Department of Gastrointestinal Oncology, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education-Beijing), Peking University Cancer Hospital and Institute, Beijing, P.R.C.
Curr Oncol. 2019 Feb;26(1):e30-e38. doi: 10.3747/co.26.4135. Epub 2019 Feb 1.
The role of systemic inflammation-based markers remains uncertain in advanced or metastatic neuroendocrine tumours (nets).
Systemic inflammatory factors, such as levels of circulating white blood cells and other blood components, were combined to yield inflammation-based prognostic scores [high-sensitivity inflammation-based Glasgow prognostic score (hsgps), neutrophil:lymphocyte ratio (nlr), platelet:lymphocyte ratio (plr), high-sensitivity inflammation-based prognostic index (hspi), and prognostic nutritional index (pni)], whose individual values as prognostic markers were retrospectively determined. Univariate and multivariate analyses were used to examine the association of inflammatory markers with overall survival (os).
The study included 135 patients. Univariate analysis revealed that elevated white blood cell count, elevated neutrophil count, low serum albumin, elevated high-sensitivity C-reactive protein, and elevated hspi, hsgps, and nlr scores were significantly associated with worse os. Multivariate analyses demonstrated that, apart from pathology grade and original site of the tumour, elevated hspi ( = 0.004) was an independent prognostic factor for worse os.
In the present study, elevated pretreatment hspi was observed to be an independent predictor of shorter os in patients with inoperable advanced or metastatic net. The hspi might thus provide additional guidance for therapeutic decision-making in such patients.
全身性炎症标志物在晚期或转移性神经内分泌肿瘤（NETs）中的作用仍不确定。
将循环白细胞和其他血液成分等全身性炎症因子结合起来，得出基于炎症的预后评分[高敏炎症格拉斯哥预后评分（hsgps）、中性粒细胞与淋巴细胞比值（nlr）、血小板与淋巴细胞比值（plr）、高敏炎症预后指数（hspi）和预后营养指数（pni）]，回顾性确定这些评分作为预后标志物的个体价值。采用单因素和多因素分析来检验炎症标志物与总生存期（OS）的相关性。
本研究纳入了 135 例患者。单因素分析显示，白细胞计数升高、中性粒细胞计数升高、血清白蛋白降低、高敏 C 反应蛋白升高以及 hspi、hsgps 和 nlr 评分升高与较差的 OS 显著相关。多因素分析表明，除了病理分级和肿瘤原发部位外，升高的 hspi（=0.004）是 OS 较差的独立预后因素。
在本研究中，发现术前 hspi 升高是不可切除的晚期或转移性 NET 患者 OS 较短的独立预测因子。因此，hspi 可能为这些患者的治疗决策提供额外的指导。
