Systemic immune-inflammation index (SII): A More Promising Inflammation-Based Prognostic Marker for Patients with synchronic colorectal peritoneal carcinomatosis
Systemic immune-inflammation index (SII): A More Promising Inflammation-Based Prognostic Marker for Patients with synchronic colorectal peritoneal carcinomatosis
复制标题
全身免疫炎症指数（SII）：针对同步性结直肠腹膜癌病患者更有前景的基于炎症的预后标志物
DOI：
10.7150/jca.46446
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发表时间：
2020-01-01
影响因子：
3.9
通讯作者：
Chen Chuangqi
中科院分区：
文献类型：
--
作者：
Qian Yan;Zhai Ertao;Chen Chuangqi
目的：慢性结直肠癌腹膜癌(SCRPC)被认为是预后不良的预测因素。本研究旨在探讨中性粒细胞/淋巴细胞比率(NLR)、血小板/淋巴细胞比率(PLR)和全身免疫炎症指数(SII)对SCRPC患者预后的影响，为SCRPC患者的治疗提供依据。方法：对1997年至2013年在中山大学附属第一医院接受细胞减灭术(CRS)和全身化疗(CT)的103例SCRPC患者进行回顾性分析。临床病理变量和系统炎症标志物NLR、PLR、SII的比较采用卡方检验和Cox回归分析。根据多因素分析的结果，生成预后诺模图，并用一致性指数(C-index)衡量其预测能力。结果：单因素分析显示NLR、PLR、SII升高与预后不良显著相关。除NLR值和PLR值外，仅低SII值是影响总生存率的独立预后因素(HR=1.772，95%CI=1.015~3.095，P=0.044)。诺模图可以很好地预测SCRPC患者的总生存期(c指数0.782)。此外，对于细胞减少评分(CCR)为0/1或CCR2/3的SCRPC患者，SII具有较强的预后判别能力，而NLR和PLR较差。结论：SII是预测接受CRS和系统CT治疗的SCRPC患者预后的较好的炎症因子。低SII值是SCRPC患者受益于不同CRS水平的最有利因素，有助于SCRPC患者选择合适的治疗策略。
Objective: Synchronic colorectal peritoneal carcinomatosis (SCRPC) was recognized as a predictor of poor prognosis. The aim of this study was to investigate the role of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) on the survival outcome, which might help determine the treatment management of SCRPC patients.Methods: A total of 103 SCRPC patients following cytoreduction surgery (CRS) and systematic chemotherapy (CT) between 1997 and 2013 in the First Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. The comparison of the clinicopathological variables and systematic inflammatory biomarkers, including NLR, PLR and SII, was performed by Chi-test and Cox regression analysis. According to the results of multivariate analysis, a prognostic nomogram was generated, and its prediction ability was measured by the concordance index (C-index). The survival curves were generated using the Kaplan-Meier method and survival comparison between groups was conducted via the log-rank test.Results: Univariate analysis revealed that elevated NLR, PLR and SII were significantly correlate with worse survival outcome. Only low SII value was recognized as an independent favorable prognostic factor for overall survival (HR=1.772, 95% CI=1.015-3.095, P=0.044), except for NLR and PLR. The nomogram could perform well in the prediction of overall survival in SCRPC patients (c-index 0.782). Moreover, SII had strong prognostic discriminatory ability to predict survival outcome for the patients receiving completeness of cytoreduction score (CCR) 0/1 or CCR2/3, rather than NLR and PLR.Conclusions: SII was a better inflammation factor to predict the outcomes of SCRPC patients receiving CRS and systematic CT. Low SII value was the most favorable factor benefiting from different level of CRS and it was useful for determining the appropriate treatment strategy for SCRPC patients.