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Liu X, Zhang Y, Li Y, Sang Y, Chai Y, Zhang L, Zhang H. Systemic immunity-inflammation index is associated with body fat distribution among U.S. adults: evidence from national health and nutrition examination survey 2011-2018. BMC Endocr Disord 2024; 24:189. [PMID: 39294646 PMCID: PMC11409527 DOI: 10.1186/s12902-024-01725-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 09/05/2024] [Indexed: 09/21/2024] Open
Abstract
OBJECTIVE The systemic immunity-inflammation index (SII) is a newly developed biomarker that provides an integrated measure of inflammation in the body. We aim to evaluate the relationship between SII and body fat distribution. METHODS Adults from the National Health and Nutrition Examination Survey (NHANES) 2011-2018 were included. The SII was computed using lymphocyte (LC), neutrophil (NC), and platelet (PC) counts as its components. Body fat distribution was assessed by (total, android, gynoid) percentage fat, total abdominal fat area, subcutaneous adipose tissue area, visceral adipose tissue area, and the ratio of visceral to subcutaneous adipose tissue area (V/S ratio). Multivariable weighted linear regression and subgroup analysis were use to examine the relationships between fat distribution and SII. Restricted cubic splines (RCS) and threshold effect analysis were used to examine analyze nonlinear associations. RESULTS After exclusions, a total of 11,192 adults with a weighted mean age of 38.46 ± 0.26 years were studied. In multivariable weighted linear regression, each level increase in log2SII was associated with increased of 0.23 SDs total percentage fat (95% CI = 0.03, 0.43) and 0.26 SDs android percentage fat (95% CI = 0.06, 0.47). Besides, the subgroup analysis showed that the positive association between SII and android percentage fat was mainly among obese individuals (BMI > 30 kg/m2) and non-obese individuals without DM or hypertension. Meanwhile, the relationship between SII and the V/S ratio was found to be significant in the female subgroup, the obese subgroup, individuals with non-alcoholic fatty liver disease (NAFLD), and those without diabetes mellitus. Finally, SII exhibited an inverted U-shaped relationship with total percentage fat, android percent fat and total abdominal fat. Accordingly, threshold effect analysis indicated a positive association between lower SII levels and total percentage fat, android percentage fat and total abdominal fat area. CONCLUSIONS In the nationwide study, it was observed that the SII exhibited a significant correlation with higher levels of body fat, specifically android fat. This association was particularly noticeable within specific subgroups of the population.
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Affiliation(s)
- Xue Liu
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, No. 324, Five-Jing Road, Jinan, Shandong Province, China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Yuhao Zhang
- Department of Urology, Linyi Central Hospital, Linyi, 276400, Shandong, China
| | - Yuchen Li
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, No. 324, Five-Jing Road, Jinan, Shandong Province, China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Yaodong Sang
- Department of Gastrointestinal Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yuwei Chai
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, No. 324, Five-Jing Road, Jinan, Shandong Province, China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Li Zhang
- Department of Vascular Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China
| | - Haiqing Zhang
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, No. 324, Five-Jing Road, Jinan, Shandong Province, China.
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong, China.
- Shandong Clinical Medical Center of Endocrinology and Metabolism, Jinan, 250021, China.
- Institute of Endocrinology and Metabolism, Shandong Academy of Clinical Medicine, Jinan, 250021, China.
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Zhang LN, Lu AX, Lin Y, Li J, Xu X, Yan CH, Zhang L. Association between systemic inflammation markers and blood pressure among children and adolescents: National Health and Nutrition Examination Survey. Pediatr Res 2024:10.1038/s41390-024-03472-1. [PMID: 39154142 DOI: 10.1038/s41390-024-03472-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 06/13/2024] [Accepted: 07/13/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND Few studies have estimated the associations of systemic inflammation markers and high blood pressure (HBP) in the pediatric population. METHODS Basing on data from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2018, we assessed the associations between four inflammation-related factors based on blood cell counts: systemic immune inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and risk for pediatric HBP by estimating odds ratios (ORs) using multivariable logistic regression models. RESULTS A total of 17,936 children aged 8-19 years were included in the analysis, representing about 36.7 million American children. The prevalence rates of elevated blood pressure (EBP) and hypertension (HTN) were 15.79% and 6.77%, respectively. The results showed that the ORs for EBP per standard deviation (SD) increment in SII and NLR were estimated at 1.11 [95% confidence interval (95%CI): 1.04, 1.17] and 1.08 (95%CI: 1.02, 1.15), respectively; and the OR for EBP per SD increment in LMP were estimated at 0.90 (95%CI: 0.83, 0.96). These associations were stronger in boys and younger children. CONCLUSIONS The study suggested that inflammation-related factors could serve as easily accessible early biomarkers for HBP risk prediction and prevention in children and adolescents. IMPACT The study suggested that inflammation-related factors could serve as easily accessible early biomarkers for HBP risk prediction and prevention in children and adolescents. This is the first study that demonstrates the close association between systemic inflammation markers and HBP in children and adolescents using nationally representative population data. The findings have more public health implications and support that systemic inflammation markers based on blood cell counts could serve as easily accessible biomarkers of HBP risk and prevention in earlier identification of the diseases.
