Wang Bei-Li, Tian Lu, Gao Xing-Hui, Ma Xiao-Lu, Wu Jiong, Zhang Chun-Yan, Zhou Yan, Guo Wei, Yang Xin-Rong
Clin Chem Lab Med. 2016 Dec 1;54(12):1963-1969. doi: 10.1515/cclm-2015-1191.
The aim of the study was to determine the utility of the dynamic change and serial monitoring of the systemic immune inflammation index (SII), which was based on the numbers of patients' lymphocytes (L), platelets (P), neutrophils (N) and defined as P*N/L, for predicting prognosis of patients with hepatocellular carcinoma (HCC) after curative resection.
We conducted a prospective study of 163 patients with HCC who underwent curative resection at Zhongshan Hospital from January 2012 to May 2013. SII was calculated using data acquired before and approximately 1 month after surgery. An optimal cutoff value stratified patients into groups with high or low SII. Patients were classified into unfavorable and favorable groups using the dynamic change of the SII. Two groups that were further divided into four categories within the entire cohort and the low-risk subgroups were serially monitored for ≥6 months. Prognostic values of the SII and other factors were determined using the Kaplan-Meier method, the Cox proportional hazards model, and the receiver operating characteristics (ROC) curve.
The favorable group was likely to have cirrhosis, and the unfavorable group was likely to have larger tumors and a higher recurrence rate. Multivariate analysis revealed that tumor size and dynamic change of the SII were independent risk factors for early recurrence. Moreover, the predictive value of the SII was retained in α-fetoprotein (AFP)-negative and HBeAg-negative-HBV-DNA <2000 IU/mL subgroups. Further, the serial changes of the SII for recurrence and no recurrence groups were statistically significant.
The dynamic change and serial monitoring of the SII represent new indicators for predicting the early recurrence of HCC determining advance optimal therapy in advance.
本研究旨在确定基于患者淋巴细胞（L）、血小板（P）、中性粒细胞（N）数量定义为P*N/L的全身免疫炎症指数（SII）的动态变化及连续监测在预测肝细胞癌（HCC）患者根治性切除术后预后中的效用。
我们对2012年1月至2013年5月在中山医院接受根治性切除的163例HCC患者进行了一项前瞻性研究。使用术前及术后约1个月获取的数据计算SII。通过一个最佳临界值将患者分为SII高或低的组。根据SII的动态变化将患者分为不良和良好组。在整个队列中将这两组进一步分为四类，并对低风险亚组进行≥6个月的连续监测。使用Kaplan-Meier法、Cox比例风险模型和受试者工作特征（ROC）曲线确定SII及其他因素的预后价值。
良好组可能有肝硬化，不良组可能有更大的肿瘤和更高的复发率。多因素分析显示肿瘤大小和SII的动态变化是早期复发的独立危险因素。此外，SII的预测价值在甲胎蛋白（AFP）阴性和乙肝e抗原阴性-乙肝病毒DNA<2000 IU/mL亚组中依然存在。而且，复发组和未复发组的SII连续变化具有统计学意义。
SII的动态变化及连续监测是预测HCC早期复发及提前确定最佳治疗方案的新指标。
