, 95% CI: [1.245-3.649]; p = 0.006), NLR >2.13 (HR: 1.911, 95% CI: [1.248-2.925]; p = 0.003), and SII >704 (HR: 1.966, 95% CI: [1.310-2.950]; p = 0.001) were significantly associated with OS. Multivariate analysis revealed that SII >704 (HR: 2.375; p < 0.001), age ≥ 60.5 years (HR: 2.728; p < 0.001), N-stage positivity (HR: 3.431; p < 0.001), and tumor in the pancreatic head vs.
ampulla (HR: 2.801; p < 0.001) were independently associated with poor survival. There was no difference between tumor locations in terms of SII (p = 0.206).
SII is an independent prognostic risk factor and may be a marker for predicting OS in patients with periampullary cancer. There was no statistical difference between the tumor locations in terms of SII. A single cut-off value of SII may be used for periampullary cancer survival without the need for a pathology specimen.