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Affiliation(s)
- Li-Na Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - An-Xin Lu
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Yin Lin
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Jing Li
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Xi Xu
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Chong-Huai Yan
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China.
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
| | - Lin Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
- Department of Labor Health and Environmental Hygiene, School of Public Health, Lanzhou University, Lanzhou, 730000, China.
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Zhu S, Zhou Q, Hu Z, Jiang J. Assessment of neutrophil to lymphocyte ratio, platelet to lymphocyte ratio and systemic immune-inflammatory index, as diagnostic markers for neonatal sepsis. J Int Med Res 2024; 52:3000605241270696. [PMID: 39180295 PMCID: PMC11344890 DOI: 10.1177/03000605241270696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 06/24/2024] [Indexed: 08/26/2024] Open
Abstract
OBJECTIVE To assess the neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and systemic immune-inflammatory index (SII), as diagnostic markers for neonatal sepsis. METHODS This retrospective study involve neonates with sepsis and healthy neonates as controls. NLR, PLR, and SII were compared between groups. RESULT In total, 60 neonates with sepsis and 60 healthy controls were involved in the study. Compared with controls, the sepsis group had higher values for NLR, PLR and SII. Logistic regression analysis suggested that the NLR, PLR and SII were independent risk factors for neonatal sepsis. In addition, receiver operating characteristic (ROC) curve analysis indicated that the NLR, PLR and SII were reliable predictors of neonatal sepsis and SII had the best predictive value. CONCLUSIONS NLR, PLR and SII appear to be useful indicators for predicting neonatal sepsis.
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Affiliation(s)
- Shanshan Zhu
- Department of Pediatrics, The First People's Hospital of Linping District, Hangzhou, China
| | - Qian Zhou
- Department of Emergency, The Second Affiliated Hospital Of Zhejiang University, Hangzhou, China
| | - Zhonghua Hu
- Department of Pediatrics, The First People's Hospital of Linping District, Hangzhou, China
| | - Junsheng Jiang
- Department of Pediatrics, The First People's Hospital of Linping District, Hangzhou, China
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Palomino-Secca I, Peña-Tuya M, Quintana-García LA, Guevara Pinares MA, Quiñones-Laveriano DM, Malpartida Palomino R, De La Cruz-Vargas JA. Pan-immune-inflammation value and survival in patients with breast cancer from a Peruvian reference hospital. Sci Rep 2024; 14:17132. [PMID: 39054357 PMCID: PMC11272920 DOI: 10.1038/s41598-024-68304-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 07/22/2024] [Indexed: 07/27/2024] Open
Abstract
The pan-immune-inflammation value (PIV), calculated as (neutrophil × platelet × monocyte)/lymphocyte count, may be useful for estimating survival in breast cancer patients. To determine the prognostic value of PIV for overall survival in breast cancer patients in Lima, Peru. A retrospective cohort study was conducted. 97 breast cancer patients diagnosed between January 2010 and December 2016 had their medical records analyzed. The primary dependent variable was overall survival, and the key independent variable was the PIV, divided into high (≥ 310) and low (< 310) groups. Patient data included demographics, treatment protocols and other clinical variables. Statistical analysis involved Kaplan-Meier survival curves and Cox proportional hazards modeling. Patients with a PIV ≥ 310 had significantly lower 5-year survival functions (p = 0.004). Similar significant differences in survival were observed for clinical stage III-IV (p = 0.015), hemoglobin levels < 12 mg/Dl (p = 0.007), histological grade (p = 0.019), and nuclear grade (p < 0.001); however, molecular classification did not show a significant survival difference (p = 0.371). The adjusted Hazard Ratios showed that PIV ≥ 310 was significantly associated with poor outcome (5.08, IC95%: 1.52-16.92). While clinical stage and hemoglobin levels were associated with survival in the unadjusted model. These factors did not maintain significance after adjustment. PIV is an independent predictor of reduced survival in Peruvian breast cancer patients.
