Development and validation of immune inflammation-based index for predicting the clinical outcome in patients with nasopharyngeal carcinoma
Development and validation of immune inflammation-based index for predicting the clinical outcome in patients with nasopharyngeal carcinoma
复制标题
开发和验证基于免疫炎症的指数，用于预测鼻咽癌患者的临床结果。
DOI：
10.1111/jcmm.15097
复制
发表时间：
2020-06-30
影响因子：
5.3
通讯作者：
Li, Yirong
中科院分区：
文献类型：
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作者：
Zeng, Xiaojiao;Liu, Guohong;Li, Yirong
炎症指标，如全身炎症反应指数（SIRI）、全身免疫炎症指数（SII）、嗜中性粒细胞与淋巴细胞比率（NLR）和血小板淋巴细胞比率（PLR），与各种实体癌的不良预后相关。在这项研究中，我们探讨了这些炎症指标在鼻咽癌（NPC）的预测价值。回顾性研究包括559例鼻咽癌患者和500例慢性鼻炎患者，255例鼻咽癌患者获得成功随访。连续性变量和定性变量分别采用t检验和卡方检验。通过受试者工作特征（ROC）曲线确定各种炎症指标的最佳临界值。曲线下面积（AUC）决定了鼻咽癌的诊断价值。采用Kaplan-Meier法和log-rank检验分析总生存期（OS）和无病生存期（DFS）。分别采用考克斯分析和Logistic回归分析影响生存的独立预后危险因素和治疗后副反应的影响因素。两组血液学指标多数有显著性差异，PLR是诊断鼻咽癌和鼻炎的最佳预测指标。多因素考克斯回归分析显示，PLR、WBC、RDW、M分期和年龄是独立的预后危险因素。Logistic回归分析评价了影响各种不良反应的多项炎症指标。结论：联合炎症指标对鼻咽癌的诊断和预后判断优于单一血液学指标，具有上级价值。这些炎症指标可作为目前鼻咽癌TNM分期的评价指标，用于预测鼻咽癌患者的预后。
Inflammation indicators, such as systemic inflammation response index (SIRI), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), are associated with poor prognosis in various solid cancers. In this study, we investigated the predictive value of these inflammation indicators in nasopharyngeal carcinoma (NPC). This retrospective study involved 559 patients with NPC and 500 patients with chronic rhinitis, and 255 NPC patients were followed up successfully. Continuous variables and qualitative variables were measured by t test and chi-square test, respectively. The optimal cut-off values of various inflammation indicators were determined by receiver operating characteristic (ROC) curve. Moreover, the diagnostic value for NPC was decided by the area under the curves (AUCs). The Kaplan-Meier methods and the log-rank test were used to analyse overall survival (OS) and disease-free survival (DFS). The independent prognostic risk factors for survival and influencing factors of side effects after treatment were analysed by Cox and logistic regression analysis, respectively. Most haematological indexes of NPC and rhinitis were significantly different between the two groups, and PLR was optimal predictive indicators of diagnosis. In the multivariable Cox regression analysis, PLR, WBC, RDW, M stage and age were independent prognostic risk factors. Many inflammation indicators that affected various side effects were evaluated by logistic regression analysis. In conclusion, the combined inflammation indicators were superior to single haematological indicator in the diagnosis and prognosis of NPC. These inflammation indicators can be used to supply the current evaluation system of the TNM staging system to help predict the prognosis in NPC patients.