炎症营养复合指标与I型子宫内膜癌预后的相关性分析

doi:10.3969/j.issn.1004-616x.2026.01.003

癌变·畸变·突变 ›› 2026, Vol. 38 ›› Issue (1): 15-21.doi: 10.3969/j.issn.1004-616x.2026.01.003

• 论著 • 上一篇

炎症营养复合指标与I型子宫内膜癌预后的相关性分析

蔡晓彤^1,2, 谢冰梦², 周莉³, 李仰康⁴, 黄裔腾⁵, 彭琳²

1. 汕头大学公共卫生学院, 广东汕头 515041;
2. 汕头大学医学院附属肿瘤医院中心实验室, 广东汕头 515041;
3. 汕头大学医学院附属肿瘤医院妇科, 广东汕头 515041;
4. 汕头大学医学院附属肿瘤医院放射科, 广东汕头 515041;
5. 汕头大学医学院第一附属医院健康管理中心, 广东汕头 515041

收稿日期:2025-10-27 修回日期:2025-12-22 发布日期:2026-01-30
通讯作者: 彭琳
基金资助:
汕头市医疗卫生科技计划(240510226499221)

Correlation analysis of inflammation-nutrition composite indexes with prognosis of type I endometrial cancer

CAI Xiaotong^1,2, XIE Bingmeng², ZHOU Li³, LI Yangkang⁴, HUANG Yiteng⁵, PENG Lin²

1. School of Public Health, Shantou University, Shantou 515041;
2. Central Laboratory, Cancer Hospital of Shantou University Medical College, Shantou 515041;
3. Department of Gynecology, Cancer Hospital of Shantou University Medical College, Shantou 515041;
4. Department of Radiology, Cancer Hospital of Shantou University Medical College, Shantou 515041;
5. Health Management Center, the First Affiliated Hospital of Shantou University Medical College, Shantou 515041, Guangdong, China

Received:2025-10-27 Revised:2025-12-22 Published:2026-01-30

摘要/Abstract

摘要： 目的：评估炎症营养复合指标与I型子宫内膜癌(EC)患者生存预后的关系。方法：将2010年1月—2022年5月经术后病理确诊的404例I型EC患者纳入研究，收集术前1周内血常规、生化常规检查结果，计算系统性炎症反应指数(SIRI)、系统性炎症综合指数(AISI)、炎性营养指标老年营养风险指数(GNRI)和晚期肺癌炎症指数(ALI)4项炎症营养复合指标，同时搜集临床病理资料和随访数据。采用受试者工作特征曲线确定最佳截断值，Kaplan-Meier法绘制生存曲线，单因素及多因素Cox比例风险回归模型筛选总生存期(OS)的独立预后因子。结果：炎症营养指标的曲线下面积排序依次为ALI (0.609)>AISI (0.592)>SIRI (0.581)>GNRI (0.556)。单因素Cox回归分析结果显示年龄≥60岁、淋巴结转移、国际妇产科联盟(FIGO)分期(III+IV)、糖类抗原125(CA125)≥35 U/mL和ALI<64.32与更短的OS显著相关(均为P<0.05)；多因素Cox回归分析结果显示高龄[HR=2.25，95% CI (1.02，4.96)，P=0.044]、高FIGO分期[HR=2.80，95% CI (1.27，6.20)，P=0.010]、低ALI[HR=0.28，95% CI (0.08，0.96)，P=0.042]是OS的独立危险因素，而SIRI、AISI和GNRI与OS无明显相关(P>0.05)。结论：在4项炎症营养复合指标中，术前ALI对I型EC的预后评估能力较优，ALI<64.32是不良预后的独立预测因素。

