Zhong Jie-Hui, Huang Dan-Hui, Chen Zi-Yu
Department of Clinical Medicine, The First Clinical Medical College, Southern Medical University, Guangzhou, 510515, China.
Oncotarget. 2017 Jun 29;8(43):75381-75388. doi: 10.18632/oncotarget.18856. eCollection 2017 Sep 26.
Inflammation may play an important role in cancer progression, and a higher systemic immune-inflammation index (SII) has been reported to be a poor prognostic marker in several malignancies. However, the results of published studies are inconsistent.
A systematic review of databases was conducted to search for publications regarding the association between blood SII and clinical outcome in solid tumors with a date up to February 12, 2017. The primary outcome was overall survival (OS) and the secondary outcomes were progression-free survival (PFS) and cancer-specific survival (CSS). Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were used to assess the strength of the association between blood SII and clinical outcome in solid tumors.
A total of 15 articles were included in the analysis. Overall, systemic immune-inflammation index greater than the cutoff predicted poor overall survival (HR = 1.55, 95% CI = 1.27-1.88; < 0.001). Subgroup analyses revealed that high systemic immune-inflammation index indicated a worse overall survival in hepatocellular carcinoma ( < 0.001), urinary cancers ( < 0.001), gastrointestinal tract cancers ( 0.02), small cell lung cancer ( < 0.05) and acral melanoma ( < 0.001). Hazard ratio for systemic immune-inflammation index greater than the cutoff for cancer-specific survival was 1.44 ( < 0.05).
Elevated systemic immune-inflammation index is associated with a worse overall survival in many solid tumors. The systemic-inflammation index can act as a powerful prognostic indicator of poor outcome in patients with solid tumors.
炎症可能在癌症进展中起重要作用，据报道，较高的全身免疫炎症指数（SII）在几种恶性肿瘤中是不良预后标志物。然而，已发表研究的结果并不一致。
对数据库进行系统回顾，以搜索截至2017年2月12日关于实体瘤血液SII与临床结局之间关联的出版物。主要结局是总生存期（OS），次要结局是无进展生存期（PFS）和癌症特异性生存期（CSS）。采用合并风险比（HRs）和95%置信区间（CIs）来评估实体瘤血液SII与临床结局之间关联的强度。
分析共纳入15篇文章。总体而言，全身免疫炎症指数高于临界值预示着较差的总生存期（HR = 1.55，95%CI = 1.27 - 1.88；<0.001）。亚组分析显示，高全身免疫炎症指数表明肝细胞癌（<0.001）、泌尿系统癌症（<0.001）、胃肠道癌症（0.02）、小细胞肺癌（<0.05）和肢端黑色素瘤（<0.001）的总生存期更差。全身免疫炎症指数高于癌症特异性生存期临界值的风险比为1.44（<0.05）。
全身免疫炎症指数升高与许多实体瘤较差的总生存期相关。全身炎症指数可作为实体瘤患者不良结局的有力预后指标。
