The Role Of Systemic Immune-Inflammation Index And Prognostic Nutrition Index In The Prognosis Of Colon Cancer: A Correlation Study

Objective: To study the correlation between systemic immune inflammation index(SII),prognostic nutrition index(PNI)and postoperative complications and survival time of colon cancer patients,and to further explore the value of combined score SII-PNI in predicting prognosis of colon cancer patients.Methods: Retrospective analysis of radical surgical treatment in gastrointestinal center of Subei hospital from March 2016 to January 2018,Based on the pathology after surgery,The clinical data of 256 confirmed colon cancer patients were collected.Collect clinical data of patients: age,sex,weight,height,history;Hematological indicators in the near future before surgery: platelets,lymphocytes,neutrophils,serum albumin,hemoglobin,CEA、CA199;And intraoperative and postoperative conditions,including tumor size,site,depth of invasion,lymph node metastasis,distant metastasis,TNM staging.Data analysis uses SPSS25.0.Set up the working curve(ROC curve)to obtain the best truncation value of the SII 、 PNI.Pass the chi-square test,The clinicopathological features of each group were compared and analyzed.By logistic regression and Cox proportional risk regression model,To conduct regression analysis.In addition,Survival analysis with Kaplan-Meier,Survival between groups was compared by Log-rank test.The area under ROC curve was used to compare the prediction performance.P<0.05 represents a statistic difference.Results:1.A total of 256 patients with colon cancer were included,ranging in age from 23 to 87 years old,with an average of(64.1±12.1)years old,including 123 patients < 65 years old(48.0%)and 133 patients ≥65 years old(52.0%);Males and females were161 cases(62.9%)and 95 cases(37.1%);76 cases(29.7%)had a long history of smoking;96 patients(37.5%)with hypertension before operation;33 cases(12.9%)with diabetes before operation;148 cases(57.8%)were located on the left side and 108cases(42.2%)were located on the right side;73 patients(28.5%)had the largest tumor diameter < 5cm,and 93 patients(72.5%)had the largest tumor diameter ≥5cm;93cases(36.3%)had abnormal CEA.;50 cases(19.5%)were abnormal in CA199;139cases(54.3%)with anemia before operation;There were 13 cases(5.1%),23 cases(9.0%),16 cases(6.3%)and 204 cases(79.6%)of infiltration depth at T1,T2,T3 and T4,respectively;94 patients(36.7%)had lymph node metastasis;6 cases had a distant metastasis(2.3%).TNM staging for Ⅰ,Ⅱ,Ⅲ,Ⅳ period of 29 cases respectively(11.3%),132 cases(51.6%),89 cases(34.8%),6 cases(2.3%).2.There were statistical differences in tumor site(X~2= 17.273,P < 0.001),depth of tumor invasion(X~2= 17.367,P < 0.001),CEA(X~2=6.147,P=0.013),hemoglobin amount(X~2= 8.429,P= 0.004),TNM stage(X~2= 4.042,P= 0.044)between the high SII group and the low SII group.3.There were statistically significant differences in age(X~2= 6.514,P= 0.011),depth of tumor invasion(X~2= 12.312,P < 0.001),CEA(X~2=5.221,P=0.022),and preoperative hemoglobin(X~2= 8.441,P= 0.004)between the high and low PNI groups.4.The results of univariate analysis showed that age(X~2 =5.221,P=0.022),preoperative hemoglobin content(X~2=5.314,P=0.021),PNI(X~2=9.333,P =0.002),SII(X~2=4.761,P=0.029)were associated with an increased incidence of postoperative complications,and multivariate logistic analysis found that only PNI were independent risk factors for immediate postoperative complications(OR:2.301,95%CI: 1.079-4.905,P=0.031).5.Univariate Cox regression showed that age,CEA value,TNM stage,PNI value and SII value were correlated with the survival time of colon cancer patients in this group with statistical significance(P < 0.05).Multivariate analysis showed that TNM stage,PNI value and SII value were independent predictors of postoperative survival time of patients with colorectal cancer(P < 0.05).6.ROC curve analysis shows The AUC of SII 、 PNI and SII–PNI were0.626(95% confidence interval,0.548-0.704)0.622(95% confidence interval,0.545-0.698),0.707(95% confidence interval,0.550-0.667).Conclusion:1.PNI is an independent risk factor for immediate postoperative complications of colon cancer.2.SII and PNI are effective predictors of postoperative survival of colon cancer.3.The combined application of SII and PNI can effectively improve the prediction efficiency.