Departments of Surgery, Jikei University School of Medicine, 3-25-8, Nishi-shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
Int J Colorectal Dis. 2020 Aug;35(8):1549-1555. doi: 10.1007/s00384-020-03615-w. Epub 2020 May 8.
Systemic inflammatory response has been reported to be associated with prognosis in cancer patients. The aim of this study is to investigate the association between Systemic Immune-Inflammation Index (SII), a novel inflammation-based prognostic score and long-term outcomes among patients with colorectal cancer (CRC) after resection.
We retrospectively investigated 733 patients who underwent resection for CRC between January 2010 and December 2014 at the Jikei University Hospital and explored the relationship between SII, calculated by multiplying the peripheral platelet count by neutrophil count and divided by lymphocyte count, and overall survival. In survival analyses, we conducted Cox proportional hazards models, adjusting potential confounders including TNM stage, serum CEA, serum CA 19-9, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and platelet count.
In multivariate analysis, age ≥ 65 years (p = 0.003), tumor location (p = 0.043), advanced TNM stage (p < 0.001), serum CA 19-9 > 37 mU/ml (p < 0.001), and SII (P for trend = 0.017) were independent and significant predictors of poor patient survival. Compared to patients with low SII, those with high and intermediate SII patients had poorer survival (Hazard ratio 2.48; 95% CI 1.31-4.69, Hazard ratio 1.65; 95% CI 0.83-3.27, respectively).
The Systemic Immune-Inflammation Index might be an independent and significant indicator of poor long-term outcomes in patients with CRC after resection.
已有报道称全身炎症反应与癌症患者的预后相关。本研究旨在探讨新型炎症相关预后评分系统——全身免疫炎症指数(SII)与结直肠癌(CRC)患者切除术后长期结局的关系。
我们回顾性调查了 2010 年 1 月至 2014 年 12 月期间在日本顺天堂大学医院接受 CRC 切除术的 733 例患者,并探讨了 SII(外周血小板计数与中性粒细胞计数的乘积除以淋巴细胞计数)与总生存期之间的关系。在生存分析中,我们进行了 Cox 比例风险模型分析,调整了包括 TNM 分期、血清 CEA、血清 CA19-9、中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值和血小板计数在内的潜在混杂因素。
在多变量分析中,年龄≥65 岁(p=0.003)、肿瘤位置(p=0.043)、晚期 TNM 分期(p<0.001)、血清 CA19-9>37 mU/ml(p<0.001)和 SII(趋势 P=0.017)是患者生存不良的独立且显著的预测因素。与 SII 低的患者相比,SII 高和中值的患者生存较差(风险比 2.48;95%CI 1.31-4.69,风险比 1.65;95%CI 0.83-3.27)。
全身免疫炎症指数可能是 CRC 患者切除术后预后不良的独立且显著的指标。