| Objective:To explore the relationship between preoperative Systemic Inflammation Response Index（SIRI）and postoperative prognosis of colon cancer patients,and its clinical significance in the evaluation of colon cancer prognosis.Method:The clinical data of patients with colon cancer who underwent surgical treatment in the Gastrointestinal and Colorectal Surgery Department of China-Japan Friendship Hospital of Jilin University were retrospectively analyzed.Follow-up information,record the absolute value of neutrophil（neutrophil,N）,lymphocyte（ymphocyte,L）,platelet（platelet.P）,monocyte（monocyte,M）,calculate NLR,PLR,LMR,S Ⅱrespectively and SIRI.The best cut-off value of SIRI was obtained by the maximum Youden index of the ROC curve,and the overall patients of the study were divided into two groups with high and low SIRI,and the general clinical data and pathological characteristics of each group were compared and analyzed.Univariate and multivariate analysis were performed by Cox proportional hazards regression model to determine the series of factors affecting postoperative prognosis and survival.Survival analysis was performed using the Kaplan-Meier method,the difference in survival between groups was compared using the Log-rank method,and the predictive power of the survival assessment was compared by comparing the area under the ROC curve（AUC）of different inflammatory response-related indices.Result:1.A total of 116 patients with colon cancer after radical resection were included,including 66 males（56.9%）and 50 females（43.1%）,aged 28-87 years,mean（60.33±11.3）years old,aged <60 years49 67 cases（57.8%）aged ≥60 years;32 cases（27.6%）with a long history of smoking,29 cases（25.0%）with a long history of drinking,10 cases（8.6%）with a history of heart disease,There were 21 patients（18.1%）with a history of hypertension,9 patients（7.8%）with a history of diabetes,23 patients（19.8%）with preoperative hypoalbuminemia,and 23 patients（19.8%）with preoperative anemia;right 40 cases（34.5%）of colon cancer and 76 cases（65.5%）of left colon cancer;AJCC colorectal cancer TNM stage I,II,III and IV were 17 cases（14.7%）and 45 cases（38.8%）respectively.),41 cases（35.3%）,13 cases（11.2%）,109cases（94.0%）of non-mucinous adenocarcinoma,94 cases（81.0%）of moderately and well differentiated tumors,and 22 cases（19.0%）of poorly differentiated tumors.69cases（59.5%）with Ki-67 expression rate >50%,41 cases（35.3%）with vascular tumor thrombus,20 cases（17.2%）with nerve invasion;58 cases（50.0%）with tumor length ≤4cm %),58 cases（50.0%）with a number of >4cm;51 cases（44.0%）with lymph node metastasis;13 cases（11.2%）with distant metastasis;18 cases（15.5%）with postoperative complications.2.In the comparison between the high SIRI group and the low SIRI group,the preoperative CEA was abnormally elevated（P=0.014）,the preoperative hypoalbuminemia（P=0.001）,the degree of tumor differentiation（P=0.009）,and the depth of invasion（P=0.009）.0.046),AJCC staging（P=0.017）,lymph node metastasis（P=0.004）and vascular tumor thrombus（P=0.013）were statistically significant（P<0.05）and were correlated.3.Univariate COX regression analysis showed: age,preoperative hypoalbuminemia,ACJJ stage,depth of invasion T stage,lymphatic metastasis,tumor differentiation,short-term postoperative complications,vascular tumor thrombus,nerve invasion,distant metastasis,NLR,MLR,PLR,SII and SIRI were related factors affecting the prognosis and survival of colorectal cancer patients（P<0.05）.Multivariate COX regression analysis showed that distant metastasis（P<0.001）,NLR（P=0.022）,SII（P=0.007）and SIRI（P=0.004）were independent prognostic factors affecting the prognosis and survival of colon cancer patients（P=0.004）.P<0.05).4.Survival analysis was performed by K-M method,and Log-rank test was used to analyze the differences between high and low SIRI groups.The results showed that the postoperative five-year survival rate of the low SIRI group was significantly higher than that of the high SIRI group（P<0.001）.5.The ROC curve was drawn with the 5-year overall survival（OS）of colon cancer patients as the outcome variable,and the area under the curve（AUC）of SIRI was compared with NLR,PLR,MLR and SII.Compared with other inflammatory indicators,SIRI had the largest AUC,namely SIRI has better ability to assess survival after colon cancer surgery.Conclusion:1.The increase of preoperative SIRI value in patients with colon cancer is related to the depth of tumor invasion,tumor differentiation,lymph node metastasis,tumor ACJJ stage,vascular tumor thrombus,abnormal preoperative CEA elevation,and preoperative hypoalbuminemia.2.SIRI is an independent factor affecting the prognosis and survival of patients with colon cancer after surgery,and it is an effective predictor for evaluating the survival time after colon cancer surgery.3.Compared with NLR,PLR,MLR and SII,SIRI can better evaluate the postoperative survival of colon cancer patients. |
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