口腔医学研究

口腔医学研究 ›› 2022, Vol. 38 ›› Issue (12): 1128-1133.DOI: 10.13701/j.cnki.kqyxyj.2022.12.006

• 涎腺疾病研究 • 上一篇    下一篇

术前免疫炎症指数和列线图对腺样囊性癌患者预后的预测价值

宗颖睿1, 秦红霞1*, 候珍珍1, 李晓娜2, 胡文彬1, 张晨1   

  1. 1.郑州大学第一附属医院口腔预防科 河南 郑州 450052;
    2.郑州大学第一附属医院口腔美容科 河南 郑州 450052
  • 收稿日期:2022-05-15 出版日期:2022-12-28 发布日期:2022-12-26
  • 通讯作者: *秦红霞,E-mail:651354253@qq.com
  • 作者简介:宗颖睿(1997~ ),女,河南人,硕士,执业医师,研究方向:口腔预防学。

Prognostic Prediction Value of Systemic Immune Inflammation Index and Nomogram in Patients with Adenoid Cystic Carcinoma

ZONG Yingrui1, QIN Hongxia1*, HOU Zhenzhen1, LI Xiaona2, HU Wenbin1, ZHANG Chen1   

  1. 1. Department of Preventive Dentistry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China;
    2. Department of Esthetic Dentistry, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
  • Received:2022-05-15 Online:2022-12-28 Published:2022-12-26

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摘要： 目的: 探讨术前免疫炎症指数(SII)与腺样囊性癌(ACC)患者根治性手术后无复发生存期(RFS)的关系,并构建可靠的预后列线图模型。方法: 根据2013年1月~2020年1月在郑州大学第一附属医院接受根治性切除手术的ACC患者的临床资料计算术前SII。通过受试者工作特征曲线(ROC)得到术前SII的最佳截断值(将患者分为高SII组和低SII组),运用Kaplan-Meier法与Cox风险比例回归模型对其进行生存分析,同时绘制森林图。根据结果构建列线图,并采用C统计量(ROC曲线下面积AUC)和校正曲线验证一致性。结果: 共纳入119例患者,中位生存时间为45个月,平均生存时间为49.34个月。SII的最佳截断值为691.900。低SII组RFS率高于高SII组(χ2=19.487,Log-rank:P<0.001)。神经侵犯(HR=2.150,95%CI:1.027~4.500,P=0.042)、淋巴结转移(HR=3.572,95%CI:1.705~7.480,P<0.001)和高SII(HR=2.386,95%CI:1.048~5.480,P<0.038)为ACC患者RFS的独立危险指标。C统计量为0.732(95%CI:0.627~0.837)。结论: 术前SII越低,患者预后越好,基于SII的列线图预测ACC预后是可靠的。

关键词: 腺样囊性癌, 免疫炎症指数, 列线图, 无复发生存

Abstract: Objective: To explore the association between systemic immune inflammation (SII) and recurrence-free survival (RFS) of adenoid cystic carcinoma (ACC) cancer, and to propose a reliable prognostic nomogram model. Methods: The preoperative SII was computed using clinical data from ACC patients who had radical resection at Zhengzhou University's First Affiliated Hospital between January 2013 and January 2020. The best cut-off value in the receiver operating characteristic curve (ROC) was used to compute SII for all patients, who were then divided into two groups: low SII and high SII. The Kaplan-Meier technique and the Cox proportional hazards regression model were employed by the Forest Plot to undertake survival analysis. On the basis of multivariate analysis, the nomogram was suggested. The C statistic (Area Under Curve, AUC) and Calibration Plots were used to assess the nomogram's consistency. Results: The research comprised a total of 119 patients. The average RFS duration was 49.34 months, while the median follow-up period was 45 months. ROC analysis determined the optimal SII cutoff value of 691.900. The high-SII cohort had significantly shorter RFS (χ2=19.487, Log-rank: P<0.001) than the low-SII cohort. The factors selected as predicting RFS were nerve invasion (HR=2.150, 95%CI: 1.027-4.500, P=0.042), and lymph node metastasis (HR=3.572, 95%CI: 1.705-7.480, P＜0.001) and high SII (HR=2.386, 95%CI: 1.048-5.480, P=0.038). C statistics was 0.732 (95%CI: 0.627-0.837). Conclusion: The lower the preoperative SII, the better the prognosis. The consistency of the nomogram revealed good predictive ability based on SII.

Key words: adenoid cystic carcinoma, systemic immune inflammation, nomogram, recurrence-free survival