关键词: 炎症营养复合指标, 子宫内膜癌, 晚期肺癌炎症指数, 总生存期, Cox比例风险回归

Abstract: OBJECTIVE： To evaluate relationships between inflammation-nutrition composite indexes and survival prognosis in patients with type I endometrial cancer (EC). METHODS： A total of 404 patients with type I EC diagnosed by postoperative pathology from January 2010 to May 2022 were included in this study. Complete blood count and biochemical examination results were collected within one week before surgery. Four inflammatory nutritional composite indicators were calculated： systemic inflammatory response index (SIRI)， aggregate index of systemic inflammation (AISI)， geriatric nutritional risk index (GNRI)， and advanced lung cancer inflammatory index (ALI). Clinicopathological data and follow-up data were also collected. The optimal cutoff value was determined using receiver operating characteristic (ROC) curves. Survival curves were plotted using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards regression models were used to screen for independent prognostic factors of overall survival (OS). RESULTS： The area under the curves for the inflammatory nutritional indicators were ranked as follows： ALI (0.609) > AISI (0.592) > SIRI (0.581) > GNRI (0.556). Univariate Cox regression showed that age ≥ 60 years，lymph node metastasis，FIGO stage (III + IV)，carbohydrate antigen 125 (CA125) ≥ 35 U/mL，and ALI<64.32 were significantly associated with shorter OS (all P<0.05). Multivariate Cox regression showed that advanced age [HR=2.25，95% CI(1.02， 4.96)，P=0.044]，high FIGO stage [HR=2.80，95% CI(1.27，6.20)，P=0.010]，and low ALI [HR=0.28，95% CI (0.08， 0.96)， P=0.042] were independent risk factors for OS， while SIRI， AISI， and GNRI were not significantly associated with OS (P>0.05). CONCLUSION： Among the four inflammatory and nutritional composite indicators，preoperative ALI had the best prognostic ability for type I EC，and ALI<64.32 was an independent risk factor for poor prognosis.

Key words: inflammation-nutrition composite index, endometrial cancer, advanced lung cancer inflammation index, overall survival, Cox proportional hazards regression

中图分类号:

R737.33

蔡晓彤, 谢冰梦, 周莉, 李仰康, 黄裔腾, 彭琳. 炎症营养复合指标与I型子宫内膜癌预后的相关性分析[J]. 癌变·畸变·突变, 2026, 38(1): 15-21.

CAI Xiaotong, XIE Bingmeng, ZHOU Li, LI Yangkang, HUANG Yiteng, PENG Lin. Correlation analysis of inflammation-nutrition composite indexes with prognosis of type I endometrial cancer[J]. Carcinogenesis, Teratogenesis & Mutagenesis, 2026, 38(1): 15-21.

