系统免疫炎症指数及纤维蛋白原与前白蛋白比值对前列腺癌预后的预测价值

完海洋; 徐卫强; 谷明利

doi:10.16766/j.cnki.issn.1674-4152.004328

系统免疫炎症指数及纤维蛋白原与前白蛋白比值对前列腺癌预后的预测价值

doi: 10.16766/j.cnki.issn.1674-4152.004328

蚌埠医科大学第二附属医院泌尿外科，安徽蚌埠 233040

基金项目:

安徽省高等学校科学研究项目 2023AH040284

详细信息

通讯作者:
谷明利，E-mail：15056353966@139.com

中图分类号: R737.25 R730.7
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- 被引次数: 0
出版历程
- 收稿日期: 2025-01-04
- 网络出版日期: 2026-04-01

The prognostic value of systemic immune-inflammation index and fibrinogen to prealbumin ratio in prostate cancer

Department of Urology, the Second Affiliated Hospital of Bengbu Medical University, Bengbu, Anhui 233040, China

摘要

摘要: 目的探讨系统免疫炎症指数(SII)及纤维蛋白原与前白蛋白比值(FPR)在前列腺癌患者中的预后价值，以期为术后患者的转归提供依据。方法以2014年1月—2020年9月在蚌埠医科大学第二附属医院泌尿外科行前列腺癌根治术(RP)的175例患者为研究对象，收集患者相关临床资料和随访信息。利用ROC曲线明确SII和FPR的最佳截断值，分为高SII组和低SII组、高FPR组和低FPR组，分析不同SII、FPR分组的前列腺癌患者临床病理特征，同时建立Kaplan-Meier曲线对PFS和OS进行分析，采用Cox比例风险模型分析影响前列腺癌预后的危险因素。结果 SII和FPR的截断值分别为575.13、13.75。不同SII分组患者切缘阳性状况、术后病理分期和不同FPR分组患者精囊侵犯情况、切缘阳性状况比较，差异均有统计学意义(P＜0.05)。生存分析显示，低SII组、低FPR组患者术后3、5年PFS和OS分别高于高SII组、高FPR组。与SII联合FPR 0、1分组相比，2分组的5年PFS和OS最低，差异有统计学意义(P < 0.001)。多因素分析表明，术前tPSA、SII、FPR是影响患者PFS的独立预后因素；切缘状况、SII、FPR是影响OS的独立预后因素。结论 SII和FPR均可作为预测前列腺癌患者的预后指标，二者联合预测的准确性更佳。
- 前列腺癌 /
- 系统免疫炎症指数 /
- 纤维蛋白原与前白蛋白比值 /
- 预后
Abstract: Objective To investigate the prognostic value of the systemic immune-inflammation index (SII) and fibrinogen to prealbumin ratio (FPR) in patients with prostate cancer, so as to provide evidence for the outcome of postoperative patients. Methods A total of 175 patients who underwent radical prostatectomy (RP)in the Department of Urology, the Second Affiliated Hospital of Bengbu Medical University from January 2014 to September 2020 were enrolled as subjects, and the relevant clinical data and follow-up information were collected. The optimal cut-off values of SII and FPR were determined using the ROC curves. Based on these cut-offs, patients were divided into high and low SII groups, and high and low FPR groups. The clinicopathological features of prostate cancer patients with different SII and FPR groups were analyzed, and Kaplan-Meier curves were established to analyze the PFS and OS. The Cox proportional hazards model was used to analyze the risk factors for PFS and OS of prostate cancer. Results The cut-off values of SII and FPR were 575.13 and 13.75, respectively. There were statistically significant differences in positive margin status, postoperative pathological stage among patients with different SII groups, and seminal vesicle invasion and positive margin status among patients with different FPR groups (P < 0.05). Survival analysis showed that PFS and OS in the low SII group and low FPR group were higher than those in the high SII group and high FPR group at 3 and 5 years after surgery, respectively. Compared with the combination of SII and FPR 0 and 1 groups, the 5-year PFS and OS of group 2 were the lowest, and the difference was statistically significant (P < 0.001). Multivariate analysis showed that preoperative tPSA, SII, and FPR were independent prognostic factors affecting PFS; margin status, SII, and FPR were independent prognostic factors affecting OS. Conclusion Both SII and FPR can be used as prognostic indicators for patients with prostate cancer, and the combination of the two has better predictive accuracy.
- Prostate cancer /
- Systemic immune-inflammatory index /
- Fibrinogen to albumin ratio /
- Prognosis

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图 1 不同SII、FPR分组PCa患者PFS生存曲线

Figure 1. PFS survival curve of PCa patients in different SII and FPR groups

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图 2 不同SII、FPR分组PCa患者OS生存曲线

Figure 2. OS survival curve of PCa patients in different SII and FPR groups

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图 3 SII联合FPR不同分组PCa患者PFS、OS生存曲线

