Gleason评分、全身炎症反应指数、预后营养指数与前列腺癌根治术后生化复发的相关性研究OA

Objective:To investigate the predictive value of Gleason score,systemic inflammatory response index(SIRI),and prognostic nutritional index(PNI)for biochemical recurrence after radical prostatectomy for prostate cancer.Methods:The clinical data of 298 patients with prostate cancer admitted between Jan.2017 and Dec.2020 were retrospectively analyzed.All patients were regularly followed up for 5 years after surgery,and were categorized into the biochemical recurrence group(n=90)and the non-biochemical recurrence group(n=208)based on the occurrence of postoperative biochemical recurrence.Perioperative clinical data were extracted from electronic medical records,including postoperative Gleason score,preoperative neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,SIRI,and PNI.Multivariate Cox regression analysis was used to screen the influencing factors of biochemi-cal recurrence,and receiver operating characteristic curve was plotted to evaluate the predictive value of Gleason score,SIRI,and PNI for postoperative biochemical recurrence.Results:Univariate analysis revealed that compared with the non-biochemical recurrence group,the biochemical recurrence group had higher proportions of T stage≥3b and positive surgical margins,higher postoperative Glea-son score,preoperative prostate-specific antigen,neutrophil-to-lymphocyte ratio,and SIRI,and lower PNI,with statistically significant differences(P＜0.05).Multivariate Cox regression analysis indicated that postoperative Gleason score(HR=2.079,95%CI=1.315～3.287)and preoperative SIRI(HR=1.896,95%CI=1.198～3.002)were independent risk factors for biochemical recurrence after radical prostatectomy,while PNI was an independent protective factor(HR=0.555,95%CI=0.339～0.909).Receiver operating characteristic curve analysis demonstrated that the combined detection of Gleason score,SIRI,and PNI achieved an area under the curve of 0.891 for predicting biochemical recurrence after radical prostatectomy,with a sensitivity of 74.44%and a specificity of 93.75%,which was superior to the predictive efficacy of single application of Gleason score,SIRI,or PNI.Conclusions:Gleason score,SIRI,and PNI are independent influencing factors of biochemical recurrence after radical prostatectomy for prostate cancer.The com-bined application of the three indicators can early predict the risk of postoperative biochemical recurrence and facilitate early clinical intervention.