Systemic immune-inflammation index predicting chemoradiation resistance and poor outcome in patients with stage III non-small cell lung cancer

Journal of Translational Medicine

Research

Juan Tan¹  Yu-Suo Tong²  Ya-Qi Song²  Xi-Lei Zhou²  Ying-Jian Song³ 

[1] Department of Gerontology, Huai’an First People’s Hospital, Nanjing Medical University, Huai’an, Jiangsu, China;Department of Radiation Oncology, Huai’an First People’s Hospital, Nanjing Medical University, Huai’an, Jiangsu, China;Department of Respiratory Medicine, Huai’an First People’s Hospital, Nanjing Medical University, Huai’an, Jiangsu, China;

关键词: Non-small cell lung cancer, prognostic factor;    Systemic immune-inflammation index;    Chemoradiation;   

DOI  :  10.1186/s12967-017-1326-1

 received in 2017-09-14, accepted in 2017-10-26,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThere is increasing evidence that the existence of systemic inflammation response is correlated with poor prognosis in several solid tumors. The aim of this retrospective study was to investigate the association between systemic immune-inflammation index (SII) and therapy response and overall survival in patients with stage III non-small cell lung cancer (NSCLC). The prognostic values of neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and prognostic nutritional index (PNI) were also evaluated.MethodsIn total, 332 patients with new diagnosis of stage III NSCLC were included in this retrospective analysis. SII was defined as platelet counts × neutrophil counts/lymphocyte counts. Receiver operating characteristic (ROC) curve was used to evaluate the optimal cut-off value for SII, NLR, PLR and PNI. Univariate and multivariate survival analysis were performed to identify the factors correlated with overall survival.ResultsApplying cut-offs of ≥ 660 (SII), ≥ 3.57 (NLR), ≥ 147 (PLR), ≤ 52.95 (PNI), SII ≥ 660 was significantly correlated with worse ECOG PS (< 0.001), higher T stage (< 0.001), advanced clinical stage (p = 0.019), and lower response rate (p = 0.018). In univariate analysis, SII ≥ 660, NLR ≥ 3.57, PLR ≥ 147, and PNI ≤ 52.95 were significantly associated with worse overall survival (pall < 0.001). Patients with SII ≥ 660 had a median overall survival of 10 months, and patients with SII < 660 showed a median overall survival of 30 months. In multivariate analysis only ECOG PS (HR, 1.744; 95% CI 1.158–2.626; p = 0.008), T stage (HR, 1.332; 95% CI 1.032–1.718; p = 0.028), N stage (HR, 1.848; 95% CI 1.113–3.068; p = 0.018), SII (HR, 2.105; 95% CI 1.481–2.741; p < 0.001) and NLR ≥ 3.57 (HR, 1.934; 95% CI 1.448–2.585; p < 0.001) were independently correlated with overall survival.ConclusionsThis study demonstrates that the SII is an independent prognostic indicator of poor outcomes for patients with stage III NSCLC and is superior to other inflammation-based factors in terms of prognostic ability.

【 授权许可】

CC BY   
© The Author(s) 2017