Wang Yan, Li Yina, Chen Pingrun, Xu Wenying, Wu Yanming, Che Guowei
Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
West China School of Medicine, Sichuan University, Chengdu 610041, China.
Ann Transl Med. 2019 Sep;7(18):433. doi: 10.21037/atm.2019.08.116.
The objective of this study is to explore the association between the pretreatment systemic immune-inflammation index (SII) and prognosis in non-small cell lung cancer (NSCLC) patients.
A systemic literature search of PubMed, EMBASE, the Web of Science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, VIP and SinoMed databases was performed from January 1, 1966 to April 15, 2019, to identify potential studies that assessed the prognostic role of the pretreatment SII in NSCLC. The hazard ratio (HR) and 95% confidence interval (CI) were combined to evaluate the correlation of the pretreatment SII with overall survival (OS), disease-free survival (DFS), progression-free survival (PFS) and cancer-specific survival (CSS) in NSCLC patients.
A total of 9 studies involving 2,441 patients were eventually included. An elevated pretreatment SII indicated significantly poorer OS (HR =1.88, 95% CI: 1.50-2.36; P<0.001) with high heterogeneity (I=60.6%, P=0.019), DFS/PFS (HR =2.50, 95% CI: 1.20-5.20; P=0.014) with high heterogeneity (I=58.2%, P=0.092) and CSS (HR =1.852, 95% CI: 1.185-2.915; P=0.007). Subgroup analyses further verified the above results. In addition, compared with the neutrophil to lymphocyte ratio (NLR) and the platelet to lymphocyte ratio (PLR), the SII showed a much higher prognostic value in NSCLC.
The pretreatment SII may serve as a useful prognostic indicator in NSCLC and contribute to prognosis evaluation and treatment strategy formulation. However, more well-designed studies are warranted to verify our findings.
本研究旨在探讨非小细胞肺癌（NSCLC）患者治疗前全身免疫炎症指数（SII）与预后之间的关联。
对1966年1月1日至2019年4月15日期间的PubMed、EMBASE、科学网、Cochrane图书馆、中国知网（CNKI）、万方、维普和中国生物医学文献数据库进行全面文献检索，以确定评估治疗前SII在NSCLC中预后作用的潜在研究。合并风险比（HR）和95%置信区间（CI），以评估治疗前SII与NSCLC患者总生存期（OS）、无病生存期（DFS）、无进展生存期（PFS）和癌症特异性生存期（CSS）的相关性。
最终纳入9项研究，共2441例患者。治疗前SII升高表明OS显著较差（HR =1.88，95%CI：1.50 - 2.36；P<0.001），异质性高（I=60.6%，P=0.019），DFS/PFS也较差（HR =2.50，95%CI：1.20 - 5.20；P=0.014），异质性高（I=58.2%，P=0.092），CSS同样较差（HR =1.852，95%CI：1.185 - 2.915；P=0.007）。亚组分析进一步验证了上述结果。此外，与中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）相比，SII在NSCLC中显示出更高的预后价值。
治疗前SII可能是NSCLC中一个有用的预后指标，有助于预后评估和治疗策略的制定。然而，需要更多设计良好的研究来验证我们的发现。