Figure 3. The survival curves of PFS and OS in PCa patients with SII combined with FPR

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表 1 高、低FPR组间和高、低SII组间PCa患者临床资料比较

Table 1. Comparison of clinical characteristics between high and low FPR groups and between high and low SII groups in patients with PCa

项目	高FPR组(n=33)	低FPR组(n=142)	统计量	P值	高SII组(n=38)	低SII组(n=137)	统计量	P值
年龄(x±s，岁)	71.39±6.10	69.36±6.33	0.165^a	0.101	71.45±5.82	69.27±6.51	0.864^a	0.064
吸烟史[例(%)]			0.245^b	0.621			1.171^b	0.279
是	9(27.3)	45(31.7)			9(23.7)	45(32.8)
否	24(72.7)	97(68.3)			29(76.3)	92(67.2)
高血压史[例(%)]			0.321^b	0.571			0.440^b	0.507
是	19(57.6)	74(52.1)			22(57.9)	71(51.8)
否	14(42.4)	68(47.9)			16(42.1)	66(48.2)
糖尿病史[例(%)]			0.076^b	0.782			0.409^b	0.522
是	6(18.2)	23(16.2)			5(13.2)	24(17.5)
否	27(81.8)	119(83.8)			33(86.8)	113(82.5)
Gleason评分[例(%)]			2.247^b	0.134			1.098^b	0.295
< 8分	16(48.5)	89(62.7)			20(52.6)	85(62.0)
≥8分	17(51.5)	53(37.3)			18(47.4)	52(38.0)
术前tPSA(x±s，μg/L)	22.94±15.17	21.55±17.90	0.412^a	0.681	22.94±15.17	21.55±17.89	0.412^a	0.681
切缘阳性状况[例(%)]			5.467^b	0.019			6.262^b	0.012
是	14(42.4)	32(22.5)			16(42.1)	30(21.9)
否	19(57.6)	110(77.5)			22(57.9)	107(78.1)
脉管神经侵犯[例(%)]			0.239^b	0.625			1.529^b	0.216
是	9(27.3)	33(23.2)			12(31.6)	30(21.9)
否	24(72.7)	109(76.8)			26(68.4)	107(78.1)
淋巴结阳性[例(%)]			2.763^b	0.096			0.015^b	0.902
是	7(21.2)	15(10.6)			5(13.2)	17(12.4)
否	26(78.8)	127(89.4)			33(86.8)	120(87.6)
精囊侵犯[例(%)]			12.050^b	0.002			3.502^b	0.061
是	11(33.3)	14(9.9)			9(23.7)	16(11.7)
否	22(66.7)	128(90.1)			29(76.3)	121(88.3)
病理分期[例(%)]			2.415^b	0.120			4.811^b	0.028
T2	21(63.6)	109(76.8)			23(60.5)	107(78.1)
T3~4	12(36.4)	33(23.2)			15(39.5)	30(21.9)
注：^a为t值，^b为χ²值。

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表 2 前列腺癌术后生存预后单因素分析

Table 2. Univariate analysis of postoperative survival prognosis in prostate cancer

变量	PFS		OS
变量	HR(95% CI)	P值	HR(95% CI)	P值
术前tPSA	2.740(1.342~5.595)	0.006	3.868(1.076~13.903)	0.038
Gleason评分	2.006(1.029~3.911)	0.041	4.706(1.473~15.038)	0.009
切缘情况	2.232(1.110~4.485)	0.024	13.930(3.802~51.035)	＜0.001
精囊侵犯	3.496(1.705~7.171)	0.001	5.350(1.852~15.461)	0.002
病理分期	1.810(0.098~3.607)	0.092	7.684(2.405~24.547)	0.001
SII	3.736(1.923~7.260)	< 0.001	5.714(1.912~17.077)	0.002
FPR	5.216(2.670~10.188)	< 0.001	7.330(2.290~23.459)	0.001

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表 3 前列腺癌术后生存预后多因素分析

Table 3. Multivariate analysis of postoperative survival prognosis of prostate cancer

变量	PFS		OS
变量	HR(95% CI)	P值	HR(95% CI)	P值
术前tPSA	2.204(1.046~4.646)	0.038	1.290(0.288~5.781)	0.740
切缘情况	1.018(0.469~2.208)	0.964	4.792(1.080~21.259)	0.039
SII	2.721(1.286~5.758)	0.009	7.643(1.976~29.560)	0.003
FPR	2.718(1.196~6.176)	0.017	4.417(1.220~15.987)	0.024

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