背景:SII,PNI,SIRI,AAPR,LIPI是基于炎症的预后评分,营养,和豁免权。这项研究的目的是检查SII的预后价值,PNI,SIRI,AAPR,接受根治性肾输尿管切除术伴膀胱袖口切除术的UTUC患者的LIPI。
方法:收集2017年1月至2021年12月四川省人民医院UTUC患者资料。SII的最佳临界值,PNI,SIRI,用ROC曲线测定AAPR,根据dNLR和LDH对LIPI进行分层。采用Kaplan-Meier法绘制生存曲线,采用Cox比例风险模型分析UTUC患者预后的影响因素。
结果:本研究共纳入81例UTUC患者。PNI的最优截断值,SII,SIRI和AAPR分别测定为48.15、596.4、1.45和0.50。单变量Cox比例风险回归显示,低PNI,高SII,高SIRI,低AAPR和低LIPI组是UTUC患者术后预后的有效预测因子.多因素Cox比例风险回归分析显示,高SII是UTUC患者术后预后的独立危险因素。根据ROC曲线,PNI拟合指标的预测效率,SII,SIRI,AAPR和LIPI比单独使用它们更好。
结论:SII,PNI,SIRI,AAPR,LIPI是接受根治性肾输尿管切除术伴膀胱袖口切除术的UTUC患者的潜在预后预测因子。
BACKGROUND: SII, PNI, SIRI, AAPR, and LIPI are prognostic scores based on inflammation, nutrition, and immunity. The purpose of this study was to examine the prognostic value of the SII, PNI, SIRI, AAPR, and LIPI in patients with UTUC who underwent radical nephroureterectomy with bladder cuff excision.
METHODS: Data of UTUC patients in Sichuan Provincial People\'s Hospital from January 2017 to December 2021 were collected. The optimal critical values of SII, PNI, SIRI, and AAPR were determined by ROC curve, and LIPI was stratified according to the dNLR and LDH. The Kaplan-Meier method was used to draw the survival curve, and Cox proportional hazard model was used to analyze the factors affecting the prognosis of UTUC patients.
RESULTS: A total of 81 patients with UTUC were included in this study. The optimal truncation value of PNI, SII, SIRI and AAPR were determined to be 48.15, 596.4, 1.45 and 0.50, respectively. Univariate Cox proportional hazard regression showed that low PNI, high SII, high SIRI, low AAPR and poor LIPI group were effective predictors of postoperative prognosis of UTUC patients. Multivariate Cox proportional hazard regression showed that high SII was an independent risk factor for postoperative prognosis of UTUC patients. According to ROC curve, the prediction efficiency of fitting indexes of PNI, SII, SIRI, AAPR and LIPI is better than that of using them alone.
CONCLUSIONS: The SII, PNI, SIRI, AAPR, and LIPI was a potential prognostic predictor in UTUC patients who underwent radical nephroureterectomy with bladder cuff excision.