Department of Medical and Radiation Oncology, Linyi People's Hospital, 27 Jie Fang Road, Linyi, 276003, Shandong, China.
Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, China.
Lung. 2020 Apr;198(2):405-414. doi: 10.1007/s00408-020-00333-6. Epub 2020 Feb 3.
Systemic immune-inflammation index (SII) has been demonstrated to be closely associated with prognosis of a series of solid tumors. However, its role in small cell lung cancer (SCLC) remains poorly understood. The present study aims to evaluate the prognostic significance of pretreatment SII in SCLC treated with etoposide and platinum-based chemotherapy.
Sixty hundred and fifty-three newly diagnosed SCLC patients were enrolled. The optimal cut-off values for SII and LDH (lactate dehydrogenase) were obtained by a receiver operating characteristic (ROC) curve analysis. Overall survival (OS) was assessed by univariate and multivariate analyses.
The optimal cut-off values of pretreatment SII and LDH were 748.51 × 10/L and 188.5 U/L, respectively. High pretreatment SII was significantly associated with advanced tumor stage (limited disease, LD vs. extensive disease, ED; 26.3% vs 46.5%; p < 0.001). On univariate analysis, age < 65 years, female, non-smoker, limited disease, SII < 748.51 × 10/L, LDH < 188.5 U/L, distant metastasis numbers < 2, chemotherapy + radiotherapy, and chemotherapy + surgery were closely correlated with a prolonged OS (p < 0.05). The median OS for patients in high SII group was 12.0 months, compared with that of 17.0 months for patients in low SII group. Multivariate analysis showed smoking history (p = 0.014), tumor stage (p < 0.001), pretreatment SII (p < 0.001), LDH (p = 0.002), distant metastasis numbers (p = 0.006), and chemotherapy + radiotherapy (p < 0.001) were independent prognostic factors of OS. Furthermore, SII remained prognostic significance for SCLC stratified by variable subgroups analysis.
Pretreatment SII represents a powerful prognostic biomarker for SCLC patients treated with etoposide and platinum-based chemotherapy. It is significant for treatment strategy making in clinics.
全身性免疫炎症指数（SII）已被证明与一系列实体瘤的预后密切相关。然而，其在小细胞肺癌（SCLC）中的作用仍知之甚少。本研究旨在评估 SII 在接受依托泊苷和铂类化疗的 SCLC 患者中的预后意义。
纳入 653 例新诊断的 SCLC 患者。通过受试者工作特征（ROC）曲线分析获得 SII 和乳酸脱氢酶（LDH）的最佳截断值。采用单因素和多因素分析评估总生存期（OS）。
SII 和 LDH 的最佳截断值分别为 748.51×10/L 和 188.5 U/L。高 SII 与晚期肿瘤分期（局限期，LD 与广泛期，ED；26.3%比 46.5%；p<0.001）显著相关。单因素分析显示，年龄<65 岁、女性、非吸烟者、局限期、SII<748.51×10/L、LDH<188.5 U/L、远处转移数<2、化疗+放疗和化疗+手术与延长 OS 密切相关（p<0.05）。高 SII 组患者的中位 OS 为 12.0 个月，而低 SII 组患者的中位 OS 为 17.0 个月。多因素分析显示，吸烟史（p=0.014）、肿瘤分期（p<0.001）、SII 水平（p<0.001）、LDH（p=0.002）、远处转移数（p=0.006）和化疗+放疗（p<0.001）是 OS 的独立预后因素。此外，SII 分层变量亚组分析后仍然是 SCLC 的预后标志物。
SII 是接受依托泊苷和铂类化疗的 SCLC 患者的一种强大的预后生物标志物。它对临床治疗策略的制定具有重要意义。
