炎症与营养指标及其联合评分系统对远端胃癌根治术患者预后的预测价值OA

Objective:To investigate the prognostic value of inflammatory and nutritional indicators,as well as their combined scoring systems,in patients undergoing radical distal gastrectomy for gastric cancer.Methods:The clinical data of gastric cancer patients who underwent radical distal gastrectomy between Jan.2013 and Dec.2018 were retrospectively analyzed.Cox proportional hazards re-gression model was used to analyze the independent prognostic factors of overall survival.Kaplan-Meier survival curves and log-rank test were used to evaluate the correlation between each indicator and prognosis.Based on the independent prognostic factors screened by multivariate Cox regression,1 point was assigned with the median as the cut-off value,and the inflammatory and nutritional indicator(INI)score system was constructed to predict the 1-year,3-year and 5-year postoperative survival rates,respectively.The predictive efficacy of each system was evaluated by the area under the receiver operating characteristic curve(AUC).Results:Among the 1033 enrolled gastric cancer patients,the patients in the death group had higher levels of systemic immune-inflammation index(SII),neutro-philtolymphocyte ratio(NLR),platelettolymphocyte ratio(PLR),and systemic inflammatory response index(SIRI),and lower levels of prognostic nutritional index(PNI)and lymphocytetomonocyte ratio(LMR).Univariate and multivariate analyses identified SII,PLR,PNI,and LMR as independent prognostic factors for overall survival of gastric cancer patients.The predictive ability of the INI scoring system was better than that of a single indicator,and the four-variable INI scoring system based on SII,PLR,PNI and LMR per-formed the best.Conclusions:Inflammatory and nutritional indicators can be used as independent prognostic predictors in gastric cancer patients.The new multivariable INI scoring system has higher accuracy for prognostic prediction.