系统免疫炎症指数在早期结直肠癌及癌前病变筛查中的应用价值

doi:10.3969/j.issn.1006-7795.2022.05.015

首都医科大学学报 ›› 2022, Vol. 43 ›› Issue (5): 760-766.doi: 10.3969/j.issn.1006-7795.2022.05.015

系统免疫炎症指数在早期结直肠癌及癌前病变筛查中的应用价值

王芸¹, 李文坤², 苏珈仪², 王亚丹³, 吴静^2,3*

1.首都医科大学附属北京友谊医院医疗保健中心,北京 100050;
2.首都医科大学附属北京友谊医院消化内科国家消化系统疾病临床医学研究中心,北京 100050;
3.首都医科大学附属北京世纪坛医院消化内科,北京 100038

收稿日期:2022-05-17 出版日期:2022-10-21 发布日期:2022-10-25
基金资助:
首都卫生发展科研专项项目(首发2022-2-2025),首都临床诊疗技术研究及转化应用(Z211100002921028),首都医科大学附属北京友谊医院博士生导师专项计划项目(YYDSZX201901)。

Application value of systemic immune-inflammation index in the screening of early colorectal cancer and precancerous lesions

Wang Yun¹, Li Wenkun², Su Jiayi², Wang Yadan³, Wu Jing^2,3*

1. Health Care Center,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China;
2. Department of Gastroenterology,Beijing Friendship Hospital,Capital Medical University,National Clinical Research Center for Digestive Diseases,Beijing Digestive Disease Center, Beijing 100050,China;
3. Department of Gastroenterology,Beijing Shijitan Hospital,Capital Medical University, Beijing 100038,China

Received:2022-05-17 Online:2022-10-21 Published:2022-10-25
Contact: * E-mail:wujing36youyi@ccmu.edu.cn
Supported by:
Capital Health Development Scientific Research Project (2022-2-2025), Research and Application of Clinical Diagnosis and Treatment Technology in Capital (Z211100002921028), Special Scientific Research Fund for Tutor (YYDSZX201901).

摘要/Abstract

摘要： 目的本研究探讨不同炎症指标在早期结直肠癌及癌前病变诊断中的应用价值。方法收集2008年2月至2020年12月在首都医科大学附属北京世纪坛医院消化内镜中心诊断为早期结直肠癌及癌前病变,并完成病变治疗患者的一般资料、实验室检查结果、结肠镜检查结果和其他临床资料,分析炎症指标与早期结直肠癌及癌前病变临床病理特征的相关性。结果单因素分析结果显示,吸烟史(P =0.006)、病变部位(P =0.000)、病变大小(P =0.000)、病变数目(P =0.004)、病变治疗方式(P =0.000)、中性粒细胞计数(P =0.000)、中性粒细胞－淋巴细胞比值(neutrophil-to-lymphocyte ratio, NLR)(P =0.000)、系统免疫炎症指数(systemic immune-inflammation index, SII)(P =0.001)与早期结直肠癌和结直肠癌前病变的病理性质相关。多因素Logistic回归分析结果显示,高脂血症病史(P =0.009)、病变部位(P =0.000)、病变大小(P =0.000)、病变数目(P =0.024)、SII(P =0.004)是早期结直肠癌和结直肠癌前病变病理性质的独立影响因素。SII区分两组患者的受试者工作特征(receiver operating characteristic,ROC)曲线下面积为0.643(95% CI: 0.560 ～ 0.725,P =0.001);当SII为500.27时,其诊断早期结直肠癌的灵敏度为54.9%,特异度为70.7%,但诊断结果与病理结果的一致性较差(Kappa < 0.40)。结论 SII用于早期结直肠癌及癌前病变的筛查,可能有助于内镜医师在行结肠镜时初步判断病变的病理性质。

关键词: 早期结直肠癌, 结直肠癌前病变, 炎症指标, 系统免疫炎症指数

Abstract: Objective To explore the application value of different inflammatory markers in the diagnosis of early colorectal cancer and precancerous lesions. Methods We collected the general data, laboratory examination results, colonoscopy results and other clinical medical records of patients with early colorectal cancer and precancerous lesions in the digestive endoscopy center of our unit from February 2008 to January 2019, and analyzed the correlation between inflammatory markers and clinicopathological characteristics of early colorectal cancer and precancerous lesions. Results The univariate analysis showed that smoking history(P =0.006), lesion location(P =0.000), lesion size(P =0.000), lesion number(P =0.004), lesion treatment method(P =0.000), neutrophil count(P =0.000), NLR(P =0.000), SII(P =0.001)are related to the pathological properties of early colorectal cancer and colorectal precancerous lesions. Multivariate Logistic regression analysis showed that history of hyperlipidemia(P =0.009), lesion location(P =0.000), lesion size(P =0.000), lesion number(P =0.024), SII (P =0.004)are independent predictors of the pathological properties of the two groups of patients, and the area under the ROC curve of SII to distinguish the two groups of patients is 0.643 (95% CI: 0.560－0.725; P=0.001). When the SII is 500.27, its sensitivity for diagnosing early colorectal cancer is 54.9%, and its specificity is 70.7%, but the consistency between the diagnostic results and pathological is poor (Kappa < 0.40). Conclusion The use of SII in the screening of early colorectal cancer and precancerous lesions may be helpful for colonoscopist to diagnose the pathological types.

Key words: early colorectal cancer, colorectal precancerous lesions, inflammation markers, systemic immune-inflammation index

中图分类号:

R574

王芸, 李文坤, 苏珈仪, 王亚丹, 吴静. 系统免疫炎症指数在早期结直肠癌及癌前病变筛查中的应用价值[J]. 首都医科大学学报, 2022, 43(5): 760-766.

Wang Yun, Li Wenkun, Su Jiayi, Wang Yadan, Wu Jing. Application value of systemic immune-inflammation index in the screening of early colorectal cancer and precancerous lesions[J]. Journal of Capital Medical University, 2022, 43(5): 760-766.

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系统免疫炎症指数在早期结直肠癌及癌前病变筛查中的应用价值

Application value of systemic immune-inflammation index in the screening of early colorectal cancer and precancerous lesions

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