Systemic Inflammation-Immune Status Predicts Survival in Stage III-N2 Non-Small Cell Lung Cancer
Systemic Inflammation-Immune Status Predicts Survival in Stage III-N2 Non-Small Cell Lung Cancer
复制标题
全身炎症免疫状态可预测 III-N2 期非小细胞肺癌的生存
DOI：
10.1016/j.athoracsur.2019.06.035
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发表时间：
2019-12-01
影响因子：
4.6
通讯作者：
Zhao, Jun
中科院分区：
文献类型：
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作者：
Wang, Jianyang;Hui, Zhouguang;Zhao, Jun
背景系统性炎症免疫状态在肿瘤的发生、发展中起着重要作用。本研究旨在评估系统性炎症免疫状态对切除后病理性N2淋巴结转移的非小细胞肺癌（pN 2-NSCLC）患者的预后价值。在对660例连续完成切除的pN 2-NSCLC患者的回顾性研究中检测了术前系统炎症免疫评分（SIS）（定义为术前外周血小板计数> 3中性粒细胞计数/淋巴细胞计数）与预后之间的关系，并通过对189例入组患者的前瞻性研究（NCT 00880971）进行了验证。SIS为650 × 109是在训练队列中将pN 2-NSCLC患者分为高（>650 × 10（9））和低（>650 × 10（9））SIS组的最佳截止点。单变量和多变量分析显示，SIS是总生存率、无病生存率和无远处转移生存率的独立预测因子。在验证组中，高SIS（>650 x 10（9））预测5年总生存率（风险比[HR]，2.418; P = .006），无病生存率（HR，1.542; P = .042）和无远处转移生存率（HR，1.682; P = .024）较差。除阳性淋巴结数量外，SIS预后的受试者工作特征曲线下面积高于中性粒细胞计数/淋巴细胞计数比值、血小板计数/淋巴细胞计数比值和其他常规临床病理指标。术前SIS是一个比大多数其他常规临床指标更敏感的生存预测指标，可以帮助更准确地对患者进行风险评估和治疗决策。(C)2019年美国胸外科医师协会
Background. Systematic inflammation-immune status has been thought to play a crucial role in tumorigenesis and progress. This study evaluated the prognostic value of systematic inflammation-immune status in patients with resected non-small cell lung cancer with pathological N2 nodal involvement (pN2-NSCLC).Methods. The relation between the preoperative systematic inflammation-immune score (SIS), defined as preoperative peripheral platelet count 3 neutrophil count/lymphocyte count, and prognosis was tested in a retrospective study of 660 consecutive patients with completed resected pN2-NSCLC and validated by a prospective study of 189 patients enrolled (NCT00880971).Results. SIS of 650 3 109 was an optimal cutoff point to stratify the patients with pN2-NSCLC into high (>650 x 10(9)) and low (>650 x 10(9)) SIS groups in the training cohort. Univariate and multivariate analyses revealed that the SIS was an independent predictor for overall survival, disease-free survival, and distant metastasis-free survival. In the validation group, high SIS (>650 x 10(9)) predicted poor 5-year overall survival (hazard ratio [HR], 2.418; P = .006), disease-free survival (HR, 1.542; P = .042), and distant metastasis-free survival (HR, 1.682; P = .024). In addition to the number of positive lymph nodes, the area under the receiver operating characteristic curve of the SIS for outcomes was higher than the neutrophil countto-lymphocyte count ratio, platelet count-to-lymphocyte count ratio, and other conventional clinicopathologic indices.Conclusions. The preoperative SIS is a more sensitive survival predictor than most of the other conventional clinical indices and may aid in more accurately stratifying patients for risk assessment and treatment decision. (C) 2019 by The Society of Thoracic Surgeons