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Affiliation(s)
- Iris Palomino-Secca
- Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Perú
| | - Mariella Peña-Tuya
- Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Perú
| | - Lynn A Quintana-García
- Instituto de Investigaciones en Ciencias Biomédicas, Universidad Ricardo Palma, Lima, Perú
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Yan Y, Lu H, Zheng Y, Lin S. Association Between Systemic Immune Inflammation Index and Diabetes Mellitus in the NHANES 2003-2018 Population. J Endocr Soc 2024; 8:bvae124. [PMID: 38974989 PMCID: PMC11226779 DOI: 10.1210/jendso/bvae124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Indexed: 07/09/2024] Open
Abstract
Objects This study aimed to explore the association between the Systemic Immune-Inflammation Index (SII) and diabetes mellitus (DM) and to assess its influence on the prognosis of the DM and no-DM groups. Methods The study used data from the National Health and Nutrition Examination Survey; 9643 participants were included. Logistic regression analysis was employed to evaluate connections between SII and DM. We used the Cox proportional hazards model, restricted cubic spline, and Kaplan-Meier curve to analyze the relationship between SII and mortality. Results The logistic regression analysis indicated that a significant increase in the likelihood of developing DM with higher SII levels (odds ratio, 1.31; 95% CI, 1.09-1.57, P = .003). The Cox model showed that there is a positive association between increased SII and higher all-cause mortality. The hazard ratios for SII were 1.53 (1.31, 1.78), 1.61 (1.31, 1.98), and 1.41 (1.12, 1.78) in the total, DM and non-DM groups, respectively. We observed a linear correlation between SII and all-cause mortality in DM participants, whereas non-DM participants and the total population showed a nonlinear correlation. Conclusion Elevated SII levels are linked to an augmented risk of DM. Those with DM and higher SII levels demonstrated an elevated risk of mortality.
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Affiliation(s)
- Yufeng Yan
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210008, Jiangsu, China
| | - Hongjing Lu
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210008, Jiangsu, China
| | - Yaguo Zheng
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210008, Jiangsu, China
| | - Song Lin
- Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210008, Jiangsu, China
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Hu L, Xie Y, Zhao H. Regarding the prognostic factors in patients with ALK-positive non-small cell lung cancer treated with crizotinib. Pulmonology 2024; 30:406-407. [PMID: 38402122 DOI: 10.1016/j.pulmoe.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/26/2024] Open
Affiliation(s)
- Limei Hu
- Department of Clinical Laboratory, The People's Hospital of Guangxi Zhuang Autonomous Region & Guangxi Academy of Medical Sciences, Nanning, Guangxi, China
| | - Youjun Xie
- Department of Clinical Laboratory, The People's Hospital of Guangxi Zhuang Autonomous Region & Guangxi Academy of Medical Sciences, Nanning, Guangxi, China
| | - Hongying Zhao
- Department of Clinical Laboratory, The People's Hospital of Guangxi Zhuang Autonomous Region & Guangxi Academy of Medical Sciences, Nanning, Guangxi, China.
