系统免疫炎性指数联合营养风险指数对胃癌根治术后患者预后的预测价值OA

Objective To investigate the factors influencing the prognosis of patients following radical gastrectomy for gastric cancer,and to analyze the value of the systemic immune inflammation index(SII)and nutritional risk index(NRI)in predicting the prognosis of these patients.Methods A total of 129 patients who underwent radical gastrectomy for gastric cancer at the Department of Gastroenterology of the Affiliated Hospital of Southwest Medical University/Mianyang No.404 Hospital from January 2021 to August 2022 were retrospectively enrolled.Additionally,123 individuals who underwent health check-ups during the same period were selected as the healthy control group.Gastric cancer patients were followed up for 3 years after surgery and were divided into a recurrence and metastasis group and a non-recurrence and non-metastasis group ac-cording to their prognosis.Clinical data and differences in SII and NRI levels were collected and compared between the two groups.A Cox regression model was used to identify factors affecting the prognosis of patients after radical gastrectomy for gastric cancer,and ROC curve analysis was used to evaluate the prognostic predictive value of SII and NRI in these patients.Results Compared with the healthy control group,SII levels were significantly increased and NRI levels were significantly decreased in the gastric cancer group(t=15.767,16.196;both P＜0.001).Eleven cases were lost to follow-up by the end of the follow-up period.Among the remaining 118 gastric cancer patients,35 had recurrence and metastasis,while 83 did not.Com-pared with the non-recurrence and non-metastasis group,the recurrence and metastasis group had a lower proportion of mo-derately or highly differentiated tumors,a lower proportion of stage Ⅱ/Ⅲ tumors,lower albumin levels,higher SII values,and lower NRI values,with statistically significant differences(Z/P=2.566/0.010,x2/P=6.039/0.014,t/P=2.788/0.006,t/P=4.402/＜0.001,t/P=4.966/＜0.001).High SII,low/moderate pathological differentiation,and pathological stage Ⅱ/Ⅲ were inde-pendent risk factors affecting the prognosis of patients after radical gastrectomy for gastric cancer,while high NRI was an in-dependent protective factor[HR(95％CI)=3.662(1.968-6.815),3.625(1.853-7.092),1.864(1.087-3.196),5.663(2.903-11.049),0.592(0.390-0.899)].The AUC values of SII,NRI,and their combination in predicting the prognosis of patients af-ter radical gastrectomy for gastric cancer were 0.739,0.746,and 0.895,respectively.The AUC of the combination was signifi-cantly higher than that of the individual indicators(Z=2.214,2.382;P=0.021,0.019).Conclusion SII is a risk factor for re-currence and metastasis in patients after radical gastrectomy for gastric cancer,while NRI is a protective factor.The combina-tion of the two demonstrates good predictive value for prognosis.