炎症营养复合指标与Ⅰ型子宫内膜癌预后的相关性分析OA

OBJECTIVE:To evaluate relationships between inflammation-nutrition composite indexes and survival prognosis in patients with type Ⅰ endometrial cancer(EC).METHODS:A total of 404 patients with type Ⅰ EC diagnosed by postoperative pathology from January 2010 to May 2022 were included in this study.Complete blood count and biochemical examination results were collected within one week before surgery.Four inflammatory nutritional composite indicators were calculated:systemic inflammatory response index(SIRI),aggregate index of systemic inflammation(AISI),geriatric nutritional risk index(GNRI),and advanced lung cancer inflammatory index(ALI).Clinicopathological data and follow-up data were also collected.The optimal cutoff value was determined using receiver operating characteristic(ROC)curves.Survival curves were plotted using the Kaplan-Meier method.Univariate and multivariate Cox proportional hazards regression models were used to screen for independent prognostic factors of overall survival(OS).RESULTS:The area under the curves for the inflammatory nutritional indicators were ranked as follows:ALI(0.609)>AISI(0.592)>SIRI(0.581)>GNRI(0.556).Univariate Cox regression showed that age≥60 years,lymph node metastasis,FIGO stage(Ⅲ+Ⅳ),carbohydrate antigen 125(CA125)≥35 U/mL,and ALI<64.32 were significantly associated with shorter OS(all P<0.05).Multivariate Cox regression showed that advanced age[HR=2.25,95％CI(1.02,4.96),P=0.044],high FIGO stage[HR=2.80,95％CI(1.27,6.20),P=0.010],and low ALI[HR=0.28,95％CI(0.08,0.96),P=0.042]were independent risk factors for OS,while SIRI,AISI,and GNRI were not significantly associated with OS(P>0.05).CONCLUSION:Among the four inflammatory and nutritional composite indicators,preoperative ALI had the best prognostic ability for type Ⅰ EC,and ALI<64.32 was an independent risk factor for poor prognosis.