Effect of preoperative systemic immune inflammation index on the prognosis of postoperative gastric cancer patients / 中华普通外科杂志

ABSTRACT

Objective To study the relationship between preoperative systemic immune inflammatory index (SII) and the prognosis of postoperative patients. Methods A retrospective analysis was made on 1 509 patients with gastric cancer who underwent gastric cancer surgery at the Department of Gastrointestinal Surgery,Affiliated Tumor Hospital of Harbin Medical University from Jan 1991 to Dec 2012.The SII values [SII =(platelets x neutrophils) / lymphocytes] were calculated and grouped according to the SII mean.The relationship between SII and clinical factors was analyzed.Results Preoperative mean SII was 570.5,substratified into SII ＜ 570.5 group (871 cases),and SII ＞ 570.5 group (638 cases).There was a statistically significant difference between SII level and gender(x2 =4.239,P =0.040),tumor maximum diameter(x2 =31.852,P ＜ 0.001),total serum protein (x2 =7.962,P =0.005),Alb/Glob ratio(x2 =26.127,P＜ 0.001) and Hb(x2 =64.647,P＜ 0.001).The 1-,3-,and 5-year survival rates were 77.1％,42.4％,31.4％ and 68.9％,28.1％,19.8％,respectively(x2 =39.557,P ＜ 0.001).Multivariate analysis showed that tumor TNM stage (HR =1.592,95％ CI1.401-1.809,P ＜ 0.001),infiltration depth(HR =1.256,95％ CI1.145-1.377,P ＜ 0.001),lymph node metastasis(HR =1.177,95 ％ CI1.042-1.329,P =0.009),tumor maximum diameter (HR =1.151,95 ％ CI1.006-1.317,P =0.040),Hb(HR =0.832,95％ CI0.737-0.940,P =0.003) and SII (HR =1.337,95％ CI1.187-1.505,P ＜ 0.001) were independent risk factors for the prognosis of patients with gastric cancer.Conclusions SII is an independent risk factor for the prognosis of patients with gastric cancer.Preoperative SII ＞ 570.5 indicates poor prognosis.