Rimini Margherita, Casadei-Gardini Andrea, Ravaioli Alessandra, Rovesti Giulia, Conti Fabio, Borghi Alberto, Dall'Aglio Anna Chiara, Bedogni Giorgio, Domenicali Marco, Giacomoni Pierluigi, Tiribelli Claudio, Bucchi Lauro, Falcini Fabio, Foschi Francesco Giuseppe
Department of Oncology and Hematology, Division of Oncology, University Hospital Modena, 73828 Modena, Italy.
Romagna Cancer Registry-Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, 47014 Meldola, Italy.
J Clin Med. 2020 Apr 20;9(4):1177. doi: 10.3390/jcm9041177.
Despite the robust data available on inflammatory indices (neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and systemic immune-inflammation index (SII)) and clinical outcome in oncological patients, their utility as a predictor of cancer incidence in the general population has not been reported in literature.
The Bagnacavallo study was performed between October 2005 and March 2009. All citizens of Bagnacavallo (Ravenna, Emilia-Romagna, Italy) aged 30-60 years as of January 2005 were eligible and were invited by written letter to participate to the study. All participants underwent a detailed clinical history and physical examination following the model of the Dionysos Study. All blood values included in the analysis were obtained the day of physical examination. Cancer incidence data were obtained from the population-based Romagna Cancer Registry, which operates according to standard methods. The aim of this analysis was to examine the association between metabolic syndrome and baseline SII, NLR, and PLR levels, and the diagnosis of an invasive cancer in the Bagnacavallo study cohort.
At univariate analysis, metabolic syndrome was not associated with an increase of cancer incidence (HR 1.30; = 0.155). High glucose (HR 1.49; = 0.0.16), NLR HR 1.54, = 0.002), PLR (HR 1.58, = 0.001), and SII (HR 1.47, = 0.006) were associated with an increase of cancer incidence. After adjusting for clinical covariates (smoking, physical activity, education, age, and gender) SII, PLR, and NLR remained independent prognostic factors for the prediction of cancer incidence.
Inflammatory indices are promising, easy to perform, and inexpensive tools for identifying patients with higher risk of cancer in cancer-free population.
尽管有关于炎症指标（中性粒细胞淋巴细胞比值（NLR）、血小板淋巴细胞比值（PLR）和全身免疫炎症指数（SII））以及肿瘤患者临床结局的丰富数据，但它们作为一般人群癌症发病率预测指标的效用在文献中尚未见报道。
巴尼亚卡瓦洛研究于2005年10月至2009年3月进行。截至2005年1月，巴尼亚卡瓦洛（意大利艾米利亚 - 罗马涅大区拉文纳市）所有30至60岁的公民均符合条件，并收到书面邀请参与该研究。所有参与者按照狄俄尼索斯研究的模式接受了详细的临床病史和体格检查。分析中纳入的所有血液值均在体格检查当天获得。癌症发病率数据来自按照标准方法运作的基于人群的罗马涅癌症登记处。本分析的目的是在巴尼亚卡瓦洛研究队列中检验代谢综合征与基线SII、NLR和PLR水平之间的关联以及浸润性癌症的诊断。
在单变量分析中，代谢综合征与癌症发病率增加无关（风险比1.30；P = 0.155）。高血糖（风险比1.49；P = 0.16）、NLR（风险比1.54，P = 0.002）、PLR（风险比1.58，P = 0.001）和SII（风险比1.47，P = <0.006）与癌症发病率增加相关。在对临床协变量（吸烟、身体活动、教育程度、年龄和性别）进行调整后，SII、PLR和NLR仍然是预测癌症发病率的独立预后因素。
炎症指标是有前景的、易于操作且成本低廉的工具，可用于识别无癌人群中患癌风险较高的患者。
