全身免疫炎症指数对肌层浸润性膀胱癌根治术后辅助替雷利珠单抗联合吉西他滨和顺铂疗效的预测价值

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ABSTRACT：ObjectiveTo explore the predictive value of systemic immuno-inflammatory index（SII）and the amplitude of change（Delta-SIIonthe efficacyofadjuvant treatment withTislelizumab（T）incombination with Gemcitabineand Cisplatin （GC in patients with muscle-invasive blader carcinoma（MIBC）afterradical surgery.MethodsAtotal of 47 MIBC patients undergoingradical surgery in theAfiliated Hospitalof Xuzhou Medical University during Jun.2O18and Jun.2022were enrolled.All patients received T+GC therapy.Baseline SII before treatment （Pre-SII） and SII after 3 cycles（Post-SI） were collected，and Delta-SIIwascaleulated.Thesensitivityand specificityofPre-SIand Delta-SII were measuredusingreceiver operating characteristic（ROC）curves，and the best cut-off values were determined.The recurrence-freesurvival（RFS）rate was analyzedwith Kaplan-Meier method.Therisk factorsof RFS were investigated withunivariateandmultivariate Cox proportional hazard models.ResultsROCcurves indicated that the best cut-off valuesof Pre-SI and Delta-SI were 516.31 and O.176，respectively.The low Pre-SII group（ <516.31 ）andhigh Delta-SI group （⩾0.176 ）were associated with longer RFS （HR=1.951，95%CI：1.063-3.581，P=0.029 HR=3.892，95%CI：2.010-7.534，P<0.001） .Cox proportional hazard models showed that high Pre-SII （⩾516.31 ），low Delta-SII （ ⩽0.176 ， T3-T4 stage， Nx stage and tumor size >3 cm were independent risk factors for tumor recurrence.ConclusionIn MIBC patients receivig T+GC therapy，the amplitude of change before treatment and after 3 cycles of treatment can be used as valuable predictors of clinical efficacy.

KEYWORDS：bladdercarcinoma;systemic immuno-inflammatory index;adjuvanttreatment;Tislelizumab;Gemcitabine;Cisplatin摘要：目的探讨全身免疫炎症指数（SII）及其变化幅度（Delta-SII）对肌层浸润性膀胱癌（MIBC）患者根治性膀胱切除术后（RC）接受替雷利珠联合吉西他滨和顺铂（ Δ（T+GC） 辅助治疗疗效的预测价值。（剩余12227字）