Department of Urology, University of Health Sciences, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey.
Department of Urology, University of Health Sciences, Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
Int J Clin Pract. 2021 Apr;75(4):e13813. doi: 10.1111/ijcp.13813. Epub 2020 Nov 20.
We aimed to investigate the predictor role of the systemic immune-inflammation index (SII) on Bacille Calmette-Guerin (BCG) response in patients with high-risk non-muscle invasive bladder cancer (NMIBC).
A total of 96 patients with high-risk NMIBC, who received intravesical BCG, were enrolled in the study. BCG responsive group (group 1) and BCG failure group (group 2) were compared in terms of demographic and pathological data, peripheral lymphocyte, neutrophil and platelet counts, neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), SII, recurrence-free survival (RFS) and progression-free survival (PFS). The SII was calculated as in the formula: SII = neutrophil × platelet/lymphocyte. The prognostic ability of the SII for progression was analysed with multivariate backward stepwise regression models.
The mean follow-up time 34.635 ± 14.7 months. Group 2 had significantly higher SII, peripheral lymphocyte, neutrophil and platelet counts than group 1. An ROC curve was plotted for the SII to predict the BCG failure and the cut-off point was calculated as 672.75. Effect of the SII to the model was statistically significant (P = .003) and a higher SII increased the progression onefold. A tumour greater than 30 mm in size and a high SII together increased the progression 3.6 folds.
The SII might be a successful, non-invasive and low-cost parameter for prediction of BCG failure in patients with high-risk NMIBC. The cut-off value for SII is 672.75 and above this level BCG failure and progression to MIBC might be anticipated. However, these results should be validated in prospective randomised controlled studies with large patient groups.
我们旨在探讨全身免疫炎症指数（SII）对高危非肌层浸润性膀胱癌（NMIBC）患者卡介苗（BCG）反应的预测作用。
本研究共纳入 96 例接受膀胱内 BCG 治疗的高危 NMIBC 患者。比较 BCG 反应组（第 1 组）和 BCG 失败组（第 2 组）的人口统计学和病理数据、外周血淋巴细胞、中性粒细胞和血小板计数、中性粒细胞淋巴细胞比（NLR）、血小板淋巴细胞比（PLR）、SII、无复发生存（RFS）和无进展生存（PFS）。SII 按公式计算：SII=中性粒细胞×血小板/淋巴细胞。采用多变量向后逐步回归模型分析 SII 对进展的预测能力。
平均随访时间为 34.635±14.7 个月。第 2 组的 SII、外周血淋巴细胞、中性粒细胞和血小板计数明显高于第 1 组。绘制 SII 预测 BCG 失败的 ROC 曲线，并计算出截断点为 672.75。SII 对模型的影响具有统计学意义（P=0.003），SII 越高，进展的风险增加 1 倍。肿瘤大小大于 30mm 和高 SII 同时使进展的风险增加 3.6 倍。
SII 可能是预测高危 NMIBC 患者 BCG 失败的一种成功、非侵入性和低成本的参数。SII 的截断值为 672.75，高于该水平可能预示着 BCG 失败和向肌层浸润性膀胱癌进展。然而，这些结果需要在具有大样本量的前瞻性随机对照研究中进一步验证。
