40岁以下青年头颈部肿瘤手术患者术前全身炎症反应指数的评价。

Pei-Yin Wu, Yao-Te Tsai, Yu-Tsai Lin, Hui-Ching Chuang, Chao-Hui Yang, Chih-Yen Chien, Fu-Min Fang, Tai-Lin Huang, Hui Lu, Ming-Hsien Tsai
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引用次数: 0

摘要

目的:评价年轻(≤40岁)头颈部鳞状细胞癌(HNSCC)患者术前系统性炎症反应指数(SIRI)的预后。方法:在2007年1月至2017年2月期间,回顾性研究了175例接受根治性手术的年轻HNSCC(≤40岁)患者。患者随机分为训练组(N = 131)和验证组(N = 44)。SIRI的定义是绝对中性粒细胞计数(×10⁹/L)乘以绝对单核细胞计数(×10⁹/L),除以外周血绝对淋巴细胞计数(×10⁹/L),所有这些都是在根治性手术前一周内测量的。进行单因素和多因素Cox回归分析,以确定与生存结果相关的变量,然后使用这些变量构建和评估预测nomogram。结果:在训练组和验证组中,通过受试者工作特征分析确定截断值为0.87,将患者分为低siri组和高siri组。这种SIRI截断有效地将患者分为两个不同的预后组,存在显著的生存差异。多变量Cox分析发现,淋巴血管浸润的存在和术前高SIRI是年轻HNSCC患者较差的癌症特异性生存(CSS)相关的重要独立预后因素。利用这些变量,构建了5年CSS的预测模型,并将其可视化为nomogram。该模型具有较强的预测能力,训练组c -指数为0.744 [95% CI(0.643-0.845)],验证组c -指数为0.839 [95% CI(0.740-0.938)]。结论:术前SIRI评估数据,再加上病理不良特征的存在,为年轻HNSCC患者的风险分层提供了有价值的参考。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessment of Preoperative Systemic Inflammation Response Index in Surgically Treated Young Head and Neck Cancer Patients Under 40.

Objectives: To assess the prognosis of young patients (≤40 years old) with head and neck squamous cell carcinoma (HNSCC), focusing on the preoperative Systemic Inflammation Response Index (SIRI).

Methods: Between January 2007 and February 2017, 175 young patients with HNSCC (≤40 years old) who underwent radical surgery were retrospectively enrolled in this study. The patients were randomly divided into a training cohort (N = 131) and a validation cohort (N = 44). The SIRI is defined as the absolute neutrophil count (×10⁹/L) multiplied by the absolute monocyte count (×10⁹/L), divided by the absolute lymphocyte count (×10⁹/L) in peripheral blood, all measured within one week prior to radical surgery. Univariate and multivariate Cox regression analyses were conducted to identify variables associated with survival outcomes, which were then used to construct and evaluate a predictive nomogram.

Results: In both the training and validation cohorts, patients were classified into low- and high-SIRI groups based on a cutoff value of 0.87, which was determined by receiver operating characteristic analysis. This SIRI cutoff effectively stratified patients into two distinct prognostic groups with significant survival differences. Multivariable Cox analysis identified the presence of lymphovascular invasion and the high preoperative SIRI as significant independent prognostic factors associated with poorer cancer-specific survival (CSS) in young patients with HNSCC. Using these variables, a predictive model for 5 year CSS was constructed and visualized as a nomogram. The model demonstrated strong predictive performance, with a C-index of 0.744 [95% CI (0.643-0.845)] in the training cohort and 0.839 [95% CI (0.740-0.938)] in the validation cohort.

Conclusion: Data from preoperative SIRI assessment, coupled with the presence of pathological adverse features, serve as valuable references for risk stratification in young patients with HNSCC.

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