目的 研究术前血小板分布宽度(Platelet volume distribution width,PDW)联合系统性炎症指数(Systemic inflammation response index,SIRI)对结肠癌术后复发转移的预测价值.方法 以2020年1月-2021年6月江苏大学附属医院胃肠外科就诊并接受根治性切除手术治疗的194例结肠癌患者为结肠癌组,选择同期在本院体检中心招募的100例健康体检者为对照组.术前检测并记录PDW和SIRI,收集患者的一般资料包括:性别、年龄、身高、体重、家族肿瘤史、是否吸烟、酗酒、体质指数(Body mass index,BMI)、肿瘤最大径、TNM分期(Tumor node metasta-sis,TNM)和分化程度.对患者随访2年,记录结肠癌复发转移情况.采用ROC曲线确定相关变量的临界最佳值,通过AUC(ROC曲线下面积)评价其预后的准确性.结果 与对照组比较,结肠癌组PDW和SIRI均显著增高,差异有统计学意义(P＜0.05).术后发生复发转移患者术前PDW与SIRI高于术后未发生复发转移的患者,差异有统计学意义(P＜0.05).TNM分期Ⅲ～Ⅳ期和中低分化程度术后复发转移患者的PDW高于Ⅰ～Ⅱ期患者和高分化程度患者,差异有统计学意义(P＜0.05).肿瘤最大径≥5 cm、TNM分期Ⅲ～Ⅳ期和中低分化程度术后复发转移患者的PDW高于肿瘤最大径＜5 cm、TNM分期Ⅰ～Ⅱ期和高分化程度的患者,差异有统计学意义(P＜0.05).PDW、SIRI及两者联合预测结肠癌术后复发转移的曲线下面积(Area under curve,AUC)分别为0.761(95％CI:0.691～0.831),0.836(95％CI:0.775～0.897)和0.918(95％CI:0.876～0.960).术后复发转移患者的PDW与SIRI呈显著正相关关系(r=0.574,P=0.003).结论 PDW、SIRI与结肠癌患者临床病理特征和术后复发转移有关,两者联合预测术后复发转移的效能较好,可为临床应用提供一定参考价值.
Study on value of preoperative platelet distribution width combined with systemic inflammatory index in predicting postoperative recurrence and metastasis of colon cancer
Objective To study the predictive value of preoperative platelet volume distribution width(PDW)combined with systemic inflammation response index(SIRI)for postoperative recurrence and me-tastasis of colon cancer.Methods From January 2020 to June 2021,194 patients with colon cancer who were treated by radical resection in the hospital were taken as the research object,and 100 healthy people were recruited in the physical examination center of the hospital as the control group during the selection period.PDW and SIRI were detected and recorded before the operation,and general data of the patients were collected,including:gender,age,height,weight,family history of tumor,whether smoking or drinking,calculation of Body mass index(BMI),maximum tumor diameter,TNM stage(TNM)and dif-ferentiation degree.The patients were followed up for 2 years to record the recurrence and metastasis of colon cancer.ROC curve were used to determine the critical optimal value of related variables,and the ac-curacy of prognosis was evaluated by AUC(area under ROC curve).Results Compared with healthy con-trol group,PDW and SIRI of colon cancer patients were significantly increased,the difference was statisti-cally significant(P＜0.05).The preoperative PDW and SIRI of the patients with postoperative recurrence and metastasis were significantly higher than those without postoperative recurrence and metastasis,and the difference was statistically significant(P＜0.05).The PDW of patients with TNM stage Ⅲ to Ⅳ and moderate to low differentiation after postoperative recurrence and metastasis was significantly higher than that of the patients with stage Ⅰ to Ⅱ and the patients with high differentiation,and the difference was statistically significant(P＜0.05).The PDW of postoperative recurrence and metastasis patients with tumor maximum diameter≥5 cm,TNM stage Ⅲ to Ⅳ and moderate to low differentiation was signifi-cantly higher than that of patients with tumor maximum diameter＜5 cm,stage Ⅰ to Ⅱ and highly differ-entiated patients,with statistical significance(P＜0.05).The area under curve(A UC)of PDW,SIRI and their combination in predicting postoperative recurrence and metastasis of colon cancer were 0.761(95％CI:0.691～0.831)and 0.836(95％ CI:0.831),respectively.0.775～0.897)and 0.918(95％CI:0.876～0.960).There was a significant positive correlation between PDW and SIRI in patients with postoperative recurrence and metastasis(r=0.574,P=0.003).Conclusion PDW and SIRI are re-lated to the clinicopathological features and postoperative recurrence and metastasis of colon cancer pa-tients,and the combined efficacy of PDW and SIRI is better in predicting postoperative recurrence and me-tastasis,which can provide certain reference value for clinical application.
colon cancerplatelet distribution widthsystemic inflammation indextumor recurrencetumor metastasis
万方数据
维普
