纤维蛋白原与白蛋白比值、预后营养指数、系统性免疫炎症指数与肺癌胸腔镜肺叶切除术病人预后关系的研究

doi:10.3969/j.issn.1005-6483.20241362

摘要/Abstract

摘要： 目的探究纤维蛋白原与白蛋白比值(FAR)、预后营养指数(PNI)、系统性免疫炎症指数(SII)与肺癌胸腔镜肺叶切除术病人预后的关系。方法 2018年2月～2020年2月行胸腔镜肺叶切除术的肺癌病人287例，术前1周内测定FAR、PNI、SII，随访术后3年生存情况。分析病人临床资料、术前FAR、PNI、SII与术后3年预后的关系；采用受试者工作特征(ROC)曲线确定术前FAR、PNI、SII预测术后3年预后的最佳截断值，观察单一指标及各指标联合预测预后价值；采用多因素Logistic回归分析评价病人预后的影响因素；采用Pearson相关分析探讨病人FAR、PNI、SII之间相关性。结果最终纳入肺癌病人242例，术后3年生存199例，总生存率为82.23%；3年死亡43例(17.77%)。年龄、血清癌胚抗原(CEA)水平、淋巴结转移、TNM分期、术前FAR、PNI、SII与肺癌病人胸腔镜肺叶切除术后3年预后有关(P<0.05)。绘制ROC曲线显示，术前FAR、PNI、SII对病人术后3年预后均有一定预测价值，3者联合预测显示出更好的预测效能，曲线下面积(AUC)为0.772。多因素Logistic回归分析显示，淋巴结转移、TNM分期、FAR、SII为病人术后预后的独立危险因素，PNI为独立保护因素(P<0.05)。Pearson相关分析显示，肺癌病人术前FAR与PNI、PNI与SII呈负相关，FAR与SII呈正相关(P<0.05)。结论 FAR、PNI、SII与肺癌胸腔镜肺叶切除术病人预后独立相关，联合应用预测预后价值更高。

关键词: 纤维蛋白原与白蛋白比值, 预后营养指数, 系统性免疫炎症指数, 肺癌, 胸腔镜手术, 预后

Abstract: Objective To explore the relationship between fibrinogen to albumin ratio (FAR),prognostic nutritional index (PNI),systemic immune inflammation index (SII) and prognosis of patients with lung cancer undergoing thoracoscopic surgery.Methods The clinical data of 287 patients with lung cancer who underwent thoracoscopic lobectomy in the hospital from February 2018 to February 2020 were retrospectively collected.The FAR,PNI,and SII values were measured within one week before surgery.The 3-year survival after operation was counted.The relationship between clinical data,preoperative FAR,PNI,SII and 3-year survival prognosis was observed.The receiver operating characteristic curve (ROC) was used to determine the optimal cut-off values of preoperative FAR,PNI,and SII values for predicting the 3-year survival prognosis after surgery,and the prognostic value of single index and combination of each index was observed.Multivariate Logistic regression analysis was used to evaluate the influencing factors of prognosis.Pearson correlation analysis was used to explore the correlation between FAR,PNI and SII values.Results Finally,242 patients with lung cancer were included in the study,and 199 patients survived 3 years after operation,with an overall survival rate of 82.23 %.43 cases (17.77 %) died in 3 years.Age,serum carcinoembryonic antigen (CEA) level,lymph node metastasis,TNM stage,preoperative FAR,PNI and SII value were related to the 3-year survival prognosis of lung cancer patients after thoracoscopic lobectomy (P<0.05).The ROC curve showed that the preoperative FAR,PNI and SII values had certain predictive value for the 3-year survival prognosis of patients after operation.The combined prediction of the three showed better predictive efficacy,and the area under the curve (AUC) was 0.772.Multivariate Logistic regression analysis showed that lymph node metastasis,TNM stage,FAR value and SII value were independent risk factors for postoperative survival and prognosis.PNI was an independent protective factor (P<0.05).Pearson correlation analysis showed that there was a negative correlation between FAR and PNI,PNI and SII,and a positive correlation between FAR and SII (P<0.05).Conclusion The values of FAR,PNI and SII are independently related to the prognosis of patients with lung cancer undergoing thoracoscopic surgery.The combined application has a higher prognostic value.

Key words: fibrinogen to albumin ratio, prognostic nutrition index, systemic immune inflammation index, lung cancer, thoracoscopic surgery, prognosis

牛磊霍承瑜刘宗志. 纤维蛋白原与白蛋白比值、预后营养指数、系统性免疫炎症指数与肺癌胸腔镜肺叶切除术病人预后关系的研究[J]. 临床外科杂志, 2025, 33(7): 708-.

NIU Lei, HUO Chengyu, LIU Zongzhi. The relationship between fibrinogen to albumin ratio,PNI,SII index and prognosis of patients with lung cancer undergoing thoracoscopic surgery[J]. JOURNAL OF CLINICAL SURGERY, 2025, 33(7): 708-.

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