SII、COP-NLR评分与局部晚期鼻咽癌患者临床病理特征和预后的关系研究

摘要 目的：探讨系统性免疫炎症指数（SII）、血小板计数和中性粒细胞与淋巴细胞比值（COP-NLR）评分与局部晚期鼻咽癌患者临床病理特征和预后的关系。方法：选择2015年1月到2017年12月徐州医科大学附属医院收治的94例局部晚期鼻咽癌患者,计算SII和COP-NLR评分,受试者工作特征（ROC）曲线确定治疗前SII的最佳临界值,比较不同SII、COP-NLR评分局部晚期鼻咽癌患者临床病理特征的差异。绘制Kaplan-Meier生存曲线分析不同SII、COP-NLR评分的局部晚期鼻咽癌患者总生存期（OS）的差异,单因素和多因素Cox回归分析影响患者预后的危险因素。结果：根据SII最佳临界值、COP-NLR评分标准将局部晚期鼻咽癌患者分为低SII组（46例）和高SII组（48例）,低COP-NLR组（0-1分,45例）和高COP-NLR组（2分,49例）。高SII组、高COP-NLR组TNM分期Ⅳa期、淋巴结转移、颅底侵犯比例高于低SII组、低COP-NLR组（P＜0.05）。高SII组、高COP-NLR组的5年OS明显降低（P＜0.05）。TNM分期Ⅳa期、SII升高、COP-NLR评分升高是局部晚期鼻咽癌患者预后不良的危险因素（P＜0.05）。结论：局部晚期鼻咽癌患者高SII、高COP-NLR评分与恶性病理特征和低生存率有关,SII、COP-NLR评分可作为局部晚期鼻咽癌预后预测的潜在生物学标志物。

Study on the Relationship between SII, COP-NLR Scores and Clinical Pathological Characteristics and Prognosis in Locally Advanced Nasopharyngeal Carcinoma Patients

ABSTRACT Objective: To explore the relationship between systemic immune inflammation index (SII), platelet count and neutrophil to lymphocyte ratio (COP-NLR) scores with clinical pathological characteristics and prognosis in locally advanced nasopharyngeal carcinoma patients. Methods: 94 locally advanced nasopharyngeal carcinoma patients who were admitted to Affiliated Hospital of Xuzhou Medical University from January 2015 to December 2017 were selected. SII and COP-NLR scores were calculated, and the optimal threshold value of SII before treatment was determined by the receiver operating characteristic (ROC) curve. The differences in clinical and pathological characteristics of locally advanced nasopharyngeal carcinoma patients with different SII and COP-NLR scores were compared. Draw Kaplan-Meier survival curves to analyzed the differences in overall survival (OS) of locally advanced nasopharyngeal carcinoma patients with different SII and COP-NLR scores, and the risk factors affecting patient prognosis through univariate and multivariate Cox regression analysis were analyzed. Results: Patients with locally advanced nasopharyngeal carcinoma were divided into a low SII group (46 cases) and a high SII group (48 cases), low COP-NLR group (0-1 point, 45 cases), and high COP-NLR group (2 points, 49 cases) based on the optimal SII threshold and COP-NLR scoring criteria. The proportion of TNM stage IVa, lymph node metastasis, and skull base invasion in the high SII group and high COP-NLR group were higher than those in the low SII group and low COP-NLR group (P<0.05). The 5-year OS of the high SII group and high COP-NLR group significantly decreased (P<0.05). TNM stage IVa, elevated SII, and elevated COP-NLR score are risk factors for poor prognosis in locally advanced nasopharyngeal carcinoma patients (P<0.05). Conclusion: High SII and COP-NLR scores are associated with malignant pathological characteristics and low survival rate in locally advanced nasopharyngeal carcinoma patients. SII and COP-NLR scores can serve as potential biological markers for predicting prognosis of locally advanced nasopharyngeal carcinoma.