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中国癌症防治杂志

中国癌症防治杂志 ›› 2023, Vol. 15 ›› Issue (5): 543-548.doi: 10.3969/j.issn.1674-5671.2023.05.12

• 临床研究 • 上一篇    下一篇

炎症负荷指数在结直肠癌诊断和预后中的临床价值

  

  1. 西安医学院第一附属医院 消化内科，普通外科
  • 出版日期:2023-10-25 发布日期:2023-11-03
  • 通讯作者: 张明鑫 E-mail：zmx3115@163.com
  • 基金资助:
    陕西省重点研发计划（2023?YBSF?072）；陕西省卫生健康科研基金项目（2022E008）；西安市科协青年人才托举计划（095920221363）；西安医学创新团队（2021TD15）

The clinical value of inflammatory burden index in the diagnosis and prognosis of colorectal cancer

  • Online:2023-10-25 Published:2023-11-03

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摘要： 目的 探讨炎症负荷指数（inflammatory burden index，IBI）在结直肠癌诊断和预后中的临床价值。方法 选取西安医学院第一附属医院2017年1月到2022年1月经病理确诊的350例结直肠癌患者为研究对象，以同期与本院进行健康体检的350名健康人群作为对照组。采用受试者工作特征（receiver operating characteristic，ROC）曲线分析IBI在结直肠癌诊断和预后预测中的价值，单因素和多因素Cox回归分析IBI与结直肠癌临床指标及预后的关系，并建立列线图对生存率进行预测。结果 ROC曲线分析结果显示，IBI在诊断结直肠癌中具有统计学意义（Z=12.382，P<0.001），其ROC曲线下面积（area under the curve，AUC）为0.813（95%CI：0.774~0.848），最佳截断点为25.52。IBI在判断结直肠癌预后中同样具有统计学意义（Z=9.473，P<0.001），AUC为0.824（95%CI：0.771~0.869），最佳截断点为33.68。单因素Cox回归分析显示高IBI与术前高CEA以及更差的T分期和N分期相关（均P<0.05）。多因素Cox回归分析显示IBI>33.68是影响结直肠癌患者预后的独立危险因素（HR=3.576，95%CI：3.114~4.138）。列线图模型总体一致性指数（C⁃index）为0.849（95%CI：0.829~0.868，P<0.001），校准曲线显示其预测生存率与实际生存率具有良好一致性。结论 IBI>33.68是结直肠癌预后的独立危险因素，且IBI具有良好的诊断及预后预测价值，可能作为结直肠癌一种新型的生物标志物。

关键词:  , 结直肠癌；炎症负荷指数；诊断；预后

Abstract: Objective To investigate the clinical value of the inflammatory burden index (IBI) in the diagnosis and prognosis of colorectal cancer. Methods A total of 350 patients with colorectal cancer diagnosed pathologically in the First Affiliated Hospital of Xi'an Medical University from January 2017 to January 2022 were selected as the study subjects, and 350 healthy individuals who underwent physical examinations during the same period were selected as the control group. The receiver operating characteristic(ROC) was used to analyze the value of IBI in the diagnosis and prognosis prediction of colorectal cancer. Univariable and multivariable Cox regression models were used to analyze the associations of IBI and clinical indicators with prognosis of colorectal cancer. A nomogram was established to predict the survival rate. Results The ROC curve analysis showed that IBI was statistically significant in the diagnosis of colorectal cancer (Z=12.382, P<0.001). The area under the curve (AUC) was 0.813 (95%CI: 0.774-0.848), and the best cut⁃off point was 25.52. IBI was also statistically significant in predicting the prognosis of colorectal cancer (Z=9.473, P<0.001). The AUC was 0.824 (95%CI: 0.771-0.869), and the best cut⁃off point was 33.68. Univariable Cox regression analysis showed that higher IBI was correlated with higher preoperative CEA and worse T and N staging (P<0.05). Multivariable Cox regression analysis showed that IBI>33.68 was an independent risk factor affecting the prognosis of colorectal cancer patients(HR=3.576, 95%CI: 3.114-4.138). The overall C⁃index of the nomogram model was 0.849 (95%CI: 0.829-0.868, P<0.001). The calibration curve showed good consistency between the predicted survival rate and the actual survival rate. Conclusions IBI >33.68 is an independent prognostic risk factor for colorectal cancer. IBI has good diagnostic and prognostic value and may be a new biomarker for colorectal cancer.

Key words: Colorectal cancer, Inflammatory burden index, Diagnosis, Prognosis

中图分类号: 

  • R735.3