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Topkan E, Kucuk A, Ozturk D, Ozkan EE, Besen AA, Pehlivan B, Selek U. Prognostic Value of Novel CARWL Score in Stage IIIC Non-Small-Cell Lung Cancer Patients Undergoing Concurrent Chemoradiotherapy. Can Respir J 2024; 2024:2803044. [PMID: 38975012 PMCID: PMC11226337 DOI: 10.1155/2024/2803044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 10/11/2023] [Accepted: 06/21/2024] [Indexed: 07/09/2024] Open
Abstract
Objectives We explored the prognostic utility of the unique combination of C-reactive-protein-to-albumin ratio (CAR) and significant weight loss (WL > 5%) over the preceding 6 months, namely, the CARWL score, in stage IIIC non-small-cell lung cancer (NSCLC) patients who underwent concurrent chemoradiotherapy (CCRT). Methods For each patient, the CAR was calculated using C-reactive protein and albumin measurements obtained on the first day of CCRT: CAR = C-reactive protein ÷ albumin. The availability of an ideal CAR cutoff that may categorize patients into two distinct progression-free (PFS) and overall survival (OS) outcomes was explored by employing receiver operating characteristic (ROC) curve analysis. Patients were additionally divided into two groups based on their status of significant WL according to the well-recognized Delphi criteria. Then, the CARWL score was created by combining all feasible combinations of the CAR and significant WL groupings. The potential links between pretreatment CARWL groups and the post-CCRT OS and PFS outcomes were determined as the primary and secondary endpoints. Results This retrospective cohort study comprised a total of 651 stage IIIC NSCLC patients. ROC curve analysis indicated that rounded 3.0 was the ideal CAR cutoff (area under the curve (AUC): 70.1%; sensitivity: 67.8%; specificity: 65.9%), which categorized the patients into CAR < 3.0 (N = 324) and CAR ≥ 3.0 (N = 327) groups. There were 308 (47.3%) and 343 (52.7%) patients without and with significant WL, respectively. The created CARWL groups were CARWL-0: CAR < 3.0 and WL ≤ 5.0%; CARWL-1: CAR < 3.0 and WL > 5.0%, or CAR ≥ 3.0 and WL ≤ 5.0%; and CARWL-2: CAR > 3.0 and WL > 5.0%. The Kaplan-Meier curves showed that the PFS (14.2 vs. 11.4 vs. 7.5 months; P < 0.001) and OS (37.3 vs. 23.6 vs. 12.8 months; P < 0.001) durations were gradually and significantly lowered from the CARWL-0 to CARWL-2 groups. The CARWL score's significant impacts on PFS and OS outcomes were found to be independent of the other variables in the multivariate analysis (P < 0.001, for each). Conclusions Our findings indicate that the novel CARWL score, which accounts for pretreatment CAR and significant WL during the preceding 6 months, can reliably stratify newly diagnosed stage IIIC NSCLC patients into three groups with significantly different PFS and OS after definitive CCRT.
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Affiliation(s)
- Erkan Topkan
- Department of Radiation OncologyBaskent UniversityMedical Faculty, Adana, Türkiye
| | - Ahmet Kucuk
- Clinic of Radiation OncologyMersin Education and Research Hospital, Mersin, Türkiye
| | - Duriye Ozturk
- Department of Radiation OncologyFaculty of MedicineAfyonkarahisar Health Sciences University, Afyonkarahisar, Türkiye
| | - Emine Elif Ozkan
- Department of Radiation OncologySuleyman Demirel University, Isparta, Türkiye
| | - Ali Ayberk Besen
- Department of Medical OncologyMedical Park Adana HospitalMedical Faculty, Adana, Türkiye
| | - Berrin Pehlivan
- Department of Radiation OncologyBahcesehir University, Istanbul, Türkiye
| | - Ugur Selek
- Department of Radiation OncologySchool of MedicineKoc University, Istanbul, Türkiye
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Zhang J, Yang Z, Zhao Z, Zhang N. Structural and pharmacological insights into cordycepin for neoplasms and metabolic disorders. Front Pharmacol 2024; 15:1367820. [PMID: 38953102 PMCID: PMC11215060 DOI: 10.3389/fphar.2024.1367820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 05/31/2024] [Indexed: 07/03/2024] Open
Abstract
Cytotoxic adenosine analogues were among the earliest chemotherapeutic agents utilised in cancer treatment. Cordycepin, a natural derivative of adenosine discovered in the fungus Ophiocordyceps sinensis, directly inhibits tumours not only by impeding biosynthesis, inducing apoptosis or autophagy, regulating the cell cycle, and curtailing tumour invasion and metastasis but also modulates the immune response within the tumour microenvironment. Furthermore, extensive research highlights cordycepin's significant therapeutic potential in alleviating hyperlipidaemia and regulating glucose metabolism. This review comprehensively analyses the structure-activity relationship of cordycepin and its analogues, outlines its pharmacokinetic properties, and strategies to enhance its bioavailability. Delving into the molecular biology, it explores the pharmacological mechanisms of cordycepin in tumour suppression and metabolic disorder treatment, thereby underscoring its immense potential in drug development within these domains and laying the groundwork for innovative treatment strategies.
