Correlation Study Of Systemic Inflammatory Composite Indicators And Immunoscore On Prognosis Of Colorectal Cancer

Objective:Studies show that preoperative systemic inflammatory response and immune characteristics of tumor tissues are related to the prognosis of multiple tumors.Some systemic inflammatory composite indicators and Immunoscore are successively proposed for the prognostic assessment of colorectal carcinoma.The aim of the study was to investigate the correlation between neutrophil-platelet score and Immunoscore,and the prognosis of colorectal carcinoma,then explore the construction of a combined NPS and IS score prediction model,and to preliminarily test the prediction efficiency of this prediction model.Methods:A total of 107 patients with colorectal carcinoma who were diagnosed with preoperative and postoperative pathological diagnosis and underwent radical surgical treatment in general Surgery department of Shanxi Bethune Hospital from January 2015 to January 2016 were included for clinical retrospective analysis.80 healthy patients were chose as control group by random number table screening.Immunohistochemical detection of CD3 and CD8 were performed on paraffin tissue samples of 107 patients and immunoscore were calculated.All data were analyzed by SPSS26.0 statistical software.The differences of lymphocyte count,platelet count,neutrophil to lymphocyte ratio and platelet to lymphocyte ratio between colorectal carcinoma patients and healthy controls were compared,ROC curves of NLR,PLR and PLR of subjects were drawn.The optimal critical values of NLR and PLR were determined according to sensitivity and specificity,and NPS was calculated.Chi-square test was employed to investigate the correlation between NPS,IS and various clinicopathological features in patients with colorectal carcinoma.Cox regression was used for univariate and multivariate analysis of clinical data affecting OS of colorectal cancer patients,and the significant factors were included in Cox regression for further variable screening.Construction of joint score prediction model and efficacy test: The principle is that the risk score is higher,the prognosis is worse,the positive factor IS regarded as negative score,and the negative factor NPS.Binary Logistic was used to establish the joint score prediction model,that IS,the joint score =0.923 NPS-0.647 IS.ROC curve test was used to compare the predictive value of combined scoring model in evaluating postoperative survival of colorectal carcinoma patients.According to the truncation value,the combined score value less than or equal to 0.41 was regarded as the low-risk group,and score which is more than0.41 was regarded as the high-risk group.Kaplan-meier method was used to draw survival curve and log-rank method was used to test the disparity of survival rate in two tranches.Hypothesis testing P< 0.05 means the discrepancy is statistically significant.Results:(1)Compared with the healthy control group,platelet,neutrophile,NLR and PLR values in colorectal cancer patients were significantly increased,while lymphocyte values were significantly decreased,the disparity were statistically remarkable(P<0.05).(2)In colorectal cancer patients,NPS and IS were correlated with N stage,degree of differentiation of tumor tissue,histological classification,vascular invasion,CEA,CA199(P<0.05).(3)Univariate regression analysis showed that NPS,IS,degree of differentiation of tumor tissue and vascular invasion were risk factors for postoperative survival of colorectal cancer patients(P<0.05),and multivariate regression analysis showed that only NPS,IS and degree of differentiation of tumor tissue were independent risk factors for postoperative survival of colorectal carcinoma patients(P<0.05).(4)NPS and IS among the above independent risk factors were selected to construct the combined score prediction model,and the formula was as follows: combined score =0.923NPS-0.647 IS.The AUC values of postoperative overall survivel predicted by NPS,IS and combined score were 0.688,0.606 and 0.726.(5)According to the ROC curve of the combined score,the cut-off value was 0.41.The combined score of less than or equal to 0.41 was considered as the low-risk group,and the combined score of greater than 0.41 was considered as the high-risk group.Kaplan-meier analysis and log-rank test showed that the 1-year,3-year and 5-year survival rates of the lowrisk group were 100%,92.3% and 83.4%.The 1-year,3-year and 5-year survival rates of high-risk group were 97.2%,81.5% and 58.4%,the discrepancy is statistically significant.Conclusion:(1)The degree of differentiation of tumor tissue,NPS and IS are independent risk factors in postoperative overall survival of colorectal cancer patients.(2)Systemic inflammatory composite indicators combined with immune score can predict postoperative overall survival of colorectal cancer patients with high accuracy,and its efficacy is better than that of single NPS and IS.The overall survival rate of the low-risk group was better than that of the high-risk group.