目的 研究结直肠癌(colorectal cancer,CRC)患者术前泛免疫炎症值(pan-immune-inflammation value,PIV)和术前血红蛋白、白蛋白、淋巴细胞及血小板评分(hemoglobin,albumin,lymphocyte and platelet score,HALP)与肿瘤病理特征和微卫星状态的关系,分析HALP及PIV对微卫星状态的预测价值.方法 回顾性分析2021年5月至2024年2月期间山西医科大学第二医院收治的156例行结直肠癌根治术患者的临床病理资料.通过术前相关化验指标计算出HALP及PIV,再以两指标计算值的中位数将患者分为相应的高HALP组/低HALP组和高PIV组/低PIV组,分析HALP和PIV与结直肠癌临床病理特征的相关性.同时根据微卫星稳定性检测结果将患者分为微卫星稳定(microsatellite standard,MSS)组和微卫星高度不稳定(microsatellite instability-high,MSI-H)组,比较2组HALP和PIV的差异.绘制受试者工作特征(receiver operating characteristic,ROC)曲线,分析HALP及PIV对微卫星状态的预测价值.结果 高PIV组和低PIV组的肿瘤直径、肿瘤部位、HALP、T分期和微卫星状态差异有统计学意义(P＜0.05);高PIV多见于右侧结肠癌和MSI-H患者,且肿瘤较大、T分期高.高HALP组和低HALP组患者的性别、体质量指数(body mass index,BMI)、肿瘤直径、肿瘤部位、PIV、T分期和微卫星状态差异具有统计学意义(P＜0.05);低HALP多见于女性、右侧结肠癌及MSI-H患者,且BMI较低、肿瘤较大、T分期高.MSS组和MSI-H组的HALP及PIV差异有统计学意义(P＜0.05),MSI-H的患者倾向于低HALP、高PIV;HALP和PIV预测结直肠癌MSI-H的ROC曲线下面积分别为0.848 9和0.851 6,最佳临界值分别为26.84分和507.04,敏感度分别为1.000和0.923,特异度分别为0.643和0.817.结论 低HALP和高PIV多见于右侧结肠癌及MSI-H的患者,患者的营养免疫状况较差,炎症较重,并且肿瘤更大,浸润程度更深,并且对MSI-H具有预测价值,在一定程度上能够协助制定临床治疗方案.
Analysis of correlation between preoperative HALP and PIV and pathological features of colorectal cancer and its predictive value on microsatellite status
Objective To study the relationship between preoperative pan-immune-inflammation value(PIV),preoperative hemoglobin,albumin,lymphocyte and platelet score(HALP)and tumor pathological features and microsatellite status of colorectal cancer,and to analyze the predictive value of HALP and PIV for microsatellite status.Methods The clinicopathological data of 156 patients who underwent radical colorectal cancer resection admitted to the Second Hospital of Shanxi Medical University from May 2021 to February 2024 were retrospectively analyzed.HALP and PIV were calculated by preoperative related laboratory indicators,and then the patients were divided into high HALP/low HALP(HHALP/LHALP)group(n=78)and high PIV/low PIV(HPIV/LPIV)group(n=78)according to the median of their calculated values.The correlation between preoperative HALP and PIV and clinicopathologic features of colorectal cancer was analyzed.According to the results of microsatellite stability detection,the patients were divided into microsatellite standard/microsatellite instability-high(MSS/MSI-H)group.The correlation between preoperative HALP and PIV and microsatellite stability was analyzed.The predictive value of HALP and PIV for microsatellite status was analyzed by using receiver operating characteristic(ROC)curve.Results There were statistically significant differences in tumor diameter,tumor location,HALP,T stage and microsatellite status between the HPIV group and the LPIV group(P＜0.05),and high PIV was more common in patients with right-sided colon cancer and MSI-H,and the tumors were larger and had higher T stage.The differences in gender,body mass index(BMI),tumor diameter,tumor location,PIV,T stage and microsatellite status between the HHALP group and the LHALP group were statistically significant(P＜0.05),and low HALP was more common in women,patients with right-sided colon cancer,and MSI-H,and had a low BMI,large tumors,and high T stage.There were statistically significant differences in HALP and PIV between MSS group and MSI-H group(P＜0.05),and patients with MSI-H tended to have low HALP and high PIV,and the area under curve of HALP and PIV in predicting MSI-H for colorectal cancer was 0.848 9 and 0.851 6,respectively,and the optimal cut-off value was 26.84 scores and 507.04,respectively,and the sensitivity was 1.000,0.923,specificity 0.643,0.817,respectively.Conclusion Low HALP and high PIV are more common in patients with right-sided colon cancer and MSI-H,who have poor nutritional and immune status,severe inflammation,larger tumors,deeper invasion,and predictive value for MSI-H,which can assist in the formulation of clinical treatment plans to a certain extent.
colorectal cancerpan-immune-inflammation valuepreoperative hemoglobin,albumin,lymphocyte and platelet scoremicrosatellite status
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