Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara, Japan.
PLoS One. 2021 May 14;16(5):e0248871. doi: 10.1371/journal.pone.0248871. eCollection 2021.
The systemic immune-inflammation index (SII), which is calculated using absolute platelet, neutrophil, and lymphocyte counts, has recently attracted attentions as a prognostic indicator in patients with solid malignancies. In the current study, we retrospectively investigated the prognostic significance of pre-treatment SII among patients with endometrial cancer.
Endometrial cancer patients treated at Nara medical university hospital between 2008 and 2018 were included in the current study. Receiver operating characteristic (ROC) curve was used to find the optimal SII cut-off values for 3-years progression free survival (PFS) and overall survival (OS). Then, the predictive abilities of SII and its superiority over neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were investigated. Kaplan-Meier method was used to calculate the OS and PFS rates, and log-rank test was used to compare the survival rate between two groups. Univariate and multivariate Cox regression analysis were performed to identify risk factors for PFS and OS.
A total of 442 patients were included in the current study. The cut-off value of SII for predicting PFS and OS were defined by ROC analysis as 931 and 910, respectively. Univariate analyses showed that elevated SII was associated with significantly shorter survival (p <0.001 for both PFS and OS). Cox regression analyses revealed that an advanced FIGO stage (p <0.001 for both PFS and OS) and an elevated SII (p = 0.014 for PFS, p = 0.011 for OS) are the independent prognostic factors for survival. When SII was compared with NLR and PLR, SII showed greater area under curve for predicting survival.
The SII is an independent prognostic factor in endometrial cancer patients, allowing more precise survival estimation than PLR or NLR.
基于绝对血小板、中性粒细胞和淋巴细胞计数计算的全身免疫炎症指数（SII）最近作为实体恶性肿瘤患者的预后指标受到关注。本研究回顾性分析了 SII 与子宫内膜癌患者预后的关系。
纳入 2008 年至 2018 年在奈良医科大学医院接受治疗的子宫内膜癌患者。采用受试者工作特征（ROC）曲线确定 SII 预测 3 年无进展生存期（PFS）和总生存期（OS）的最佳截断值。然后，评估 SII 及其优于中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）的预测能力。Kaplan-Meier 法计算 OS 和 PFS 率，对数秩检验比较两组生存率。单因素和多因素 Cox 回归分析用于识别 PFS 和 OS 的危险因素。
本研究共纳入 442 例患者。ROC 分析确定 SII 预测 PFS 和 OS 的截断值分别为 931 和 910。单因素分析显示，SII 升高与生存时间明显缩短相关（PFS 和 OS 均<0.001）。Cox 回归分析显示，FIGO 分期较高（PFS 和 OS 均<0.001）和 SII 升高（PFS：p=0.014，OS：p=0.011）是生存的独立预后因素。与 NLR 和 PLR 相比，SII 预测生存的曲线下面积更大。
SII 是子宫内膜癌患者的独立预后因素，比 NLR 或 PLR 更能准确估计生存情况。
