Modified Systemic Inflammation Score is Useful for Risk Stratification After Radical Resection of Squamous Cell Carcinoma of the Esophagus
Modified Systemic Inflammation Score is Useful for Risk Stratification After Radical Resection of Squamous Cell Carcinoma of the Esophagus
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DOI：
10.1245/s10434-019-07914-7
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发表时间：
2019-10-11
影响因子：
3.7
通讯作者：
Kodera, Yasuhiro
中科院分区：
文献类型：
--
作者：
Kanda, Mitsuro;Koike, Masahiko;Kodera, Yasuhiro
背景炎症在癌症的发生和进展中起着至关重要的作用。我们评估了术前改良全身炎症评分（mSIS）对预测食管鳞状细胞癌（ESCC）患者长期预后的临床意义。方法 我们纳入了 443 名接受食管鳞癌根治性切除术的患者。 mSIS 根据血清白蛋白水平 (ALB) 和淋巴细胞与单核细胞比率 (LMR) 制定如下：mSIS 0（ALB >= 4.0 g/dL 且 LMR >= 3.4）、mSIS 1（ALB < 4.0 g/dL 或 LMR < 3.4）和 mSIS 2（ALB < 4.0 g/dL 且 LMR < 3.4）。结果 患者被分为术前 mSIS 0 (n = 165)、mSIS 1 (n = 183) 和 mSIS 2 (n = 95) 组。术前mSIS与年龄、术前体重指数和病理疾病阶段显着相关。术前mSIS 0、1、2期患者的疾病特异性生存时间依次缩短（P = 0.009），mSIS 2被确定为独立预后因素（风险比2.63，95%置信区间1.33-5.27，P = 0.0053）。在大多数患者亚组中，mSIS 与较高的疾病特异性死亡风险相关。血行复发率的逐步增加与 mSIS 成正比。在新辅助治疗前通过 mSIS 对患者进行细分时，疾病特异性生存率没有显着差异。结论 我们的研究结果表明，术前 mSIS 可以作为 ESCC 的强大预测指标，明确对临床结果进行分层，并作为选择治疗策略的工具。
Background Inflammation plays a critical role in the development and progression of cancers. We evaluated the clinical significance of the preoperative modified systemic inflammation score (mSIS) to predict long-term outcomes of patients with esophageal squamous cell carcinoma (ESCC). Methods We included 443 patients who underwent curative resection of ESCC. The mSIS was formulated according to the serum albumin level (ALB) and lymphocyte-to-monocyte ratio (LMR) as follows: mSIS 0 (ALB >= 4.0 g/dL and LMR >= 3.4), mSIS 1 (ALB < 4.0 g/dL or LMR < 3.4), and mSIS 2 (ALB < 4.0 g/dL and LMR < 3.4). Results Patients were categorized into preoperative mSIS 0 (n = 165), mSIS 1 (n = 183), and mSIS 2 (n = 95) groups. Preoperative mSIS was significantly associated with age, preoperative body mass index, and pathological disease stage. The disease-specific survival times of patients in preoperative mSIS 0, 1, and 2 sequentially shortened (P = 0.009), and mSIS 2 was identified as an independent prognostic factor (hazard ratio 2.63, 95% confidence interval 1.33-5.27, P = 0.0053). In most patient subgroups, the mSIS was associated with greater risk of disease-specific death. A stepwise increase in the prevalence of hematogenous recurrences was directly proportion to the mSIS. When patients were subdivided by mSIS before neoadjuvant treatment, there were no significant differences in disease-specific survival. Conclusions Our findings demonstrate that the preoperative mSIS may serve as a powerful prognosticator of ESCC that definitively stratifies clinical outcomes as well as a tool for selecting treatment strategies.