Hua Xin, Long Zhi-Qing, Zhang Yu-Ling, Wen Wen, Guo Ling, Xia Wen, Zhang Wen-Wen, Lin Huan-Xin
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China.
Jiangxi Provincial People's Hospital, Nanchang, China.
Front Oncol. 2020 Apr 21;10:580. doi: 10.3389/fonc.2020.00580. eCollection 2020.
It was reported that the novel preoperative systemic immune-inflammation index (SII) can predict survival in cases of many malignant tumors. However, the prognostic significance of preoperative SII in breast cancer remains unclear. The purpose of this study was to investigate the relationship between SII and survival in breast cancer patients. Breast cancer patients (1,026) who underwent a mastectomy at Sun Yat-sen University Cancer Center were retrospectively studied. The SII was determined using the following formula: neutrophil count × platelet count/lymphocyte count. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value for SII. Propensity score matching (PSM) was applied to develop comparable cohorts of high SII group and low SII group. A total of 1,026 patients were included as the primary cohort, and 894 patients were matched and regarded as the matched cohort. Patients were divided into two groups based on SII value: SII <601.7 and high SII >601.7. In the primary cohort, the 5-years overall survival (OS), recurrence-free survival (RFS), and distant metastasis-free survival (DMFS) rates for high SII group and low SII group were (85.6% vs. 91.3%, = 0.016), (95.8% vs. 96.4%, = 0.684), and (83.5% vs. 90.6%, = 0.007), respectively. Univariate analysis showed that histological type, T stage, N stage, PR, HER2, Ki67, and SII all showed significant associations with OS; and histological type, T stage, N stage, and SII all showed significant associations with DMFS. Multivariate survival analysis revealed that SII can independently predict OS ( = 0.017) and DMFS ( = 0.007). Similar results were found in PSM cohort. Preoperative SII may be a reliable predictor of OS and DMFS in patients with operable breast cancer to provide personalized prognostication and assist in formulation of the clinical treatment strategy.
据报道，新型术前全身免疫炎症指数（SII）可预测多种恶性肿瘤患者的生存情况。然而，术前SII在乳腺癌中的预后意义仍不明确。本研究旨在探讨SII与乳腺癌患者生存之间的关系。对中山大学肿瘤防治中心行乳房切除术的1026例乳腺癌患者进行回顾性研究。SII采用以下公式计算：中性粒细胞计数×血小板计数/淋巴细胞计数。采用受试者工作特征（ROC）曲线确定SII的最佳临界值。应用倾向评分匹配（PSM）方法构建SII高分组和低分组的可比队列。共纳入1026例患者作为原始队列，894例患者进行匹配并作为匹配队列。根据SII值将患者分为两组：SII<601.7为低SII组，SII>601.7为高SII组。在原始队列中，高SII组和低SII组的5年总生存（OS）率、无复发生存（RFS）率和无远处转移生存（DMFS）率分别为（85.6%对91.3%，P = 0.016）、（95.8%对96.4%，P = 0.684）和（83.5%对90.6%，P = 0.007）。单因素分析显示，组织学类型、T分期、N分期、PR、HER2、Ki67和SII均与OS显著相关；组织学类型、T分期、N分期和SII均与DMFS显著相关。多因素生存分析显示，SII可独立预测OS（P = 0.017）和DMFS（P = 0.007）。在PSM队列中也发现了类似结果。术前SII可能是可手术乳腺癌患者OS和DMFS的可靠预测指标，可为个性化预后评估提供依据，并有助于制定临床治疗策略。
