临床外科杂志 ›› 2025, Vol. 33 ›› Issue (10): 1086-1090.doi: 10.3969/j.issn.1005-6483.20241630

• 论著 • 上一篇    下一篇

炎症负荷指数在胃癌诊断和预后预测中的价值

妥进虎 沈亦敏 张乐 刘海鹏 陈晓   

  1. 730013 甘肃兰州,兰州大学第二临床医学院(妥进虎、沈亦敏、张乐);兰州大学第二医院普通外科(刘海鹏、陈晓)
  • 收稿日期:2024-10-11 出版日期:2025-11-11 发布日期:2025-11-11
  • 通讯作者: 陈晓,Email:chenxiaomd@163.com
  • 基金资助:
    甘肃省青年科技基金计划(21JR7RA424)

Diagnostic and prognostic value of the inflammatory load index in patients with gastric cancer

TUO Jinhu*,SHEN Yimin,ZHANG Le,LIU Haipeng,CHEN Xiao   

  1. *The Second Clinical Medical College,Lanzhou University,Lanzhou 730013,China
  • Received:2024-10-11 Online:2025-11-11 Published:2025-11-11

摘要: 目的 探讨炎症负荷指数(IBI)在胃癌诊断和预后预测中的价值。方法 回顾性分析2016年1月~2018年12月行胃癌手术病人的临床资料,依据IBI最佳截断值将病人分为高IBI组和低IBI组。采用受试者工作特征(ROC)曲线确定IBI的最佳截断值,采用Kaplan-Meier法构建生存曲线,组间差异比较采用Log-rank检验。采用Cox回归分析影响胃癌病人的预后因素。结果 IBI诊断最佳截断值为8.796,预后的最佳截断值为28.75。IBI与胃癌病人的手术入路、分化程度、组织角蛋白(CK)7、CK20、潜伏膜蛋白(LMP)-1、Ki-67有关(P<0.05)。单因素Cox回归分析结果显示,术中出血量、术前癌胚抗原(CEA)、术前糖类抗原(CA)125、术前CA19-9、IBI、肿瘤直径、切缘、脉管侵犯、神经侵犯、pT分期和pN分期是胃癌病人预后的影响因素(P<0.05)。多因素Cox回归分析结果显示,术中出血量、术前CEA、术前CA19-9、IBI、肿瘤直径、pT分期和pN期是胃癌病人预后不良的独立危险因素(P<0.05)。高IBI组和低IBI组病人的平均总生存时间分别为32.9个月和74.8个月,两组比较差异有统计学意义(P<0.001)。结论 IBI是胃癌病人预后不良的独立危险因素,在其诊断和预后预测中具有较高的价值。

关键词: 胃癌, 炎症负荷指数, 炎症, 预后

Abstract: Objective To explore the value of inflammatory load index(IBI) in the diagnosis and prognosis of gastric cancer patients.Methods Clinical data of patients who underwent gastric cancer surgery in the Department of General Surgery of the Second Hospital of Lanzhou University from January 2016 to December 2018 were retrospectively analyzed,and the patients were divided into the high IBI group and the low IBI group based on the optimal cut-off value of IBI.ROC curve was used to determine the optimal cut-off value of IBI,and the survival curve was constructed using the Kaplan-Meier method,and the differences between groups were examined using the Log-rank test.Cox regression analysis was performed to study the prognostic factors of gastric cancer patients.Results The best cut-off value for IBI diagnosis was 8.796,and the best cut-off value for prognosis was 28.75.IBI was related to the clinical case characteristics of gastric cancer patients,such as surgical access,the degree of differentiation,CK7,CK20,LMP-1,and Ki-67(P<0.05).The results of univariate analysis showed that intraoperative bleeding,preoperative CEA,preoperative CA125,preoperative CA199,IBI,tumor diameter size,margins of incision,vascular invasion,nerve invasion,pT stage and pN stagewere the influencing factors on the prognosis of gastric cancer patients(P<0.05) .The results of multifactorial regression analysis showed that intraoperative bleeding,preoperative CEA,preoperative CA199,IBI,tumor diameter size,pT stage and pN stagewere independent risk factors affecting the prognosis of gastric cancer patients(P<0.05) .The median OS of patients in the high IBI group and low IBI group were 32.9 months and 74.8 months,respectively,with statistically significant differences(P<0.001).Conclusion IBI is an independent risk factor for poor prognosis of patients with gastric cancer,and it has a good predictive value in diagnosis and prognosis.

Key words: gastric cancer, inflammatory load index, inflammation, prognosis

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