| 章金丽,张 奇,朱红娟.系统炎症指数变化率在预测肝细胞肝癌复发中的意义[J].肿瘤学杂志,2017,23(8):667-671. |
| 系统炎症指数变化率在预测肝细胞肝癌复发中的意义 |
| Delta Systematic Inflammation Index in Predicting Recurrence of Hepatocellular Carcinoma |
| 投稿时间：2017-01-21 |
| DOI：10.11735/j.issn.1671-170X.2017.08.B004 |
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| 中文关键词: 肝细胞肝癌 根治性切除术 系统炎症指数 复发 |
| 英文关键词:hepatocellular carcinoma curative resection systematic inflammation index recurrence |
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| 中文摘要: |
| 摘 要：［目的］ 探讨肝细胞肝癌（hepatocellular carcinoma，HCC）患者切除术前外周血系统炎症指数变化率（deltas ystematic inflammation index，Delta SII）对术后HCC复发的影响。［方法］回顾性分析接受HCC根治性切除术的患者123例。SII变化率（Delta SII）计算方式为：（术后SII-术前SII）/天数。术后SII为术后首次复查时采血检验所得数据。使用X-tile软件估算Delta SII对于术后复发的最佳决定值。Kaplan-meier法绘制生存曲线，Log-rank检验评估Delta SII在全部患者人群以及多种低危风险组中的价值。单因素Cox回归模型分析术前各临床参数对于术后复发的影响，有统计学意义的术前单因素进入Cox回归模型进行多因素分析。ROC曲线分析各参数对于复发预测的效能。［结果］截止2016年7月，123例患者中位随访时间43.60个月，共有55例（44.72%）患者复发。X-tile计算得到的Delta SII最佳切点为-2.64，其中 Delta SII≤-2.64患者98例（79.67%），Delta SII>-2.64患者25例（20.33%）。单因素分析显示术前SII（P=0.041）、术后SII（P=0.035）以及Delta SII（P=0.027）是术后无瘤生存率的影响因素。多因素分析显示Delta SII是预测术后肿瘤复发的唯一独立危险因子（OR=2.49，95%CI：1.22～6.54，P=0.044）。对AFP阴性（≤400ng/ml）以及BCLC 0+A期的早期肝癌两个低复发风险亚组，Delta SII>-2.64依然是一个具有显著意义的复发评估指标（P均<0.05）。Delta SII>-2.64与多灶性肿瘤的发生具有显著的相关性（P=0.048）。ROC曲线分析显示Delta SII具有最大的复发预测效能。［结论］ Delta SII是一个简便、高效、易检测、低成本的HCC切除术后早期复发预测指标，Delta SII>-2.64的HCC患者术后早期复发风险显著增加，在临床工作中检测Delta SII有利于临床制定更加有效的HCC综合治疗监测方案。 |
| 英文摘要: |
| Abstract: ［Objective］ To investigate the application of delta systematic inflammation index (ΔSII) in predicting recurrence of hepatocellular carcinoma (HCC) after curative resection. ［Methods］ The clinical data of 123 patients with HCC received curative resection were retrospectively reviewed. ΔSII was calculated: postoperative SII-preoperative SII/time interval. X-tile software was used to evaluate the optimal cutoff value for ΔSII，and the patients were stratified according to the cutoff value. The recurrence rate was analyzed by Kaplan-Meier curves and log-rank tests. Univariate and multivariate analyses were performed to determine the independent factor for predicting tumor recurrence. ROC curve analysis was performed to compare the predictive value of recurrence among various clinical parameters. ［Results］ The median follow-up time was 43.60 months，and 55 patients encountered recurrence during this period. -2.64 was set as the optimal cutoff value according to X-tile and patients were stratified into two groups based on this value. Univariate analysis revealed that preoperative SII，postoperative SII，and ΔSII were significantly associated with the recurrence(P=0.041，0.035，0.027). Multivariate analysis showed that ΔSII was the only independent indictor for predicting recurrence(OR=2.49，95%CI:1.22～6.54，P=0.044). Delta SII retained its prognostic value in low AFP and early-HCC subgroups(all P<0.05). ROC curve analysis confirmed that ΔSII exhibited the most significant value among clinical parameters for recurrence prediction(P=0.048). ［Conclusion］ Delta SII is a convenient，effective and low-cost predictive indicator of recurrence in HCC patients after curative resection，and patients with ΔSII >-2.64 are at high risk of encountering recurrence. |
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