Adenocarcinoma of the gastroesophageal junction (AEG) is an aggressive cancer with rising incidence and poor long-term survival despite multimodal treatment. Reliable preoperative prognostic markers are lacking. Methods: The study is based on data from a prospectively maintained institutional database, which was retrospectively analyzed. In total, 211 patients were analyzed who underwent curative resection for AEG to evaluate the association of SII and LVI and their combined prognostic value. Results: LVI was present in 45% of patients and was significantly associated with higher median SII values compared to patients without LVI (943 vs. 652;p< 0.001). Both high SII and the presence of LVI were independently associated with worse overall survival (p< 0.001 for both). In patients treated with primary surgery (65%), the combined presence of high SII and LVI identified a subgroup with particularly poor prognosis (pseudo-R2increased from 0.451 to 0.524; likelihood-ratio testp< 0.001). Among patients who received neoadjuvant therapy (NT) (35%), SII remained a strong prognostic factor (pseudo-R2= 0.432), while LVI alone was not statistically significant (p= 0.135), and its addition to the SII model did not improve prognostic performance (p= 0.377). Conclusions: The combined assessment of SII and LVI may improve prognostic stratification in AEG, especially in patients undergoing upfront surgery. These findings suggest that combined assessment of SII and LVI enhances prognostic stratification, particularly in patients treated with upfront surgery, and may aid personalized treatment and follow-up planning in AEG. To the best of our knowledge, this is the first study investigating the association of SII and LVI in AEG.
胃食管结合部腺癌是一种侵袭性强的恶性肿瘤，其发病率呈上升趋势，且即使接受多模式治疗，长期生存率仍不理想。目前尚缺乏可靠的术前预后标志物。方法：本研究基于前瞻性维护的机构数据库进行回顾性分析。共纳入211例接受根治性切除术的胃食管结合部腺癌患者，以评估全身免疫炎症指数与淋巴血管侵犯的关联性及其联合预后价值。结果：45%的患者存在淋巴血管侵犯，与无淋巴血管侵犯的患者相比，这些患者的中位全身免疫炎症指数显著更高（943 vs. 652；p<0.001）。高全身免疫炎症指数和淋巴血管侵犯的存在均与较差的总生存期独立相关（p值均<0.001）。在接受直接手术的患者（65%）中，高全身免疫炎症指数与淋巴血管侵犯同时存在可识别预后特别差的亚组（伪R²从0.451提升至0.524；似然比检验p<0.001）。在接受新辅助治疗的患者（35%）中，全身免疫炎症指数仍是强预后因素（伪R²=0.432），而单独淋巴血管侵犯无统计学意义（p=0.135），将其加入全身免疫炎症指数模型并未改善预后预测性能（p=0.377）。结论：联合评估全身免疫炎症指数和淋巴血管侵犯可改善胃食管结合部腺癌的预后分层，尤其适用于接受直接手术的患者。这些发现表明，联合评估全身免疫炎症指数和淋巴血管侵犯能增强预后分层能力，对直接手术患者的临床指导意义尤为突出，可能有助于制定个体化治疗及随访方案。据我们所知，这是首个探讨胃食管结合部腺癌中全身免疫炎症指数与淋巴血管侵犯关联性的研究。
肿瘤(癌症)患者之家