The Role Of Systemic Immune-inflammatory Index And Prognostic Nutritional Index In The Prognosis Of Oral Squamous Cell Carcinoma: A Correlation Study

Objective:To analyze the correlation between systemic immune-inflammatory index(SII),prognostic nutritional index(PNI)and clinicopathologic characteristics of patients with oral squamous cell carcinoma.To study the relationship between prognostic nutritional index(PNI),systemic immune-inflammatory index(SII)and postoperative survival time in patients with oral squamous cell carcinoma after the first radical surgical treatment.To investigate and compare the effect of the two indexes in predicting the prognosis of oral squamous cell carcinoma,and further study the predictive value of the combination of the two.Methods:The study retrospectively collected and analyzed the clinical data of patients who received radical surgery in the Department of Stomatology of Northern Jiangsu People’s Hospital from 2015 to 2017 and were diagnosed as squamous cell carcinoma by routine pathology after surgery.Finally,the data of 108 patients with oral squamous cell carcinoma were collected.Data collected include general clinical data:age,sex,contact person,contact number,operation time,weight,height,and past medical history;Relevant blood data in the near term before operation:neutrophils,platelets,lymphocytes,serum albumin count;Tumor related data:Primary focus site,degree of tumor differentiation,T stage,lymph node metastasis,TNM stage.After data collection,SPSS25.0 software was used for statistical analysis.Receiver operating characteristic curves(ROC curves)were plotted,Youden index was calculated to determine the best cutoff values of the two indicators,and patients were divided into high-value and low-value groups.The correlation between SII,PNI and clinicopathological features was compared by chi-square test,corrected chi-square test or Fisher exact probability method.Hazard analysis used Cox proportional hazards regression models for univariate analysis of clinicopathological characteristics,followed by multivariate analysis of clinicopathological characteristic variables with significant associations.Kaplan-Meier survival analysis was used to plot the survival curves of SII and PNI groups,and log-rank test was applied to analyze the difference in survival time between the two groups.Finally,by comparing the size of the area under the ROC curve(AUC)of SII,PNI and SII-PNI,we can compare their ability to evaluate the prognosis of patients with oral squamous cell carcinoma.P<0.05,indicating a statistical difference.Result:1.There were statistical differences in Gender(χ~2=4.060,P=0.044)、T stage(χ~2=4.224,P=0.04)、TNM stage(χ~2=4.200,P=0.04)between the high SII group and the low SII group.However,there were significant differences in Gender(χ~2=4.615,P=0.032)、lymph node metastasis(χ~2=4.303,P=0.038)between the high PNI group and the low PNI group.2.Univariate Cox regression analysis showed that age(P=0.033)、BMI(P=0.037)、lymph node metastasis(P=0.046)、SII(P=0.002)and PNI(P<0.001)were risk factors for the prognosis of oral squamous cell carcinoma,further,multivariate COX regression analysis showed that age(P=0.039)、SII(P=0.048)and PNI(P<0.001)were independent prognostic factors of oral squamous cell carcinoma.3.Using Kaplan-Meier analysis,the survival rate of patients with oral squamous cell carcinoma in low SII group was better than that in high SII group,P=0.001.The survival rate of patients with oral squamous cell carcinoma in high PNI group was significantly higher than that in low PNI group,P<0.001.4.ROC curve analysis showed that the AUC of PNI,SII,and SII-PNI were0.773(95%CI,0.676-0.870)、0.678(95%CI,0.572-0.784)、0.793(95%CI,0.699-0.886)Conclusion:1.SII and PNI were independent predictors of oral squamous-cell carcinoma.2.Higher SII and lower PNI are risk factors for poorer outcomes in squamous-cell carcinoma patients.3.The combined application of SII and PNI can improve the prediction efficiency.