参考文献

[1] SIEGEL R L, GIAQUINTO A N, JEMAL A. Cancer statistics, 2024[J]. CA A Cancer J Clin, 2024, 74(1): 12-49.
[2] HAN B F, ZHENG R S, ZENG H M, et al. Cancer incidence and mortality in China, 2022[J]. J Natl Cancer Cent, 2024, 4(1): 47-53.
[3] 中国抗癌协会妇科肿瘤专业委员会. 子宫内膜癌诊断与治疗指南(2021年版)[J]. 中国癌症杂志, 2021, 31(6): 501-512.
[4] NI L W, TAO J L, XU J H, et al. Prognostic values of pretreatment neutrophil-to-lymphocyte and platelet-tolymphocyte ratios in endometrial cancer: a systematic review and meta-analysis[J]. Arch Gynecol Obstet, 2020, 301(1): 251-261.
[5] MOHAMADIANAMIRI M, AKLAMLI M, ALEMOHAMMAD F. Hematologic inflammatory indexes as a prognostic factor in endometrial cancer grading and staging[J]. Caspian J Intern Med, 2023, 14(3): 443-448.
[6] MAO S Y, ZHANG Z X, LI Y. Prognostic and clinicopathological role of prognostic nutritional index (PNI) in endometrial cancer: a meta-analysis[J]. Heliyon, 2024, 10(15): e35211.
[7] ZHANG N, LIU H, YANG J K, et al. Development and validation of a nomogram based on multiple preoperative immunoinflammatory indexes for survival prediction in patients with stage IA-IB endometrial cancer[J]. Am J Transl Res, 2023, 15(10): 6286-6298.
[8] HAAS M, LEIN A, FUEREDER T, et al. The geriatric nutritional risk index (GNRI) as a prognostic biomarker for immune checkpoint inhibitor response in recurrent and/or metastatic head and neck cancer[J]. Nutrients, 2023, 15(4): 880.
[9] WANG H K, WEI Q, YANG Y L, et al. Clinical usefulness of the lymphocyte-to-monocyte ratio and aggregate index of systemic inflammation in patients with esophageal cancer: a retrospective cohort study[J]. Cancer Cell Int, 2023, 23(1): 13.
[10] ZHANG S H, CHENG T T. Prognostic and clinicopathological value of systemic inflammation response index (SIRI) in patients with breast cancer: a meta-analysis[J]. Ann Med, 2024, 56(1): 2337729.
[11] FEARON K, STRASSER F, ANKER S D, et al. Definition and classification of cancer Cachexia: an international consensus[J]. Lancet Oncol, 2011, 12(5): 489-495.
[12] QI Q, ZHUANG L P, SHEN Y H, et al. A novel systemic inflammation response index (SIRI) for predicting the survival of patients with pancreatic cancer after chemotherapy[J]. Cancer, 2016, 122(14): 2158-2167.
[13] 张亚瑾. 术前全身炎症反应指数(SIRI)与子宫内膜癌临床病理特征和预后的相关性研究[D]. 开封: 河南大学, 2024.
[14] 代荣芬. 微卫星不稳定型子宫内膜癌与炎症指标的相关性研究[D]. 昆明: 昆明医科大学, 2024.
[15] ZINELLU A, COLLU C, NASSER M, et al. The aggregate index of systemic inflammation (AISI): a novel prognostic biomarker in idiopathic pulmonary fibrosis[J]. J Clin Med, 2021, 10(18): 4134.
[16] ZINELLU A, PALIOGIANNIS P, SOTGIU E, et al. Blood cell count derived inflammation indexes in patients with idiopathic pulmonary fibrosis[J]. Lung, 2020, 198(5): 821-827.
[17] YANG Y, HU Z L, YE Y Q, et al. Association of aggregate index of systemic inflammation with increased all-cause and cardiovascular mortality in female cancer patients[J]. Front Oncol, 2025, 15: 1552341.
[18] BOUILLANNE O, MORINEAU G, DUPONT C, et al. Geriatric Nutritional Risk Index: a new index for evaluating at-risk elderly medical patients[J]. Am J Clin Nutr, 2005, 82(4): 777-783.
[19] CHANG L W, HUNG S C, LI J R, et al. Geriatric nutritional risk index as a prognostic marker for patients with metastatic castration-resistant prostate cancer receiving docetaxel[J]. Front Pharmacol, 2021, 11: 601513.
[20] YANG M, LIU Z H, LI G J, et al. Geriatric nutritional risk index as a prognostic factor of patients with non-small cell lung cancer: a meta-analysis[J]. Horm Metab Res, 2022, 54(9): 604-612.
[21] NAKAYAMA M, GOSHO M, ADACHI M, et al. The geriatric nutritional risk index as a prognostic factor in patients with advanced head and neck cancer[J]. Laryngoscope, 2021, 131(1): E151-E156.
[22] SONG M M, ZHANG Q, SONG C H, et al. The advanced lung cancer inflammation index is the optimal inflammatory biomarker of overall survival in patients with lung cancer[J]. J Cachexia Sarcopenia Muscle, 2022, 13(5): 2504-2514.
[23] QIU X, SHEN S, LU D H, et al. Predictive efficacy of the advanced lung cancer inflammation index in hepatocellular carcinoma after hepatectomy[J]. J Inflamm Res, 2024, 17: 5197-5210.
[24] ZHANG L L, ZHAO K L, KUANG T R, et al. The prognostic value of the advanced lung cancer inflammation index in patients with gastrointestinal malignancy[J]. BMC Cancer, 2023, 23(1): 101.
[25] 张涅, 王婷婷, 刘婉明, 等. 基于炎症营养相关指标建立I—II期子宫内膜癌患者术后的列线图预测模型及验证[J]. 徐州医科大学学报, 2022, 42(10): 710-715.
[26] VAN ARSDALE A, MILLER D T, KUO D Y, et al. Association of obesity with survival in patients with endometrial cancer[J]. Gynecol Oncol, 2019, 154(1): 156-162.
[27] LEI J, WANG Y, GUO X Q, et al. Low preoperative serum ALB level is independently associated with poor overall survival in endometrial cancer patients[J]. Future Oncol, 2020, 16(8): 307-316.
[28] ETHIER J L, DESAUTELS D N, TEMPLETON A J, et al. Is the neutrophil-to-lymphocyte ratio prognostic of survival outcomes in gynecologic cancers? A systematic review and meta-analysis[J]. Gynecol Oncol, 2017, 145(3): 584-594.
[29] GAO X Y, QI J C, DU B, et al. Combined influence of nutritional and inflammatory status and breast cancer: findings from the NHANES[J]. BMC Public Health, 2024, 24(1): 2245.
[30] PEDUZZI P, CONCATO J, KEMPER E, et al. A simulation study of the number of events per variable in logistic regression analysis[J]. J Clin Epidemiol, 1996, 49(12): 1373-1379.

炎症营养复合指标与I型子宫内膜癌预后的相关性分析

Correlation analysis of inflammation-nutrition composite indexes with prognosis of type I endometrial cancer

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