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Affiliation(s)
- Jinming Zhang
- Department of Gastroenterology, First Hospital of Jilin University, Jilin University, Changchun, China
| | - Ziling Yang
- Second Hospital of Jilin University, Jilin University, Changchun, China
| | - Zhuo Zhao
- Department of Gastroenterology, First Hospital of Jilin University, Jilin University, Changchun, China
| | - Nan Zhang
- Department of Gastroenterology, First Hospital of Jilin University, Jilin University, Changchun, China
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Song YD, Bai XM, Ma J. The association of systemic immune-inflammation index with lung function, risk of COPD and COPD severity: A population-based study. PLoS One 2024; 19:e0303286. [PMID: 38875233 PMCID: PMC11178193 DOI: 10.1371/journal.pone.0303286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 04/22/2024] [Indexed: 06/16/2024] Open
Abstract
PURPOSE The relationship between the levels of Systemic Immune-inflammation Index (SII) and chronic obstructive pulmonary disease (COPD), lung function, and COPD severity were not fully understood. We conducted this cross-sectional, population-based study to investigate the complex association between SII and COPD, lung function, and COPD severity among the US adults. METHODS Overall, 18,349 participants were included in the National Health and Nutrition Examination Survey (NHANES) between 2005 and 2018. The exposure variable was SII, calculated from platelet counts, neutrophil counts, and lymphocyte counts. Weighted univariable and multivariable logistic regression, subgroup analysis, and restricted cubic spline (RCS) regression were performed to assess the relationship between COPD, lung function, COPD severity and SII. Last, we used a propensity score matching (PSM) analysis to reduce selective bias and validate these relationships. RESULTS Approximately 1,094 (5.96%) of the participants were diagnosed as COPD. The multivariable-adjusted odds ratio (OR) (95% confidence interval, CI) for the Q2 group (Log-SII > 2.740) was 1.39 (1.16 to 1.68). Before and after matching, multivariable logistic regression models revealed that increased Log-SII levels (SII Logarithmic transformation) associated positively with the risk of COPD. The subgroup analysis showed no interaction between Log-SII and a variety of variables (P for interaction > 0.05). RCS showed a reversed L-shaped relationship between Log-SII with COPD (P for nonlinear = 0.001) in individuals. In addition, we observed negative significant correlations between forced expiratory volume in one second (FEV1) / forced vital capacity (FVC) %, FEV1/FVC% predicted and SII, and reversed U-shaped curve relationships between FEV1, FEV1% predicted and SII. High SII level is associated with severity of COPD, especially at Global Initiative on Obstructive Lung Disease (GOLD) 1 and GOLD 3. CONCLUSIONS In summary, the Log-SII level is associated with COPD risk, lung function, and COPD severity.
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Affiliation(s)
- Ying-da Song
- Department of Thoracic Surgery, Shanxi Provincial People's Hospital, Taiyuan, Shanxi Province, China
- Fifth Clinical Medical College, Shanxi Medical University, Taiyuan, Shanxi Province, People's Republic of China
| | - Xiao-Ming Bai
- Department of Thoracic Surgery, Shanxi Provincial People's Hospital, Taiyuan, Shanxi Province, China
| | - Jun Ma
- Department of Thoracic Surgery, Shanxi Provincial People's Hospital, Taiyuan, Shanxi Province, China
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Yin X, Chen H, Sun Y, Xiao L, Lu H, Guo W, Yang H, Zhou J, Fan K, Liang W. Prognostic value of neutrophil-to-lymphocyte ratio change in patients with locally advanced non-small cell lung cancer treated with thoracic radiotherapy. Sci Rep 2024; 14:11984. [PMID: 38796631 PMCID: PMC11127913 DOI: 10.1038/s41598-024-62662-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 05/20/2024] [Indexed: 05/28/2024] Open
Abstract
In prior investigations, a correlation was established between patient outcomes in locally advanced non-small cell lung cancer (LA-NSCLC) following thoracic irradiation and parameters, such as pre/post-treatment neutrophil-to-lymphocyte ratio (NLR) and NLR change (ΔNLR). However, these parameters could potentially be influenced by radiation-related variables, such as gross tumor volume (GTV). The primary aim of this study was to elucidate the factors impacting post-treatment NLR and ΔNLR and to further assess their prognostic relevance. In this retrospective study, a cohort of 188 LA-NSCLC patients who underwent thoracic radiation between 2012 and 2017 was assessed. The calculation of pre/post-treatment NLR involved