Predictive value of preoperative systemic immune-inflammation index and prognostic nutrition index in patients with epithelial ovarian cancer.

IF 3.8 3区 医学 Q1 REPRODUCTIVE BIOLOGY
Jingping Chen, Lu Jin, Rui Luo, Xiaofei Zhang, Yizhi Chen, Ze Han, Tianfeng Liu
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引用次数: 0

Abstract

Background: This study aimed to evaluate the predictive value of Prognostic Nutritional Index (PNI), Systemic Immunoinflammatory Index (SII), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) in patients with epithelial ovarian cancer ( EOC). Also, to explore the predictive value of a new scoring system combining PNI and SII (coPNI-SII) in patients with EOC.

Methods: In this study, 154 patients with EOC were analyzed and classified according to the best cut-off values for SII, PNI, PLR, and NLR. Spearman's rank correlation was used to analyze the correlation of variables. The Kaplan-Meier survival curve and log-rank test were used to investigate the relationship between inflammatory indicators and overall survival (OS), which was then followed by a multivariate Cox proportional hazards model. All patients were categorized into three groups based on PNI-SII scores. The coPNI-SII score ranged from 1 to 3 as follows: score of 1, high PNI (≥ 48.98) and low SII(< 998.87); score of 2, high PNI and high SII or low PNI and low SII; score of 3, low PNI and high SII. To assess the prognostic value of coPNI-SII in patients with EOC.

Results: The areas under the ROC curves for SII, PNI, PLR, NLR, and coPNI-SII were 0.814, 0.814, 0.780, 0.769, and 0.860, respectively. The optimal cut-off values for SII, PNI, PLR, and NLR were 998.87, 48.98, 217.63, and 2.61, respectively. The Kaplan-Meier analysis showed that the OS of the patients in the high PNI group, low SII group, low NLR group, and low PLR group was significantly higher than that of the patients in the low PNI group, high SII group,high NLR group, and high PLR group (p < 0.01). SII (P = 0.034), PNI (P = 0.013), FIGO staging (P = 0.009), ascites (P = 0.003), CA199 (P = 0.003), HE4 (P = 0.028), residual lesions (P = 0.022), and margins of incision (P < 0.001) were found to be significant prognostic indicators of OS by multifactorial Cox regression analysis. There was a significant inverse relationship between the PNI and SII (r = -0.484; P < 0.01). EOC patients with a coPNI-SII score of 1 had a higher 5-year OS rate (P < 0.05) than EOC patients with a coPNI-SII score of 2 or 3. When taking into account both the SII and PNI, the predictive value rose.

Conclusion: Interestingly, we found that low preoperative PNI and high SII were strong indicators of poor prognosis in patients with EOC. The combination of SII and PNI can enhance the accuracy of prognosis.

研究背景本研究旨在评估预后营养指数(PNI)、全身免疫炎症指数(SII)、血小板与淋巴细胞比值(PLR)和中性粒细胞与淋巴细胞比值(NLR)对上皮性卵巢癌(EOC)患者的预测价值。同时,探讨结合 PNI 和 SII(coPNI-SII)的新评分系统对 EOC 患者的预测价值:方法:本研究根据 SII、PNI、PLR 和 NLR 的最佳临界值对 154 例 EOC 患者进行了分析和分类。采用斯皮尔曼秩相关分析变量之间的相关性。采用 Kaplan-Meier 生存曲线和对数秩检验研究炎症指标与总生存期(OS)之间的关系,然后采用多变量 Cox 比例危险度模型。根据PNI-SII评分将所有患者分为三组。coPNI-SII 评分从 1 到 3 分不等,具体如下:1 分,PNI 高(≥ 48.98),SII 低(结果:PNI-SII 评分为 1 分,PNI-SII 评分为 2 分,PNI-SII 评分为 3 分):SII、PNI、PLR、NLR 和 coPNI-SII 的 ROC 曲线下面积分别为 0.814、0.814、0.780、0.769 和 0.860。SII、PNI、PLR 和 NLR 的最佳临界值分别为 998.87、48.98、217.63 和 2.61。Kaplan-Meier 分析表明,高 PNI 组、低 SII 组、低 NLR 组和低 PLR 组患者的 OS 显著高于低 PNI 组、高 SII 组、高 NLR 组和高 PLR 组(P有趣的是,我们发现术前低 PNI 和高 SII 是 EOC 患者预后不良的有力指标。结合 SII 和 PNI 可以提高预后的准确性。
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来源期刊
Journal of Ovarian Research
Journal of Ovarian Research REPRODUCTIVE BIOLOGY-
CiteScore
6.20
自引率
2.50%
发文量
125
审稿时长
>12 weeks
期刊介绍: Journal of Ovarian Research is an open access, peer reviewed, online journal that aims to provide a forum for high-quality basic and clinical research on ovarian function, abnormalities, and cancer. The journal focuses on research that provides new insights into ovarian functions as well as prevention and treatment of diseases afflicting the organ. Topical areas include, but are not restricted to: Ovary development, hormone secretion and regulation Follicle growth and ovulation Infertility and Polycystic ovarian syndrome Regulation of pituitary and other biological functions by ovarian hormones Ovarian cancer, its prevention, diagnosis and treatment Drug development and screening Role of stem cells in ovary development and function.
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