Predictive Value Of Systemic Inflammatory Response Index For Clinicopathological Characteristics And Cellular Immune Function In Patients With Adenocarcinoma Of The Esophagogastric Junction

Objective:1.To evaluate the predictive value of the systemic inflammatory response index in patients with adenocarcinoma of the esophagogastric junction for AJCC staging;2.To evaluate the predictive value of the systemic inflammatory response index in patients with adenocarcinoma of the esophagogastric junction on clinicopathological characteristics;3.To evaluate the predictive value of the systemic inflammatory response index in patients with adenocarcinoma of the esophagogastric junction on cellular immune function.Methods:A retrospective analysis was performed in Shanxi Cancer Hospital from January 1,2020 to December 31,2020,and the diagnosis was confirmed by gastroscopy +pathological examination as esophagogastric junction adenocarcinoma(Siewert type Ⅰ,Ⅱ,Ⅲ),preoperative experiments There were 131 patients undergoing radical resection of adenocarcinoma of the esophagogastric junction with complete laboratory data.Collect the number of neutrophils,platelets,lymphocytes and monocytes in blood cell analysis within 1 week before surgery.Collect the patient’s gender,age,smoking history,drinking history and other general information,collect the degree of tissue differentiation,tumor size,T staging,N staging,M staging,AJCC staging and other tumor clinicopathological characteristics,and collect total T cell levels and helper T cells Level,cytotoxic T cell level,double positive cell level,helper T cell/cytotoxic T cell ratio,natural killer cell level,natural killer T cell level,regulatory T cell level,and tumor immune-related factors,including soluble interleukins 2 Receptors and malignant tumor-specific growth factors and other immune function-related indicators.The NLR,MLR,PLR and SIRI values of 131 patients were calculated according to the formula.According to the ROC curve,the best cut-off values of NLR,MLR,PLR and SIRI are obtained.According to the best cut-off values of NLR,MLR,PLR and SIRI,patients were divided into high-inflammatory group and low-inflammatory group.Measurement data are expressed as mean ± standard deviation(?x±s),and t-test is used for comparison;count data is expressed as constituent ratio,and χ2 test is used for comparison.P<0.05 indicates that the difference is statistically significant.Results:A total of 131 cases were included in the sample,of which 107 were males and 24 were females;the number of patients ≤60 years old was 51,and the number of patients over 60 years old was 80.The number of smokers was 65,and the number of non-smokers was 66.The number of patients who drink alcohol is 29 cases,and the number of patients who do not drink alcohol is 102 cases.The differences in NLR,MLR,PLR and SIRI values of general data group comparison were not significant(P<0.05).According to the ROC curve,the best cut-off values of NLR,MLR,PLR and SIRI were 2.46,0.25,133 and 1.11.According to the best cut-off value of each inflammation index,it is divided into NLR≤2.46(low group)and NLR>2.46(high group),MLR≤0.25(low group)and MLR>0.25(high group),PLR≤133(low group)and PLR>133(high group),SIRI≤1.11(low group)and SIRI>1.11(high group).In the SIRI group,the difference in tumor size,T stage,N stage,and AJCC stage is significant(P<0.05).In the NLR group,the differences in the degree of differentiation,T stage,and M stage were significant(P<0.05).In the MLR and PLR groupings,the differences in the indicators were meaningless(P>0.05).When using NLR,MLR,PLR and SIRI to predict the clinicopathological characteristics of AEG patients,when the state variable is tumor size,the area under the curve of NLR,MLR,PLR and SIRI are 0.551,0.566,0.555 and 0.597,respectively.Compared with other inflammatory indicators,SIRI has the largest area under the curve(AUC).When the state variable is AJCC staging,the AUC of NLR,MLR,PLR and SIRI are 0.559,0.618,0.581 and 0.620,respectively.Compared with other inflammatory indexes,the AUC of SIRI is the largest.The results of statistical analysis of inflammatory index evaluate preoperative immune function showed that the levels of natural killer T cells,regulatory T cells,and malignant tumor-specific growth factors between the low SIRI group and the high SIRI group were statistically significant(P<0.05).The differences in the levels of natural killer T cells,double-positive cells,and malignant tumor-specific growth factors between the low MLR group and the high MLR group were statistically significant(P<0.05).Conclusion:1.Compared with the NLR,PLR,and MLR,the preoperative SIRI value can better assess the size of the tumor in AEG patients and the AJCC staging of the tumor.2.The level of SIRI before operation is significantly related to the tumor size,T stage,N stage,and AJCC stage of AEG patients.3.Preoperative SIRI>1.11 indicates that the immune status of AEG patients is low and there is the possibility of early metastasis.Therefore,SIRI is a simple,convenient,reliable,and low-cost detection index that can reflect the cellular immune function of AEG patients,and it can be combined with other inflammatory indicators to better evaluate the immune level of the body.