the use of absolute neutrophil and lymphocyte counts. ΔNLR was defined as the difference between post- and pre-treatment NLR values. To assess the relationships between various variables and overall survival (OS), local progression-free survival (LPFS), and distant metastasis-free survival (DMFS), the Kaplan-Meier technique and Cox proportional hazards regression were employed. Additionally, Spearman's rank correlation analysis was carried out to investigate correlations between the variables. The analysis revealed that both post-treatment NLR (r = 0.315, P < 0.001) and ΔNLR (r = 0.156, P = 0.032) were associated with GTV. However, OS, LPFS, and DMFS were not independently correlated with pre/post-treatment NLR. ΔNLR, on the other hand, exhibited independent associations with OS and DMFS (HR = 1.054, P = 0.020, and P = 0.046, respectively). Elevated ΔNLR values were linked to poorer OS (P = 0.023) and DMFS (P = 0.018) in the Kaplan-Meier analysis. Furthermore, when stratifying by GTV, a higher ΔNLR remained to be associated with worse OS and DMFS (P = 0.047 and P = 0.035, respectively) in the GTV ≤ 67.41 cm3 group, and in the GTV > 67.41 cm3 group (P = 0.028 and P = 0.042, respectively), highlighting ΔNLR as the sole independent predictive factor for survival and metastasis, irrespective of GTV.
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Affiliation(s)
- Xiaoming Yin
- Department of Radiation Oncology, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province, Affiliated Hospital of Hebei Medical University, No. 31, Huanghe West Road, Cangzhou, 061000, Hebei, China
| | - Haijun Chen
- Department of Anesthesiology, Cangzhou Central Hospital, Cangzhou, 061000, Hebei, China
| | - Yunchuan Sun
- Department of Radiation Oncology, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province, Affiliated Hospital of Hebei Medical University, No. 31, Huanghe West Road, Cangzhou, 061000, Hebei, China.
| | - Li Xiao
- Department of Radiation Oncology, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province, Affiliated Hospital of Hebei Medical University, No. 31, Huanghe West Road, Cangzhou, 061000, Hebei, China
| | - Hongling Lu
- Department of Radiation Oncology, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province, Affiliated Hospital of Hebei Medical University, No. 31, Huanghe West Road, Cangzhou, 061000, Hebei, China
| | - Wei Guo
- Department of Radiation Oncology, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province, Affiliated Hospital of Hebei Medical University, No. 31, Huanghe West Road, Cangzhou, 061000, Hebei, China
| | - Hongjuan Yang
- Department of Radiation Oncology, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province, Affiliated Hospital of Hebei Medical University, No. 31, Huanghe West Road, Cangzhou, 061000, Hebei, China
| | - Jianxi Zhou
- Department of Radiation Oncology, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province, Affiliated Hospital of Hebei Medical University, No. 31, Huanghe West Road, Cangzhou, 061000, Hebei, China
| | - Kui Fan
- Department of Radiation Oncology, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province, Affiliated Hospital of Hebei Medical University, No. 31, Huanghe West Road, Cangzhou, 061000, Hebei, China
| | - Wei Liang
- Department of Radiation Oncology, Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine of Hebei Province, Affiliated Hospital of Hebei Medical University, No. 31, Huanghe West Road, Cangzhou, 061000, Hebei, China
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Chen WH, Shao JJ, Yang Y, Meng Y, Huang S, Xu RF, Liu JB, Chen JG, Wang Q, Chen HZ. Prognostic significance of systemic immune inflammatory index in NSCLC: a meta-analysis. Lung Cancer Manag 2024; 13:LMT67. [PMID: 38812771 PMCID: PMC11131347 DOI: 10.2217/lmt-2023-0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 01/29/2024] [Indexed: 05/31/2024] Open
Abstract
Aim: The aim of this meta-analysis was to investigate the relationship between the baseline systemic immune inflammatory index (SII) and prognosis in patients with NSCLC. Materials & methods: The relation between pretreatment SII and overall survival, disease-free survival, cancer-specific survival, progression-free survival and recurrence-free survival in NSCLC patients was analyzed combined with hazard ratio and 95% CI. Results: The results showed that high SII was significantly correlated with overall survival and progression-free survival of NSCLC patients, but not with disease-free survival, cancer-specific survival and recurrence-free survival. Conclusion: The study suggests that a higher SII has association with worse prognosis in NSCLC patients. PROSPERO registration number: CRD42022336270.
