Systemic Immune-Inflammation Index Predicts Overall Survival in Patients with Gastric Cancer: a Propensity Score-Matched Analysis
Systemic Immune-Inflammation Index Predicts Overall Survival in Patients with Gastric Cancer: a Propensity Score-Matched Analysis
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DOI：
10.1007/s11605-020-04710-7
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发表时间：
2020-06-30
影响因子：
3.2
通讯作者：
Taniura, Takahito
中科院分区：
文献类型：
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作者：
Hirahara, Noriyuki;Tajima, Yoshitsugu;Taniura, Takahito
研究背景全身免疫炎症指数（systemic immune-inflammatory index，SII）是一种反映肿瘤患者机体炎症反应和免疫反应平衡的客观生物标志物，由外周血淋巴细胞、中性粒细胞和血小板计数组成。在此，我们研究了SII在胃癌患者中的预后意义。方法回顾性分析415例腹腔镜根治性胃切除术患者的临床资料，采用倾向评分匹配（PSM）分析。根据SII值比较低SII组（SII < 661.9）和高SII组（SII ≥ 661.9）的预后价值。结果在多因素分析中，美国麻醉医师协会身体状况（ASA PS）（p < 0.001），肿瘤分化（p = 0.019），病理分期（p = 0.046），癌胚抗原（CEA）水平（p < 0.001）、SII（p = 0.006）和手术操作（p = 0.009）是整个PSM队列中总生存期（OS）的独立预后因素。对数秩检验表明，高SII患者的OS显著差于低SII患者（p = 0.002）。在年龄分层亚组分析（≥ 65岁）中，多变量分析显示，ASA-PS（p < 0.001）、肿瘤分化（p = 0.019）、CEA水平（p = 0.008）、SII（p = 0.013）和手术方式（p = 0.026）是老年组OS的独立预后因素。同样，高SII的老年患者的OS显著低于低SII的患者（p = 0.009）。同时，SII不是OS的独立预后因素，在非老年患者中未观察到SII与OS之间的显著相关性。结论SII是判断胃癌患者预后的独立指标，尤其是在老年人群中。
Background The systemic immune-inflammation index (SII), integrated by peripheral lymphocyte, neutrophil, and platelet counts, is used as an objective biomarker that reflects the balance between host inflammatory and immune response status in cancer patients. Herein, we examined the prognostic significance of SII in gastric cancer patients. Methods We retrospectively reviewed data of 415 patients who underwent curative laparoscopic gastrectomy using propensity score-matched (PSM) analysis. The prognostic value of SII was compared between two groups based on SII values: low SII group (SII < 661.9) and high SII group (SII >= 661.9). Results In multivariate analysis, the American Society of Anesthesiologists physical status (ASA-PS) (p < 0.001), tumor differentiation (p = 0.019), pathological stage (p = 0.046), carcinoembryonic antigen (CEA) level (p < 0.001), SII (p = 0.006), and operative procedure (p = 0.009) were independent prognostic factors of overall survival (OS) in the overall PSM cohort. The log-rank test demonstrated that patients with a high SII had significantly worse OS than did those with low SII (p = 0.002). In age-stratified subgroups analysis (< 65/>= 65 years), multivariate analysis revealed that ASA-PS (p < 0.001), tumor differentiation (p = 0.019), CEA level (p = 0.008), SII (p = 0.013), and operative procedure (p = 0.026) were independent prognostic factors of OS in the elderly group. Similarly, elderly patients with a high SII had significantly worse OS than did those with a low SII (p = 0.009). Meanwhile, SII was not an independent prognostic factor of OS, and no significant association was observed between SII and OS in non-elderly patients. Conclusions SII was an independent prognostic indicator in gastric cancer patients, especially in the elderly population.