Hirahara Noriyuki, Matsubara Takeshi, Fujii Yusuke, Kaji Shunsuke, Kawabata Yasunari, Hyakudomi Ryoji, Yamamoto Tetsu, Taniura Takahito, Tajima Yoshitsugu
Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Shimane 693-8501, Japan.
Oncotarget. 2020 Jul 7;11(27):2625-2635. doi: 10.18632/oncotarget.27653.
Systemic immune-inflammation index (SII)-comprising platelet, neutrophil, and lymphocyte count-is an objective and reliable biomarker for predicting the prognosis in cancer patients because it comprehensively reflects the balance between host inflammatory and immune responses. In this study, we clarified the prognostic impact of immunoinflammation-based indices, i. e. SII, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR), in gastric cancer patients. In multivariate analysis, the American Society of Anesthesiologists physical status (ASA-PS) (hazard ratio [HR]: 3.366, < 0.001), tumor differentiation (HR: 1.705, = 0.020), pathological Tumor, Node, Metastasis (pTNM) stage (HR: 2.160, = 0.008), and carcinoembryonic antigen (CEA) (HR: 1.964, = 0.003) were independent prognostic factors for OS in all patients. Further, multivariate analysis revealed that age (HR: 2.088, = 0.040), ASA-PS (HR: 2.339, = 0.043), tumor differentiation (HR: 1.748, = 0.044), and pTNM stage (HR: 2.114, = 0.024) were independent prognostic factors for OS among patients without inflammation; SII was not a prognostic factor for OS. Meanwhile, body mass index (HR: 5.055, = 0.011), ASA-PS (HR: 3.403, = 0.007), and SII (HR: 4.208, = 0.026) were independent prognostic factors for OS among patients with inflammation. We performed a retrospective review of 412 patients who underwent curative laparoscopic gastrectomy. The prognostic value of SII was compared between a low SII group (SII<661.9) and high SII group (SII≥661.9). We analyzed the predictive ability of immunoinflammation-based indices for overall survival (OS) based on a C-reactive protein (CRP) level of 0.5. Compared to NLR and PLR, SII is the most significant prognostic biomarker for OS, especially in gastric cancer patients with inflammation.
全身免疫炎症指数（SII）由血小板、中性粒细胞和淋巴细胞计数组成，是预测癌症患者预后的客观可靠生物标志物，因为它全面反映了宿主炎症和免疫反应之间的平衡。在本研究中，我们阐明了基于免疫炎症的指标，即SII、中性粒细胞/淋巴细胞比值（NLR）和血小板/淋巴细胞比值（PLR）对胃癌患者预后的影响。在多因素分析中，美国麻醉医师协会身体状况（ASA-PS）（风险比[HR]：3.366，<0.001）、肿瘤分化程度（HR：1.705，=0.020）、病理肿瘤、淋巴结、转移（pTNM）分期（HR：2.160，=0.008）和癌胚抗原（CEA）（HR：1.964，=0.003）是所有患者总生存期（OS）的独立预后因素。此外，多因素分析显示，年龄（HR：2.088，=0.040）、ASA-PS（HR：2.339，=0.043）、肿瘤分化程度（HR：1.748，=0.044）和pTNM分期（HR：2.114，=0.024）是无炎症患者OS的独立预后因素；SII不是OS的预后因素。同时，体重指数（HR：5.055，=0.011）、ASA-PS（HR：3.403，=0.007）和SII（HR：4.208，=0.026）是有炎症患者OS的独立预后因素。我们对412例行根治性腹腔镜胃切除术的患者进行了回顾性研究。比较了低SII组（SII<661.9）和高SII组（SII≥661.9）之间SII的预后价值。我们基于C反应蛋白（CRP）水平0.5分析了基于免疫炎症指标对总生存期（OS）的预测能力。与NLR和PLR相比，SII是OS最显著的预后生物标志物，尤其是在有炎症的胃癌患者中。
