| Objective:To explore the prognostic value of Systemic Immune Inflammation Inde x(SII),Neutrophil-Lymphocytes Ratio(NLR),Platelet-Lymphocyte Ratio(PLR)and Ly mphocyte-Monocyte Ratio(LMR)in patients with ⅠA2~ⅡA2 cervical cancer.Methods: Clinical data of 196 patients who were initially diagnosed with stage ⅠA2~ⅡA2 cervical cancer and underwent radical resection of cervical cancer in the First Affiliated Hospital of Bengbu Medical College from May 2012 to December 2014 were included.Clinical case data of 200 patients with high-grade cervical intraepithelial lesions who underwent conical cervical resection in our hospital during the same period;The physical examination results of 200 women in the physical examination center of our hospital during the same period were generally normal.Fastfasting routine blood results of all subjects were collected one week before surgery or on the day of physical examination.Neutrophil count(N),Lymphocyte count(L),Monocyte count(M)and Platelet count(P)were recorded.NLR,PLR,LMR and SII values were calculated according to the formula.Firstly,the differences of SII,NLR,PLR and LMR among the three groups of cervical cancer patients,patients with high-grade cervical intraepithelial lesions and healthy subjects were investigated.The indicators with statistical significance were analyzed to determine their cut-off values and evaluate their diagnostic validity.Then,the Cut-off values of NLR,PLR,LMR and SII in 196 cervical cancer patients were analyzed and divided into corresponding high and low value groups.The relationship between the high and low values of four indexes and clinicopathological parameters was observed.The difference of survival time(OS)between high and low value groups was compared.Univariate and multivariate analyses were performed on the factors affecting the prognosis,and the prediction validity of independent risk factors was tested,and a histogram was established for predicting the prognosis.Results:1.NLR(3.38±2.847),PLR(139.65±55.861)and SII(822.45±671.977)in tumor group were significantly higher than those in pre-cancer and healthy group,and LMR(4.37±1.988)were significantly lower than those in pre-cancer and healthy group,with statistical significance(P < 0.05).2.SII,NLR,PLR and LMR showed statistically significant differences between cervical cancer patients and non-cervical cancer patients(P < 0.05),which were not applicable to precancerous lesions and healthy people.3.Assisted diagnostic validity of four inflammatory indicators: When SII(Cut-Off=660.33,AUC=72.9%,95%CI :[0.6799-0.778],OR=5.44)and NLR(Cut-Off =1.68,AUC=0.712,95%CI :[0.661-0.763],OR=4.27)the diagnostic value was reliable,P <0.05;PLR(when Cut-off=119.87,AUC=0.654)and LMR(when Cut-off=4.10,AUC=0.336)had lower diagnostic validity.4.NLR was correlated with histological type and lymphatic vascular interstitial infiltration(LVSI),PLR was correlated with histological type and tumor size,and SII was correlated with histological type,with statistical significance(P < 0.05).5.The OS in the high NLR,PLR and SII groups and the low LMR groups were shorter,with statistical significance(P < 0.05).6.PLR,SII,histological type and lymph node metastasis were independent risk factors affecting postoperative survival time(P < 0.05);Predictive validity: Histological types of PLR > SII > lymph node metastases(AUC: 73.2% >,71.9% >,65.1% >,37%).7.The prognosis prediction accuracy of the histogram was high(OS3-year/OS5-year AUC:90.7%/79.1%).Conclusion:1.SII and NLR in peripheral blood of patients with stage ⅠA2 ~ ⅡA2 cervical cancer before treatment have certain diagnostic value,and SII is superior to NLR.2.PLR and SII values of patients with stage ⅠA2-ⅡA2 cervical cancer before treatment can be used as reliable prognostic indexes before surgery. |
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