Second Department of Oncology, Faculty of Medicine, Comenius University, Klenova 1, Bratislava 833 10, Slovakia.
Department of Oncology, National Cancer Institute, Klenova 1, Bratislava 833 10, Slovakia.
Br J Cancer. 2018 Mar 20;118(6):831-838. doi: 10.1038/bjc.2017.460. Epub 2018 Feb 27.
We evaluated systemic immune-inflammation index (SII) and its association with patient outcome in germ-cell tumours (GCTs).
Two independent cohorts of patients were analysed; the discovery set (n=171) from a single institution and the validation set (n=181) previously included in a study evaluating PD-L1 in GCTs. The SII was calculated using platelet (P), neutrophil (N) and lymphocyte (L) counts before chemotherapy and correlated with survival using regression analyses and Kaplan-Meier method.
In the discovery cohort, the SII was associated with poor risk clinical features. Patients with low SII had significantly longer progression-free survival (HR=0.22, 95% CI 0.12-0.41, P<0.001) and overall survival (OS) (HR=0.16, 95% CI 0.08-0.32, P<0.001) compared to high SII. This index was independent of International Germ Cell Cancer Collaborative Group criteria in multivariable Cox regression analysis for OS and was validated in an independent cohort. When combining PD-L1 expression on tumour infiltrating lymphocytes (TILs) and SII, we identified three distinctive prognostic groups.
High SII was associated with poor outcome in GCTs. Combination of PD-L1 positive TILs and SII could further refine prognosis in GCTs.
我们评估了全身免疫炎症指数（SII）及其与生殖细胞肿瘤（GCT）患者预后的关系。
分析了两个独立的患者队列；一个是来自单个机构的发现队列（n=171），另一个是以前包含在评估 GCT 中 PD-L1 的研究中的验证队列（n=181）。在化疗前使用血小板（P）、中性粒细胞（N）和淋巴细胞（L）计数计算 SII，并使用回归分析和 Kaplan-Meier 方法将其与生存相关联。
在发现队列中，SII 与不良风险的临床特征相关。低 SII 患者的无进展生存期（HR=0.22，95%CI 0.12-0.41，P<0.001）和总生存期（OS）（HR=0.16，95%CI 0.08-0.32，P<0.001）显著长于高 SII。该指数在多变量 Cox 回归分析中独立于国际生殖细胞癌协作组标准用于 OS，并且在独立队列中得到验证。当将肿瘤浸润淋巴细胞（TILs）上的 PD-L1 表达与 SII 相结合时，我们确定了三个不同的预后组。
高 SII 与 GCT 的不良预后相关。PD-L1 阳性 TILs 和 SII 的组合可以进一步细化 GCT 的预后。
