系统免疫炎症指数预测 III 期非小细胞肺癌患者的放化疗耐药和不良预后。
Systemic immune-inflammation index predicting chemoradiation resistance and poor outcome in patients with stage III non-small cell lung cancer.
机构信息
Department of Radiation Oncology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China.
Department of Gerontology, Huai'an First People's Hospital, Nanjing Medical University, Huai'an, Jiangsu, China.
出版信息
J Transl Med. 2017 Oct 31;15(1):221. doi: 10.1186/s12967-017-1326-1.
BACKGROUND
There is increasing evidence that the existence of systemic inflammation response is correlated with poor prognosis in several solid tumors. The aim of this retrospective study was to investigate the association between systemic immune-inflammation index (SII) and therapy response and overall survival in patients with stage III non-small cell lung cancer (NSCLC). The prognostic values of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and prognostic nutritional index (PNI) were also evaluated.
METHODS
In total, 332 patients with new diagnosis of stage III NSCLC were included in this retrospective analysis. SII was defined as platelet counts × neutrophil counts/lymphocyte counts. Receiver operating characteristic (ROC) curve was used to evaluate the optimal cut-off value for SII, NLR, PLR and PNI. Univariate and multivariate survival analysis were performed to identify the factors correlated with overall survival.
RESULTS
Applying cut-offs of ≥ 660 (SII), ≥ 3.57 (NLR), ≥ 147 (PLR), ≤ 52.95 (PNI), SII ≥ 660 was significantly correlated with worse ECOG PS (< 0.001), higher T stage (< 0.001), advanced clinical stage (p = 0.019), and lower response rate (p = 0.018). In univariate analysis, SII ≥ 660, NLR ≥ 3.57, PLR ≥ 147, and PNI ≤ 52.95 were significantly associated with worse overall survival (p < 0.001). Patients with SII ≥ 660 had a median overall survival of 10 months, and patients with SII < 660 showed a median overall survival of 30 months. In multivariate analysis only ECOG PS (HR, 1.744; 95% CI 1.158-2.626; p = 0.008), T stage (HR, 1.332; 95% CI 1.032-1.718; p = 0.028), N stage (HR, 1.848; 95% CI 1.113-3.068; p = 0.018), SII (HR, 2.105; 95% CI 1.481-2.741; p < 0.001) and NLR ≥ 3.57 (HR, 1.934; 95% CI 1.448-2.585; p < 0.001) were independently correlated with overall survival.
CONCLUSIONS
This study demonstrates that the SII is an independent prognostic indicator of poor outcomes for patients with stage III NSCLC and is superior to other inflammation-based factors in terms of prognostic ability.
背景
越来越多的证据表明，全身炎症反应的存在与几种实体瘤的预后不良相关。本回顾性研究旨在探讨全身免疫炎症指数（SII）与 III 期非小细胞肺癌（NSCLC）患者治疗反应和总生存期之间的关系。还评估了中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和预后营养指数（PNI）的预后价值。
方法
本回顾性分析共纳入 332 例新诊断的 III 期 NSCLC 患者。SII 定义为血小板计数×中性粒细胞计数/淋巴细胞计数。使用受试者工作特征（ROC）曲线评估 SII、NLR、PLR 和 PNI 的最佳截断值。进行单因素和多因素生存分析以确定与总生存期相关的因素。
结果
应用截断值≥660（SII）、≥3.57（NLR）、≥147（PLR）、≤52.95（PNI）时，SII≥660 与较差的 ECOG PS（<0.001）、较高的 T 分期（<0.001）、较晚期的临床分期（p=0.019）和较低的反应率（p=0.018）显著相关。单因素分析显示，SII≥660、NLR≥3.57、PLR≥147 和 PNI≤52.95 与较差的总生存期显著相关（p<0.001）。SII≥660 的患者中位总生存期为 10 个月，SII<660 的患者中位总生存期为 30 个月。多因素分析仅显示 ECOG PS（HR，1.744；95%CI，1.158-2.626；p=0.008）、T 分期（HR，1.332；95%CI，1.032-1.718；p=0.028）、N 分期（HR，1.848；95%CI，1.113-3.068；p=0.018）、SII（HR，2.105；95%CI，1.481-2.741；p<0.001）和 NLR≥3.57（HR，1.934；95%CI，1.448-2.585；p<0.001）与总生存期独立相关。
结论
本研究表明，SII 是 III 期 NSCLC 患者预后不良的独立预后指标，在预后能力方面优于其他炎症相关因素。
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