Prognostic and clinical significance for the combination of systemic
inflammation response index and platelet--lymphocyte ratio in patients
with adenocarcinoma of the esophagogastric junction and upper gastric
cancer
Abstract
Abstract Background Tumor immunity plays an important role in assessing
the tumor progression. The purpose of this study was to investigate the
prognostic value of combined systemic inflammation response index (SIRI)
and platelet–lymphocyte ratio (PLR) for treatment of gastroesophageal
junction cancer (AEG) and upper gastric cancer (UGC). Methods In this
retrospective cohort study, patients from 2003 to 2014 were divided into
training set (n=194) and validation set (n=177). The prognostic accuracy
of each variable was compared using time-ependent ROC analysis. The
scoring system was calculated by cut-off values of SIRI and PLR by ROC
curve for survival in 5 years. Kaplan-Meier and Log-rank tests were used
to analyze overall survival (OS). The chi-square test was used to
analyze the association between clinical characteristics and the scoring
system. Univariate and multivariate analyses based on the competitive
risk regression model were used to analyze independent predictors of
death due to AGC and UGC. The R software was used to construct the
Nomogram model of risk assessment. Results Patients with SIRI–PLR=2 had
worse survival time than those with 0 and 1 (P<0.001) and more
suitable for postoperative adjuvant chemotherapy (P=0.003) and proximal
gastrectomy (P=0.045). SIRI and PLR were independent predictors in
training set (P=0.036, P=0.045), which could be combined with age and
pTNM to construct Nomogram for predicting OS. Conclusions Preoperative
SIRI–PLR score was an independent predictor for patients with AEG and
UGC. The Nomogram model constructed by age, SIRI, PLR and pTNM can
correctly predict the prognosis of patients.