Clinical Study on Prognosis of Patients with Colorectal Cancer Based on Preoperative Prognostic Nutritional Index Combined with Systemic Inflammatory Index
Objective This study aims to explore the value of the combined use of preoperative Prognostic Nutritional Index(PNI)and Systemic Immune-Inflammation Index(SII)in assessing the prognosis of col-orectal cancer(CRC)patients undergoing curative surgery.Methods A retrospective analysis was conducted on the clinical case data and follow-up information of 120 CRC patients who underwent curative surgery at the First Affiliated Hospital of Xinxiang Medical University from June 2015 to July 2018.PNI and SII values were calculated based on the initial peripheral blood results upon hospital admission.The optimal cutoff values for PNI and SII were determined using Receiver Operating Characteristic(ROC)curves,and patients were categorized into high/low PNI and high/low SII groups.The independent factors affecting overall survival(OS)were in-vestigated through univariate and Cox multivariate regression models.Kaplan-Meier curves were used for sur-vival analysis,and the prognostic prediction efficacies of PNI,SII,and their combination were compared.Re-sults The ROC curves identified the optimal cutoff values of 48 for PNI and 560 for SII.Grouping based on these cutoff values showed that both PNI and SII were significantly associated with differentiation degree,TNM staging,nerve invasion,and venous cancer thrombus(P＜0.05).Cox multivariate analysis indicated that TNM stage,PNI,and SII were independent prognostic factors for OS.Survival analysis revealed that the OS of the high PNI and low SII groups was significantly better than that of the control groups.Further analysis showed that the OS of the high PNI and low SII group was significantly better than the other three groups(P＜0.05).The AUC for the combined prediction of PNI and SII was 0.811,which was higher than that of the individual indicators.Conclusion PNI,SII and TNM staging are independent prognostic factors affecting the OS of CRC patients undergoing surgery.The combined use of PNI and SII enhances the predictive efficacy compared to the use of each indicator alone.
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