术前全身炎症反应指数和纤维蛋白原在肾癌切除术后肿瘤预后的影响

韩雪阳; 高瞻; 刘勇

doi:10.13201/j.issn.1001-1420.2021.07.012

术前全身炎症反应指数和纤维蛋白原在肾癌切除术后肿瘤预后的影响

- 青岛大学医学部青岛大学附属医院泌尿外科(山东青岛, 266000)

详细信息

通讯作者: 刘勇,E-mail:qyfyliuy@163.com

中图分类号: R737.11

收稿日期: 2020-11-20

Effect of preoperative systemic inflammatory response index and fibrinogen on tumor prognosis after nephrectomy

- Department of Urology, Qingdao University Medical College, Affiliated Hospital of Qingdao University, Qingdao, Shandong, 266000, China

More Information

Corresponding author: LIU Yong, E-mail: qyfyliuy@163.com

Received Date: 20 November 2020

摘要

摘要: 目的:探讨肾癌患者术前全身炎症反应指数(systemic inflammation response index,SIRI)和纤维蛋白原(fibrinogen,FIB)在预后评估中的临床价值。方法:回顾性分析2011年1月—2014年12月我院收治肾癌患者的临床及术后随访资料;采用受试者工作曲线(ROC)确定SIRI和FIB的最佳临界值。分析低SIRI组与高SIRI组和低FIB组与高FIB组临床特征间的差异;运用Kaplan-Meier法计算生存率,通过log-rank检验比较组间的生存率差异;通过Cox比例风险回归模型分析影响肾癌预后的影响因素。采用所有5年生存率的独立预后指标,包括Fuhrman分级,SIRI值,FIB值建立列线图,预测患者5年生存率。结果:本研究共收集188例肾癌患者,ROC曲线确定SIRI和FIB的最佳临界值分别为1.81和3.42 g/L,分为高SIR组、低SIRI组,高FIB组、低FIB组。术前SIRI水平与组间患者肿瘤大小、TNM分期、Fuhrman分级、淋巴结转移、高血压病史密切相关(P＜0.05);术前FIB水平与组间患者年龄、TNM分期、Fuhrman分级、淋巴结转移、有无高血压密切相关(P＜0.05)。Cox多因素回归分析结果显示,SIRI＞1.81、FIB＞3.42 g/L、Fuhrman分级是影响肾癌预后的独立危险因素。列线图结果发现可以预测患者术后5年生存率。结论:高SIRI和FIB是影响肾癌预后不良的独立危险因素,对预测患者术后生存状况有积极的作用。
- 肾癌 /
- 全身炎症反应指数 /
- 纤维蛋白原 /
- 预后
Abstract: Objective: To investigate the clinical prognosis value of preoperative systemic inflammation response index(SIRI) and fibrinogen(FIB) in renal cell carcinoma patients.Methods: The clinical and postoperative follow-up data of renal cell carcinoma patients admitted to our hospital from January 2011 to December 2014 were retrospectively analyzed. The receiver operating curve(ROC) was used to determine the optimal cut-off values for SIRI and FIB. The difference between the clinical characteristics of the low SIRI group and the high SIRI group and the low FIB group and the high FIB group were analyzed. The Kaplan-Meier method was used to calculate the survival rate. The Log-rank test was used to compare the survival rate difference between the groups. The Cox proportional hazards regression model was used to determine the prognostic factors of renal cell carcinoma. All five-year survrial rate independent prognostic indicators including Fuhrman rating, SIRI value and FIB value were used to establish a nomograph to predict patient survival.Results: A total of 188 renal cancer patients were collected in this study. The ROC curve determined that the optimal critical values of SIRI and FIB were 1.81 and 3.42 g/L, respectively, and they were divided into the high SIRI group, the low SIRI group, the high FIB group, and the low FIB group. Preoperative SIRI level was closely correlated with tumor size, TNM grading, Fuhrman grading, lymph node metastasis, and history of hypertension(P＜0.05). Preoperative FIB level was closely correlated with age, TNM grading, Fuhrman grading, lymph node metastasis, and hypertension(P＜0.05). Cox multivariate regression analysis showed that SIRI＞1.81, FIB＞3.42 g/L and Fuhrman classification were independent risk factors affecting the prognosis of renal cancer. The results of the nomogram showed that the 5-year postoperative survival rate could be predicted.Conclusion: High SIRI and FIB are independent risk factors for poor prognosis of renal carcinoma. It has positive effect on predicting postoperative survival of patients.
- renal cancer /
- systemic inflammatory response index /
- fibrinogen /
- prognosis

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