| Objective:The systemic immunoinflammatory index(SII)and prognostic nutrition index(PNI),which are calculated by peripheral blood immunoinflammatory cell count,are considered to be predictors of survival outcomes of several solid tumors,including gastric cancer.However,there has been no study on the prognostic value of SII and PNI in patients with resectable gastric cancer at multiple time points.The purpose of this study was to simultaneously analyze the predictive ability of perioperative multi-time point immunoinflammatory index and prognostic nutritional index,and further verify the prognostic value of SII and PNI in overall postoperative survival(OS)of stage I-III GC patients.Methods: 208 patients with non-stage IV GC after radical surgery were retrospectively analyzed.Routine blood and biochemical parameters were collected,SII was calculated based on neutrophil(N),platelet(P)and lymphocyte(L)counts,and PNI was calculated based on albumin(ALB)and lymphocyte counts.Clinicopathologic features were collected,including gender,age,smoking,drinking history,tumor site,pathological type,lymph node metastasis,tumor size,surgical method,gastrectomy,neurovascular infiltration,and TNM stage.X-tile software was used to determine the optimal cutoff value for each blood parameter.The indexes that could generate meaningful optimal truncation value were calculated and selected as preoperative SII579.00(P <0.001),preoperative PNI43.42(P=0.0309),postoperative day PNI34.76(P=0.0078),postoperative day 7 PNI37.28(P=0.0224),respectively.Based on this,the corresponding index is divided into two groups.Results:1.The survival analysis of patients with gastric cancer by SII index showed that the survival of patients with gastric cancer whose preoperative SII≤579 was better than that of patients with SII > 579.2.The survival analysis of patients with gastric cancer showed that preoperative PNI≥43.42 was better than preoperative PNI <43.42.The survival rate of gastric cancer patients with PNI≥34.76 on the first day after surgery was better than that of those with PNI < 34.76 before surgery.The survival rate of gastric cancer patients with PNI≥37.28 on the 7th day after surgery was better than that of those with PNI < 37.28 on the 7th day after surgery.3.It can be concluded from the results of COX univariate analysis that preoperative SII,preoperative PNI,postoperative day 1 and postoperative day 7 are independent prognostic factors in the univariate Cox analysis,P<0.05.4.COX multivariate analysis showed that preoperative SII and PNI on the 7th day after surgery were still independent.Conclusions: 1.SII and PNI are independent prognostic factors for the prognosis of gastric cancer.The prognosis of gastric cancer patients with high 2.SII and low PNI was worse. |
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