Oncology Department, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan, Ningxia, China.
Eur Rev Med Pharmacol Sci. 2023 Jun;27(12):5706-5720. doi: 10.26355/eurrev_202306_32811.
The aim of this study is to explore the potential value of high preoperative systemic immune-inflammation index (SII) expression in the prognosis of patients with gastric cancer (GC) by meta-analysis.
The major databases were searched to screen relevant clinical studies on the prognostic value of SII in gastric cancer (GC) patients, published from the establishment of the database to May 2022. RevMan 5.3 was utilized to perform a meta-analysis of relevant data. The differences in age, tumor size, differentiation degree, tumor-node-metastasis (TNM) stage, overall survival (OS), neutrophil to lymphocyte ratio (NLR), and platelet to lymphocyte ratio (PLR) between the high SII expression group (H-SII) and the low SII expression group (L-SII) were compared. Heterogeneity was assessed by Cochran's Chi-square test.
A total of 16 studies with 5,995 GC patients were included. Compared with the L-SII group, the proportion of patients older than 60 years in the H-SII group was markedly higher (OR=0.85, 95% CI: 0.75-0.97; Z=2.45, p=0.01); the proportion of patients with tumor size larger than 5 cm increased (OR=2.18, 95% CI: 1.69-2.81; Z=6.03, p<0.00001); the proportion of patients with TNM stage ≥T3 increased (OR=2.41, 95% CI: 1.89-3.08; Z=7.06, p<0.00001); overall survival (OS) decreased (OR=-23.92, 95% CI: -37.57 to -10.26; Z=3.43, p=0.0006); the 5-year survival rate (SR) decreased markedly (OR=0.39, 95% CI: 0.24-0.64; Z=3.81, p=0.0001); the proportion of patients with high NLR expression was increased (OR=22.19, 95% CI: 10.66-46.18; Z=8.29, p<0.00001); and the proportion of patients with high PLR expression was also markedly increased (OR=15.97, 95% CI: 8.57-29.75; Z=8.73, p<0.00001).
A high preoperative SII was an independent risk factor for poor prognosis in GC patients.
本研究旨在通过荟萃分析探讨术前高全身免疫炎症指数（SII）表达对胃癌（GC）患者预后的潜在价值。
检索主要数据库，筛选出关于 SII 对 GC 患者预后预测价值的相关临床研究，检索时间从数据库建立至 2022 年 5 月。采用 RevMan 5.3 对相关数据进行荟萃分析。比较高 SII 表达组（H-SII）和低 SII 表达组（L-SII）在年龄、肿瘤大小、分化程度、肿瘤-淋巴结-转移（TNM）分期、总生存（OS）、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）方面的差异。采用 Cochran's Chi-square 检验评估异质性。
共纳入 16 项研究，包含 5995 例 GC 患者。与 L-SII 组相比，H-SII 组年龄大于 60 岁的患者比例明显更高（OR=0.85，95%CI：0.75-0.97；Z=2.45，p=0.01）；肿瘤直径大于 5cm 的患者比例增加（OR=2.18，95%CI：1.69-2.81；Z=6.03，p<0.00001）；TNM 分期≥T3 的患者比例增加（OR=2.41，95%CI：1.89-3.08；Z=7.06，p<0.00001）；OS 降低（OR=-23.92，95%CI：-37.57 至-10.26；Z=3.43，p=0.0006）；5 年生存率（SR）显著降低（OR=0.39，95%CI：0.24-0.64；Z=3.81，p=0.0001）；高 NLR 表达患者的比例增加（OR=22.19，95%CI：10.66-46.18；Z=8.29，p<0.00001）；高 PLR 表达患者的比例也显著增加（OR=15.97，95%CI：8.57-29.75；Z=8.73，p<0.00001）。
术前高 SII 是 GC 患者预后不良的独立危险因素。
