SII And PNI Are Correlated With The Prognosis Of Patients With Alveolar Echinococcosis

Objective: To calculate the inflammation index series,systemic immune inflammation index(SII),neutrophil to lymphocyte count ratio(NLR)and platelet to lymphocyte count ratio(PLR)and prognostic nutritional index(PNI)by collecting clinical case data of patients with hepatic alveolar disease for statistical and analytical purposes.NLR,Platelet to lymphocyte ratio(PLR),and Prognostic nutritional index(PNI)are correlated with the prognosis of patients with hepatic alveolar disease,and to guide clinicians in the clinical treatment of patients.To guide clinicians in their clinical work.Methods:(1)The clinical data of patients with hepatic vesicular disease treated by surgical methods in the Department of Hepatobiliary and Pancreatic Surgery of the Affiliated Hospital of Qinghai University were systematically analyzed,and 351 patients were finally included in the study to calculate SII,PNI,PLR and NLR.SPearman was used to analyze the correlation between SII,PNI,PLR and NLR.(2)The optimal thresholds of SII,PNI,PLR and NLR were determined using X-tile software,and the cardinality test was used to evaluate the relationship between SII,PNI and clinicopathological characteristics of patients with hepatic vesicular echinococcosis.The risk factors that may be associated with patient prognosis and thus guide the prognosis of patients with hepatic vesicular echinococcosis were also screened from patient admission data.(3)The indicators with P-value less than 0.05 were screened out by one-way COX regression analysis,and the risk indicators associated with the prognosis of patients with vesicular disease were screened out by multi-way COX regression analysis.Finally,the K-M method was used to plot the 1,3,5-year survival curves of patients.Results: 1.Results of data analysisA total of 398 patients with surgically treated hepatic vesicular encapsulation disease data were included according to the inclusion criteria,and finally 351 patients were included in this study according to the exclusion criteria requirements,including 140(39.88%)males and 211(60.12%)females,aged 7.0-73.0(36.98±12.5)years.All patients were successfully discharged after treatment.As of October 1,2021,all 351patients were followed up,of which 110(31.3%)died and 241(68.7%)patients were still alive.2.Determination of optimal threshold values for pathological parametersThe optimal threshold values of pathological parameters were determined by X-Tile analysis to predict OS at 5 years after surgery.the threshold values of SII,PNI,PLR and NLR were 634.7,35.7,291 and 4,respectively.the patients were further analyzed by dividing them into two groups based on the threshold values: the low SII group(SII≤634.7,n=184)and the high SII group(SII > 634.7,n = 167);low PNI group(PNI ≤ 35.7,n = 169)and high PNI group(PNI > 35.7,n = 182);low PLR group(< 290,n = 288)and high PLR group(≥ 290,n = 63);low NLR group(< 4,n = 282)and high NLR group(≥ 4,n = 69).3.results of one-way COX regression analysis for each study index(1)SII was associated with worm stage,Child-Pugh classification(hereinafter referred to as CP classification),surgical method,blood loss,comorbidity,worm metastasis,TBil,NE,PLT,LY,and WBC count(P<0.05).(2)PNI was associated with worm stage,surgical method,blood loss,worm metastasis,CP classification,ALT,AST,TBil,ALB,ALP,PT,and PLT(P<0.05).(3)PLR was associated with worm stage,surgical method,blood loss,comorbidity,ALT,AST,TBil,ALB,ALP,PT,and LY(P<0.05).(4)NLR was associated with the stage of encapsulation,surgical method,blood loss,comorbidity,ALT,AST,TBil,ALB,ALP,PT,neutrophil,lymphocyte and PLT counts(P<0.05).The overall survival time affecting the prognosis of patients with hepatic vesicular disease was related to the surgical approach and preoperative SII,PNI,NLR,and PLR,and the differences were statistically significant(all P<0.05).4.Results of multifactorial COX regression analysisThe results of multi-factor analysis showed that preoperative SII,PNI and PLR could be used as independent risk factors affecting the prognosis of patients with hepatic vesicular disease.5.With the above findings,the study finally combined the systemic immune inflammation index and the prognostic nutritional index,named co SII-PNI,to assign a score of 1 for the protective prognostic factors related to encapsulation(low SII and high PNI)and a score of 0 for the risk factors(high SII and low PNI),with a final combined index score of 2(low SII-high PNI)and 1(low SII-high PNI).PNI),1(lowSII-low PNI/high SII-high PNI),and 0(high SII-low PNI),and finally the above groupings were plotted for the joint index 1,3,and 5-year patient survival rates.Conclusion: 1.Preoperative SII,PNI and PLR can be used as independent risk factors related to the prognosis of patients with hepatic vesicular echinococcosis.2.In the analysis of the combined indexes,the prognosis of patients with coSII-PNI scores of 2 was significantly better than the other groups;therefore,high SII and low PNI are independent risk factors for the prognosis of patients with hepatic vesicular encystment.