Preoperative Systemic Inflammatory Response Index Combined With PLT For Predictive Value Of Postoperative Liver Cancer Patients

Objective:To explore the postoperative value of systemic inflammation response index(SIRI)and peripheral blood platelets(PLT)in patients with liver cancer after surgery.Methods:Retrospectively analyzed the clinical data of 177 patients with liver cancer who underwent surgical treatment in the Department of Hepatobiliary and Pancreatic Surgery of Qinghai University Affiliated Hospital from August 2011 to August2017,collected the results of the patient’s blood routine in the first week of surgery,and calculated the SIRI value.The receiver operating characteristic curve was applied to determine the optimal clinical cut-off value of SIRI and PLT,and the patients were divided into low SIRI group and high SIRI group,low PLT group and high PLT group,and the survival curve was plotted by Kaplan-Meier method,the relationship between SIRI and PLT and liver cancer patients was analyzed,and the log-rank was applied for testing.Risk factors for clinical prognosis were analyzed using the Cox regression proportional risk model.Finally,THE ROC curve was used to evaluate the predictive efficacy of SIRI,PLT and co SIRI-PLT on the prognosis of liver cancer patients.Results:A total of 177 patients were included,including 144 males and 36 females,aged 25.0-82.0(56.33±9.765)yearsold.The ROC curve determined the optimal clinical cutoff values of SIRI and PLT at 1.362 and 163.5,and divided 177 patients into low SIRI group(SIRI≦1.362,n=130)and high SIRI group(SIRI>1.362,n=47),Low PLT group(PLT≦163.5,n=114)and high PLT group(PLT>163.5,n=63).The 5-year survival rate in the low SIRI group was significantly higher than that in the high SIRI group(34.3% vs 11.2%,p<0.0001);the 5-year survival rate in the low PLT group was significantly higher than that in the high SIRI group(34.7% vs 15.1%,p<0.0001).Cox multivariate analysis showed that SIRI(HR=1.857,95%CI: 1.102-3.130,P=0.020)and PLT(HR=1.629,95%CI:1.061-2.501,P=0.026)were associated with the overall survival rate of liver cancer patients independent risk factors.ROC curve analysis showed that the AUCs of SIRI,PLT and co SIRI-PLT were 0.625(95%CI:0.539-0.711,P<0.0001),0.630(95%CI:0.542-0.718,P<0.0001),0.685(95%CI:0.604-0.766,P<0.0001),the efficacy of co SIRI-PLT to evaluate the prognosis was better than that of SIRI or PLT alone(P<0.05).Conclusion: SIRI and PLT can be used as prognostic indicators for predicting postoperative prognosis in patients with liver cancer.The lower the SIRI and PLT in peripheral blood,the better the prognosis of patients,and the combined application of SIRI and PLT can improve the accuracy of prediction.