Relationship Between Systemic Immune Inflammation Index And Prognosis Of Patients With Distal Cholangiocarcinoma

Objective:To investigate the association between systemic immune inflammation index(SII)and postoperative prognosis of patients with distal cholangiocarcinoma undergoing pancreaticoduodenectomy(PD).Materials and methods:The clinical data of patients who underwent pancreaticoduodenectomy and confirmed as distal cholangiocarcinoma by postoperative pathological examination in the First Affiliated Hospital of Zhengzhou University from January 2009 to December 2018 were analyzed retrospectively.SII values were calculated by statistical collation of the most recent preoperative blood routine results in all patients.Draw the receiver operating characteristic curve and obtain its optimal cutoff value according to the best Youden index,divide them into two groups according to the SII optimal cutoff value.Kaplan-Meier method was used to draw SII-related survival curves of patients with distal cholangiocarcinoma,the overall survival time between the two groups was compared,and log-rank test was used to perform univariate analysis between the clinicopathological characteristics and postoperative survival of patients.Then,the Cox regression proportional hazards model was used to analyze the independent factors that influenced the patient's prognosis.Results:A total of 178 patients were enrolled in this study,including 113 males and 65 females,ranging in age from 30 to 77 years.According to the ROC curve,the optimal preoperative SII threshold was 496.9.178 patients with distal cholangiocarcinoma were divided into two groups,a low SII group(SII?496.9)and a high SII group(SII>496.9),with 79 and 99 cases,respectively.The clinical pathological factors related to SII include tumor AJCC staging,marginal status,NLR,and PLR(p<0.05,both).According to Kaplan-Meier survival curves,the survival rates of patients with distal bile duct cancer in two groups at 1,3,and 5 years after surgery were analyzed.In the low SII group,the survival rates were 93.7%,66.4%,27.3%respectively,in the other group,the survival rates were 70.9%,41.3%,and 9.9%,respectively.The survival rate of patients with distal bile duct cancer in the SII group was better than that in the high SII group,and the overall survival rate was significantly different between the two groups(p<0.05).Univariate analysis revealed that SII>496.9(HR=3.097,95%CI:1.308-7.330,p<0.05)is a risk factor affecting the overall survival of patients with distal cholangiocarcinoma after pancreaticoduodenectomy.Factor analysis found that SII(HR=2.698,95%CI:1.095-6.646,p<0.05)was an independent risk factor affecting the overall survival of patients with distal cholangiocarcinoma.Conclusions:SII is an independent prognostic factor for predicting overall survival after pancreaticoduodenectomy in patients with distal cholangiocarcinoma.Patients with SII>496.9 in peripheral blood before surgery have a worse prognosis than patients with SII ?496.9.