Correlation Analysis Between Preoperative SIRI-FAR Score And Prognosis Of Patients With Esophageal Squamous Cell Carcinoma

Objective:To explore the relationship between preoperative systemic inflammatory response index(SIRI)and fibrinogen to albmin ratio(FAR)combined score(SIRI-FAR)and esophageal squamous cell carcinoma(esophageal squamous cell carcinoma,ESCC)patients’ prognosis,and established a nomogram model to predict the prognosis of patients with esophageal squamous cell carcinoma after surgery.Methods:The patients who underwent radical resection of esophageal squamous cell carcinoma who were treated in our hospital from 2015 to 2018 were retrospectively analyzed.The general information and clinicopathological data of the patients were collected.The ROC curve was used to determine the cut-off values?of SIRI and FAR to determine the value of SIRI-FAR.The best cut-off value was used and grouped,the count data was expressed by the number of cases or percentage(%),and the χ2 test or Fisher’s exact test was used for comparison between groups.Using the multivariate logistic regression equation,based on the multivariate analysis results,the Nomogram prediction model was established with the rms installation package in the R 4.1.2 software to predict the 3-year survival rate of the patients.P<0.05 was considered statistically significant.Results:1.A total of 139 patients with esophageal squamous cell carcinoma were included,including 125 males(89.93%)and 14 females(10.07%).Through the ROC curve,the best cut-off values of SIRI and FAR were determined to be 1.39 and 0.09,respectively.According to the best cut-off value,they were divided into 3 groups: 61 patients in SIRI-FAR score group 0(SIRI<1.39 and FAR<0.09);45 patients in SIRI-FAR score 1group(SIRI ≥ 1.39,FAR<0.09,or FAR ≥ 0.09,SIRI<1.39);SIRI-FAR score 2 groups of 33 cases(SIRI≥1.39 and FAR≥0.09).2.Grouped according to SIRI-FAR score,comparison between groups showed that SIRI-FAR score was related to tumor lesion length,TNM stage,lymph node metastasis and tissue differentiation(all P<0.05).Logistic regression analysis showed that lymph node metastasis,postoperative adjuvant therapy,degree of differentiation,and SIRI-FAR score 2 grouping were independent risk factors affecting the prognosis of patients with ESCC.KM survival analysis showed that the 3-year overall survival rate of the high SIRI-FAR score group was lower than that of the low group(P<0.05).3.Incorporate the factors obtained from the logistic multi-factor regression equation into the nomogram model.Through the establishment of the calibration curve,it can be seen that the predicted value in the model is basically consistent with the actual observed value,which shows that the prediction performance of this model is better.Based on this,the ROC curve of the nomogram model was drawn,and the area under the curve was0.895(P<0.001,95% CI: 0.811-0.980),suggesting that the model had a good discrimination.Conclusion:The preoperative SIRI-FAR score plays a positive role in predicting the prognosis of patients with esophageal squamous cell carcinoma.The higher the preoperative SIRI-FAR score,the poorer the prognosis.The nomogram model established in this way has a good degree of discrimination and calibration,and provides a reference for clinical diagnosis and individualized treatment.