| Background and purposeGastric cancer(GC)is a common malignant tumor of the digestive tract.With the improvement of medical conditions in recent years,the detection rate has increased year by year.According to the latest statistics of Freddie et al.in 2012,the number of newly diagnosed gastric cancers reached one million every year,of which about 70 % died of stomach cancer.In the 19 th century,pathologists such as Virchow detected lymphocytes inside the tumor,and for the first time speculated that there may be an inflammatory reaction inside the tumor.In recent years,scientists have conducted in-depth research on this view and found that inflammation plays different roles in various stages of tumor development.Immune factors in peripheral blood are considered to be a potential marker that can judge the prognosis and even early diagnosis of malignant tumors,and guide postoperative chemotherapy.Some scholars have combined the immune indicators,inflammation indicators and blood coagulation indicators in the body to construct a new marker for judging the progress of cancer.Such as the Glasgow score(GPS),fibrinogen to albumin ratio(FAR),neutrophil/lymphocyte ratio(NLR),etc.have been confirmed related to prognosis in gastric cancer,colorectal cancer,liver cancer,lung cancer,and esophageal cancer.The systemic immune inflammation index(SII),as a new inflammatory marker,has recently been confirmed to be related to the biological characteristics and of a variety of malignant tumors,but its application in gastric cancer is still rare.In this study,by comparing the SII value,analyzing the relationship with the clinicopathological characteristics of gastric cancer,evaluating its role in the prognosis.MethodsThe clinical database of gastrointestinal surgery was used to retrieve the clinical data and follow-up information of 823 patients with gastric cancer who underwent radical surgery.Calculate the SII value [SII =(platelets × neutrophils)/lymphocytes]according to the results of the first blood routine admission.The critical value of SII was selected by Youden index to group,and the correlation between the variables was analyzed by chi-square test,survival analysis was performed on the two groups of patients to draw the survival curve,and the prognostic indicators were determined by univariate and multivariate COX regression analysis.ResultsThe best cut-off value of SII was 427.3.Among all patients,there were 459 cases in the SII≤427.3 group and 364 cases in the SII>427.3 group.Compared with the low SII group,the average age of patients in the high SII group was older,there were more lymph node metastases,deeper tumor infiltration,deviations in the nutritional status of patients,late tumor staging,and higher CEA(all P<0.05).As of March 2018,514 patients survived and 309 died.The overall survival(OS)of this group of patients with SII≤427.3 was significantly better than that of patients with SII>427.3,and the difference was statistically significant(P = 0.000).For older age,high tumor location,poor histological classification,deep infiltration,more lymph node metastasis,late stage,preoperative hypotrophic state(low albumin,prealbumin)and preoperative tumor markers(CEA,CA-199)The prognosis of the high part of patients is relatively poor.The results of multivariate analysis showed that the location of the tumor(HR=0.696,95% CI=0.597-0.811,P=0.000),lymph node metastasis(HR=1.337,95%CI=1.121-1.595,P=0.001),tumor invasion depth(HR=2.241,95% CI=1.184-4.244,P=0.013),tumor TNM staging(HR=1.289,95% CI=1.057-1.558,P=0.008),prealbumin(HR=0.720,95 % CI=0.560-0.926,P=0.01),CA-199(HR=1.513,95%CI=1.204-1.901,P=0.000),age(HR=1.487,95% CI=1.162-1.902,P=0.02)And SII(HR=1.577,95% CI=1.253-1.984,P=0.000)are independent risk factors affecting the prognosis of patients undergoing radical gastrectomy.ConclusionsSII is a reliable predictor of prognosis for gastric cancer patients undergoing radical surgery.A high SII value before surgery indicates a poor prognosis. |
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