Tomita Masaki, Ayabe Takanori, Maeda Ryo, Nakamura Kunihide
Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki, Kiyotake, Japan
Department of Thoracic and Breast Surgery, Faculty of Medicine, University of Miyazaki, Kiyotake, Japan.
In Vivo. 2018 May-Jun;32(3):663-667. doi: 10.21873/invivo.11291.
The systemic immune-inflammation index (SII) is reported to be associated with clinical outcomes and has been proven to be a promising prognostic indicator in several solid tumor types. To the best of our knowledge, however, no studies regarding SII in patients with resectable non-small cell lung cancer (NSCLC) are available.
Three hundred forty-one patients with NSCLC who underwent surgery at our Institution between 2008 and 2012 were included. The SII was calculated using the formula: platelet count × neutrophil/lymphocyte count. The optimal cut-off value was calculated using the Cutoff Finder (http://molpath.charite.de/cutoff). Univariate and multivariate analyses were calculated by the Cox proportional hazards regression model.
The optimal cut-off value was 471.2×109/l for SII. A low SII was associated with female gender, never smoking status, adenocarcinoma histology, higher pathological TNM stage and low level of serum C-reactive protein, but not age, serum carcinoembryonic antigen or cytokeratin 19 fragment level. Patients of the low SII group had a significantly better 5-year overall survival than those with high SII (83.61% vs. 60.39%, p<0.001). Multivariate analysis revealed that the SII was a significant independent predictive indicator for cancer-specific survival (p=0.007).
This is the first study to demonstrate that the SII could represent an independent prognostic factor for patients with resectable NSCLC.
据报道,全身免疫炎症指数(SII)与临床结局相关,并且已被证明是几种实体瘤类型中有前景的预后指标。然而,据我们所知,尚无关于可切除非小细胞肺癌(NSCLC)患者SII的研究。
纳入2008年至2012年在本机构接受手术的341例NSCLC患者。SII采用以下公式计算:血小板计数×中性粒细胞/淋巴细胞计数。使用Cutoff Finder(http://molpath.charite.de/cutoff)计算最佳临界值。采用Cox比例风险回归模型进行单因素和多因素分析。
SII的最佳临界值为471.2×10⁹/L。低SII与女性、从不吸烟、腺癌组织学类型、较高的病理TNM分期及低水平血清C反应蛋白相关,但与年龄、血清癌胚抗原或细胞角蛋白19片段水平无关。低SII组患者的5年总生存率显著高于高SII组患者(83.61%对60.39%,p<0.001)。多因素分析显示,SII是癌症特异性生存的显著独立预测指标(p=0.007)。
这是第一项证明SII可作为可切除NSCLC患者独立预后因素的研究。