Li Duqiang, Zhao Xiaoyan, Pi Xingtao, Wang Kai, Song Dong
Department of Interventional Therapy, Shanxi Bethune Hospital, 99 Longcheng Street, Xiaodian District, Taiyuan, 030032, China.
Department of Breast Surgery, Shanxi Maternal and Child Health Hospital, Taiyuan, 030013, China.
Clin Exp Med. 2023 Oct;23(6):2105-2114. doi: 10.1007/s10238-022-00889-y. Epub 2022 Oct 26.
The systemic immune-inflammation index (SII), derived from neutrophil, platelet, and lymphocyte counts, has been associated with prognosis of patients with cancer. We performed a meta-analysis to evaluate the association between pretreatment SII and survival of patients with hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE). Cohort studies were identified by search of PubMed, Embase, Web of Science, CNKI, and Wanfang databases. Pooling the results was achieved with a random-effect model that incorporates potential heterogeneity between studies. Nine studies including 3557 patients with HCC contributed to the meta-analysis. Compared to patients with a lower SII, HCC patients with a higher pretreatment SII had poor overall survival (OS, hazard ratio [HR] 1.66, 95% confidence interval [CI] 1.25-2.21, p < 0.001; I = 80%) and poor progression-free survival (PFS, HR 1.28, 95% CI 1.05-1.56, p = 0.01; I = 0%) after TACE treatment. Further subgroup analyses confirmed a significant association between a high pretreatment SII and poor OS after TACE, which was not significantly affected by study country, sample size, age of the patients, cutoff values for SII, and adjustment of Child-Pugh score or alpha fetoprotein (p for subgroup effect all < 0.05). However, a higher SII was associated with poor OS in studies with follow-up duration ≤ 24 months (HR 1.94, 95% CI 1.39-2.72, p < 0.001), but the association was not statistically significant in studies with follow-up duration > 24 months (HR 1.27, 95% CI: 0.96-1.68, p = 0.09). A higher pretreatment SII was correlated with poor survival of HCC patients after TACE. A preliminary measurement of SII may be valuable for the prediction of the prognosis in HCC patients after TACE.
全身免疫炎症指数（SII）由中性粒细胞、血小板和淋巴细胞计数得出，与癌症患者的预后相关。我们进行了一项荟萃分析，以评估经动脉化疗栓塞（TACE）前SII与肝细胞癌（HCC）患者生存之间的关联。通过检索PubMed、Embase、Web of Science、CNKI和万方数据库确定队列研究。采用纳入研究间潜在异质性的随机效应模型汇总结果。9项研究共纳入3557例HCC患者，参与了荟萃分析。与SII较低的患者相比，TACE治疗前SII较高的HCC患者总生存期（OS，风险比[HR]1.66，95%置信区间[CI]1.25-2.21，p<0.001；I=80%）和无进展生存期（PFS，HR 1.28，95%CI 1.05-1.56，p=0.01；I=0%）较差。进一步的亚组分析证实，TACE治疗前SII较高与OS较差之间存在显著关联，且不受研究国家、样本量、患者年龄、SII临界值以及Child-Pugh评分或甲胎蛋白调整的显著影响（亚组效应p均<0.05）。然而，在随访时间≤24个月的研究中，较高的SII与较差的OS相关（HR 1.94，95%CI 1.39-2.72，p<0.001），但在随访时间>24个月的研究中，这种关联无统计学意义（HR 1.27，95%CI：0.96-1.68，p=0.09）。TACE治疗前较高的SII与HCC患者较差的生存率相关。SII的初步测量可能对预测TACE术后HCC患者的预后有价值。
