FAR AGR PNI 及SII与ⅠA～ⅡA期宫颈癌临床病理特征的关系

钱樱; 阿迪莱·扎克尔; 孙玮琳; 陈志芳

doi:10.12354/j.issn.1000-8179.2022.20211475

FAR AGR PNI 及SII与ⅠA～ⅡA期宫颈癌临床病理特征的关系

Correlation of fibrinogen-to-albumin ratio, albumin-to-globulin ratio, prognostic nutritional index and systemic immune-inflammation index with clinicopathologicalfeatures of patients with stage ⅠA-ⅡA cervical cancer

摘要

摘要:
目的探讨术前纤维蛋白原-白蛋白比值（fibrinogen-to-albumin ratio，FAR）、白蛋白-球蛋白比值（albumin-to-globulin ratio，AGR）、预后营养指数（prognostic nutritional index，PNI）及系统性免疫炎症指数（systemic immune-inflammation index，SII）与ⅠA～ⅡA期宫颈癌患者临床病理特征的相关性。
方法回顾性分析2010年1月至2021年6月就诊于新疆医科大学第一附属医院确诊为ⅠA～ⅡA期宫颈癌并初次行手术的131例（ⅠA～ⅡA期宫颈癌组）、同期就诊经病理诊断为宫颈癌前病变102例（宫颈癌前病变组）和常规体检健康女性100例（正常组）患者的临床病理资料，采用非参数检验及Spearman法对FAR、AGR、PNI及SII值与ⅠA～ⅡA期宫颈癌组的相关性、临床病理特征关系、各指标间有无关联及术后指标变化情况进行分析。
结果术前FAR、PNI、SII值与ⅠA～ⅡA期宫颈癌组相关（均P<0.05），而AGR值与之无关（P>0.05）。单因素分析显示，患者年龄≥50岁、FIGO分期为IIA期、肿瘤直径≥4 cm、肿瘤浸润深度≥1/2肌层对应的术前FAR值较高（均P<0.05），患者年龄≥50岁、腺癌、肿瘤浸润深度≥1/2肌层对应的术前PNI值较低（均P<0.05）；术后为腺癌、肿瘤直径≥4 cm、肿瘤浸润深度≥1/2肌层对应的术前SII值较高（均P<0.05）。Spearman相关性分析显示，在ⅠA～ⅡA期宫颈癌组中PNI与FAR值（r=–0.225，P=0.010）、PNI与SII值（r=–0.309，P<0.001）均呈负相关。术后FAR和SII值较术前降低［0.073（0.061～0.078）vs. 0.075（0.066～0.089），P=0.011和461.250（314.032～612.397）vs. 567.553（389.542～724.156），P=0.002］，PNI值较术前升高［54.670（51.350～57.860）vs. 52.400（49.250～55.900），P=0.038］。
结论术前外周血中高FAR、SII 值及低PNI值与ⅠA～ⅡA期宫颈癌临床及术后病理组织学特征密切相关，可为术前临床治疗决策提供参考。

Abstract:
Objective To investigate the correlation of preoperative fibrinogen-to-albumin ratio (FAR), albumin-to-globulin ratio (AGR), prognostic nutritional index (PNI), and systemic immune-inflammation index (SII) with clinicopathological features of patients with stage ⅠA-ⅡA cervical cancer.
Methods Clinicopathologic data of 131 patients (stage ⅠA-ⅡA cervical cancer group) diagnosed with stage ⅠA-ⅡA cervical cancer who underwent surgery for the first time, 102 patients (cervical precancerous lesion group) pathologically diagnosed with cervical precancerous lesions during the same period, and 100 healthy women (normal group) who underwent routine physical examination at The First Affiliated Hospital of Xinjiang Medical University from January 2010 to June 2021 were retrospectively analyzed. Using nonparametric tests and Spearman’s rank correlation coefficient, we analyzed the correlation of FAR, AGR, PNI, SII, and stage ⅠA-ⅡA cervical cancer with clinicopathologic characteristics, as well as the association between each index and changes in postoperative indexes.
Results In this study, preoperative FAR, PNI, and SII were associated with stage IA-IIA cervical cancer (P<0.05) but AGR was not (P>0.05). Univariate analysis revealed higher preoperative FAR values in patients with age ≥50 years, FIGO stage IIA, tumor diameter≥4cm, and tumor invasion depth ≥1/2 muscular thickness (all P<0.05); lower preoperative PNI values in patients with age ≥50 years, adenocarcinoma, and tumor invasion depth ≥1/2 muscular thickness (all P<0.05); higher preoperative SII values in patients with adenocarcinoma, tumor diameter ≥4 cm, and tumor invasion depth ≥1/2 muscular thickness (all P<0.05). Spearman's rank-order correlation analysis revealed a negative correlation between PNI and FAR (r=-0.225, P=0.010) and PNI and SII (r=-0.309, P<0.001). FAR and SII values were lower and PNI values were higher in postoperative patients than in preoperative patients FAR: 0.073 (0.061–0.078) vs. 0.075 (0.066–0.089), P=0.011; SII: 461.250 (314.032–612.397) vs. 567.553 (389.542–724.156), P=0.002; PNI: 54.670 (51.350–57.860) vs. 52.400 (49.250–55.900), P=0.038.
Conclusions High FAR and SII values and low PNI values in preoperative peripheral blood are closely related to poor clinical and postoperative histopathological features of stage ⅠA-ⅡA cervical cancer, which can provide a reference for preoperative clinical treatment decisions.

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