Systemic Immune-Inflammation Index Predicts Prognosis of Patients after Curative Resection for Hepatocellular Carcinoma
Systemic Immune-Inflammation Index Predicts Prognosis of Patients after Curative Resection for Hepatocellular Carcinoma
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DOI：
10.1158/1078-0432.ccr-14-0442
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发表时间：
2014-12-01
影响因子：
11.5
通讯作者：
Fan, Jia
中科院分区：
文献类型：
--
作者：
Hu, Bo;Yang, Xin-Rong;Fan, Jia
目的：我们开发了一种新的基于淋巴细胞、中性粒细胞和血小板计数的全身免疫炎症指数（SII），并探讨了其在肝细胞癌（HCC）中的预后价值。SII是基于对2005年至2006年间接受切除术的133例HCC患者的回顾性研究而开发的，并在2010年至2011年招募的123名患者的前瞻性研究中得到验证。使用CellSearch系统测量验证队列中的循环肿瘤细胞（CTC）水平。结果：以SII值330 × 10 9为最佳截断点，将训练队列中的HCC患者分为高SII值组（>= 330）和低SII值组（< 330）。单变量和多变量分析显示，SII是总生存期和无复发生存期的独立预测因子，也是甲胎蛋白阴性和巴塞罗那临床肝癌0+A期患者的预后预测因子。SII的生存和复发AUC高于其他常规临床指标。SII > 330与血管浸润、大肿瘤和早期复发显著相关。SII >= 330组的CTC水平显著更高（1.71 +/- 0.34 vs. 4.37 +/- 1.04，P = 0.029）。在可检测到CTC的患者中，SII >= 330的患者复发率高于SII <330的患者，生存期短于SII <330的患者。结论：SII是HCC患者预后不良的一个强有力的预后指标，是HCC治疗策略决策的一个有希望的工具。高SII评分患者的不良结局可能与较高的CTC水平有关。(C)2014年AACR。
Purpose: We developed a novel systemic immune-inflammation index (SII) based on lymphocyte, neutrophil, and platelet counts and explored its prognostic value in hepatocellular carcinoma (HCC).Experimental Design: The SII was developed based on a retrospective study of 133 patients with HCC undergoing resection between 2005 and 2006, and validated in a prospective study of 123 patients enrolled from 2010 to 2011. The circulating tumor cell (CTC) level in the validation cohort was measured using the CellSearch system. Prediction accuracy was evaluated with area under the receiver operating characteristic curve (AUC).Results: An optimal cutoff point for the SII of 330 x 10 9 stratified the patients with HCC into high (>= 330) and low SII (< 330) groups in the training cohort. Univariate and multivariate analyses revealed the SII was an independent predictor for overall survival and relapse-free survival, and prognostic for patients with negative a-fetoprotein and Barcelona Clinic Liver Cancer stage 0+A. The AUCs of the SII for survival and recurrence were higher than other conventional clinical indices. An SII > 330 was significantly associated with vascular invasion, large tumors, and early recurrence. CTC levels were significantly higher in the SII >= 330 group (1.71 +/- 0.34 vs. 4.37 +/- 1.04, P = 0.029). In patients with detectable CTCs, those with SII >= 330 had higher recurrence rates and shorter survival time than patients with SII < 330.Conclusion: The SII was a powerful prognostic indicator of poor outcome in patients with HCC and is a promising tool for HCC treatment strategy decisions. The dismal outcome in patients with high SII scores might be related to higher CTC levels. (C) 2014 AACR.