| 【Objective】Due to the close relationship between inflammation and tumor,this study aims to explore the correlation between preoperative comprehensive inflammatory indicators SII and SIRI and the mismatch repair status and prognosis of colorectal cancer,providing new ideas for clinical diagnosis,treatment,and prevention.【Methods】Retrospectively collect the basic clinical and pathological data of patients with colon cancer who underwent radical surgery at the Department of Gastrointestinal Surgery of the Second Affiliated Hospital of Guangzhou Medical University from January 1st,2018 to December 31 st,2020,including patient gender,age,tumor location,tumor diameter,and the latest blood routine indicators within 1 week before surgery.According to the preoperative blood routine counts of the enrolled patients,the preoperative inflammatory indicators SII and SIRI values were respectively calculated,and the optimal cut-off values of preoperative inflammatory indicators SII and SIRI were determined based on the ROC curve.The patients were then divided into high and low inflammatory indicator groups according to the optimal cut-off values of each inflammatory indicator.Firstly,the correlation between MMR and clinical,pathological,and inflammatory indicators was analyzed.Secondly,the clinical and pathological data of each high and low inflammatory indicator group were compared and analyzed separately.Then,all clinical and pathological data and inflammatory indicators were subjected to univariate Cox regression analysis related to prognosis,and the significant clinical indicators were further included in the multivariate Cox analysis to determine the factors that affect the prognosis of colorectal cancer patients.Finally,Kaplan-Meier method was used to perform survival analysis on the high and low inflammatory indicator groups,and the intergroup survival differences were compared and verified using the Log-rank test.【Results】1.According to the inclusion and exclusion criteria,392 patients with colorectal cancer who underwent radical surgery were eventually included in this study,Among them,163 were female and 229 male;131 cases were aged<60 years,261 cases were aged ≥ 60 years;The tumors were located in the right colon in 135 cases,in the left colon in 111 cases,and in the rectum in 146 cases;221 cases had tumor diameter<5cm,146 cases had tumor diameter ≥ 5cm;The general classification of the tumor was as follows: 126 cases of protuberant type,175 cases of ulcerative type,and91 cases of annular narrow type;The degree of differentiation of tumor tissue was low differentiation in 39 cases,medium differentiation in 270 cases,and high differentiation in 83 cases;There were 296 cases without nerve invasion and 96 cases with nerve invasion;There were 335 cases without vascular invasion and 57 cases with vascular invasion;There were 252 cases without vascular cancer thrombus and140 cases with vascular cancer thrombus;76 cases in T1-2 stage,316 cases in T3-4stage;There were 210 patients in N0 stage and 182 patients in N1-2 stage;The TNM staging of tumors was stage I in 57 cases,stage II in 149 cases,and stage III in 186cases;242 cases had normal CEA and 150 cases had abnormal CEA;There were 350 cases of pMMR and 42 cases of dMMR.2.There were statistically significant differences(P < 0.05)between the dMMR and pMMR groups in terms of gender,tumor location,tumor diameter,tumor tissue differentiation,SII,and SIRI.3.There were statistically significant differences(P < 0.05)in tumor location,tumor diameter,tumor macroscopic type,tumor tissue differentiation,tumor T stage,tumor TNM stage,and abnormal CEA levels between the high and low SII groups.There were statistically significant differences(P < 0.05)in gender,tumor location,tumor diameter,tumor macroscopic type,tumor T stage,and tumor TNM stage between the high and low SIRI groups.4.A univariate COX regression analysis of the prognosis of colorectal cancer patients showed that age,tumor gross classification,presence or absence of neurological invasion,tumor N stage,tumor TNM stage,and preoperative inflammatory index SII were related factors for OS prognosis in colorectal cancer patients(P<0.05).Multivariate COX regression analysis showed that age(P=0.026),tumor TNM stage(P=0.047),and preoperative inflammatory index SII(P=0.024)were independent prognostic factors for OS in colorectal cancer patients.5.The Kaplan-Meier survival analysis and Log-rank test were used to analyze the differences between groups for preoperative inflammatory indicators,MMR status,and TNM stage,respectively.The results showed that the overall 3-year survival rate was 89%;The 3-year survival rate of patients with low SII was higher than that of patients with high SII(P=0.008);In TNM staging,the 3-year survival rate in the stage I and stage II groups was higher than that in the stage III group(P=0.004)【Conclusions】1.SII and SIRI are closely associated with the clinical and pathological features of colorectal cancer.2.Inflammatory indicators are associated with MMR status,with dMMR being more common in the high SII group and high SIRI group of colorectal cancer patients.3.The inflammatory indicator SII was associated with colorectal cancer prognosis,and colorectal cancer patients in the low SII group had a better prognosis. |
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