摘要
目的 分析胰腺癌患者全身免疫炎症指数(SII)与临床特征之间的关系及SII影响因素.方法 回顾分析2018年1月至2023年1月贵州医科大学附属医院肝胆外科98例行R0切除的胰腺癌患者资料,其中男性54例,女性44例,年龄(59.2±10.7)岁.98例患者依据术前SII的中位数668分为高SII组(n=49)和低SII组(n=49).比较两组术前白蛋白、肿瘤位于胰头比例、术前总胆红素、住院时间等.分析SII与临床特征的相关性.采用单因素与多因素线性回归分析胰腺癌患者SII影响因素.结果 高SII组胰腺癌患者术前白蛋白低于低SII组,肿瘤位于胰头比例、术前总胆红素、住院时间高于低SII组,差异均有统计学意义(均P＜0.05).相关性分析显示术前白蛋白与SII呈负相关(r=-0.28,P=0.050),术前总胆红素与SII呈正相关(r=0.36,P＜0.001),住院时间与SII呈正相关(r=0.28,P=0.050).肿瘤位于胰头(n=81)与胰体尾(n=17)的患者SII分别为734(418,1241)、431(276,613),出 院时生存(n=92)和死亡(n=4)患者的 SII 分别为 628(383,1 113)、1283(1 176,1507),不同肿瘤位置和不同出院状态患者的SII比较,差异均有统计学意义(Z=-2.51、2.05,P=0.012、0.038).单因素线性回归筛选变量,结果显示术前总胆红素、肿瘤体积、术前白蛋白与SII水平相关(均P＜0.05).将上述变量纳入多因素线性回归,胰腺癌患者术前总胆红素越高(β=2.74,95％CI:1.48～4.00,P＜0.001)以及肿瘤体积越大(β=2.34,95％CI:1.04～3.63,P＜0.001),SII值越高.结论 胰腺癌患者SII与术前白蛋白、肿瘤位置、术前总胆红素、住院时间、出院时生存或死亡相关.术前总胆红素及肿瘤体积是胰腺癌患者SII的影响因素.
Abstract
Objective To analyze the relationship between systemic immune-inflammatory index(SII)and clinical characteristics of pancreatic cancer patients and the factors influencing SII.Methods To retrospectively analyze the data of 98 pancreatic cancer patients with R0 resection in the Department of Hepa-tobiliary Surgery,Affiliated Hospital of Guizhou Medical University,from January 2018 to January 2023,of whom 54 were male and 44 were female at the age of(59.2±10.7)years.All patients were divided into the high SII group(n=49)and the low SII group(n=49)based on the median SII of 668.Preoperative albumin,proportion of tumor located in the head of the pancreas,preoperative total bilirubin,and length of hospitalization were compared between the two groups.The correlation between SII and clinical features was analyzed.The SII influencing factors of pancreatic cancer patients were analyzed by linear regression with univariate and multivariate analysis.Results The preoperative albumin of pancreatic cancer patients in the high SII group was lower than thatof the low SII group,while the proportion of tumors located in the head of the pancreas,the preoperative total bilirubin,and the length of hospital stay were higher than that of the low SII group,and the differences were all statistically significant(all P＜0.05).Correlation analysis showed a negative correlation between preoperative albumin and SII(r=-0.28,P=0.050),while a positive corre-lation between preoperative total bilirubin and SII(r=0.36,P＜0.001),as well as between hospitalization time and SII(r=0.28,P=0.050).The SII of patients with tumors located in the head of the pancreas(n=81)and the tail of the pancreatic body(n=17)were 734(418,1241)and 431(276,613),respectively,and the SII of patients who survived(n=92)and died(n=4)at the time of discharge were 628(383,1 113)and 1 283(1 176,1 507),respectively,and the differences in SII of patients with dif-ferent tumor locations and different discharge status were all significant.The SII of the patients were com-pared,and the differences were statistically significant(Z=-2.51,2.05,P=0.012,0.038).Screening variables in the univariate linear regression model showed that admission total bilirubin,tumor volume,and preoperative albumin were associated with SII levels(all P＜0.05).When the above variables were included in the multivariate linear regression,the higher the preoperative total bilirubin(β=2.74,95％CI:1.48-4.00,P＜0.001)as well as the larger the tumor volume(β=2.34,95％CI:1.04-3.63,P＜0.001)in pancreatic cancer patients,the higher the value of SII.Conclusions SII in pancreatic cancer patients was associated with preoperative albumin,tumor location,preoperative total bilirubin,length of hospital stay,and survival or death at discharge.Preoperative total bilirubin and tumor volume were influential factors of SII in patients with pancreatic cancer.
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