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Affiliation(s)
- Wen-Hua Chen
- Medical School of Nantong University, Nantong, 226000, China
| | - Jing-Jing Shao
- Cancer Institute, Nantong Tumor Hospital/Affiliated Tumor Hospital of Nantong University, Nantong, 226000, China
| | - Ying Yang
- Cancer Institute, Nantong Tumor Hospital/Affiliated Tumor Hospital of Nantong University, Nantong, 226000, China
| | - Yun Meng
- Department of Oncology, Nantong Tumor Hospital/Affiliated Tumor Hospital of Nantong University, Nantong, 226000,China
| | - Sheng Huang
- Department of Oncology, Nantong Tumor Hospital/Affiliated Tumor Hospital of Nantong University, Nantong, 226000,China
| | - Rong-Fang Xu
- Department of Oncology, Nantong Tumor Hospital/Affiliated Tumor Hospital of Nantong University, Nantong, 226000,China
| | - Ji-Bin Liu
- Cancer Institute, Nantong Tumor Hospital/Affiliated Tumor Hospital of Nantong University, Nantong, 226000, China
| | - Jian-Guo Chen
- Cancer Institute, Nantong Tumor Hospital/Affiliated Tumor Hospital of Nantong University, Nantong, 226000, China
| | - Qin Wang
- Cancer Institute, Nantong Tumor Hospital/Affiliated Tumor Hospital of Nantong University, Nantong, 226000, China
| | - Hai-Zhen Chen
- Medical School of Nantong University, Nantong, 226000, China
- Cancer Institute, Nantong Tumor Hospital/Affiliated Tumor Hospital of Nantong University, Nantong, 226000, China
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Seo BM, Choi J, Chang B, Kim BG, Park TS, Lee H, Moon JY, Kim SH, Kim TH, Yoo SJ, Park HJ, Yoon HJ, Sohn JW, Lee SH, Park DW. Clinical significance of the advanced lung cancer inflammation index in patients with limited-stage small cell lung cancer treated with chemoradiotherapy. Sci Rep 2024; 14:10347. [PMID: 38710892 PMCID: PMC11074130 DOI: 10.1038/s41598-024-61145-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 05/02/2024] [Indexed: 05/08/2024] Open
Abstract
The aim of the study was to investigate the prognostic significance of the advanced lung cancer inflammation index (ALI) in patients with limited-stage small-cell lung cancer (LS-SCLC) undergoing definite chemo-radiotherapy (CRT). We included 87 patients with LS-SCLC from South Korea, treated between 2005 and 2019 with definite CRT. ALI was calculated using body mass index, serum albumin, and neutrophil-lymphocyte ratio. We categorized 38 patients into the high ALI group (ALI ≥ 44.3) and 48 into the low ALI group (ALI < 44.3). Patients in the high ALI group exhibited longer overall survival (OS) than patients in the low ALI group. In multivariate analysis, prophylactic cranial irradiation (hazard ratio [HR] = 0.366, 95% confidence interval [CI] 0.20-0.66, P = 0.0008), and high ALI (HR = 0.475, 95% CI 0.27-0.84, P = 0.0103) were identified as independent prognostic factors for predicting better OS. Notably, a high ALI score was particularly indicative of longer survival in patients treated with the combination of etoposide and cisplatin. In conclusion, this study demonstrated that a high pretreatment ALI was significantly associated with better OS in patients with LS-SCLC undergoing definite CRT. This suggests that ALI could be a useful tool for predicting prognosis and guiding chemotherapy regimen selections in clinical practice for LS-SCLC.
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Affiliation(s)
- Bo Mi Seo
- Department of Internal Medicine, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Jiin Choi
- Office of Hospital Information, Seoul National University Hospital, Seoul, South Korea
| | - Boksoon Chang
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University College of Medicine, Kyungheedae-ro 23, Dongdaemun-gu, Seoul, 02447, Republic of Korea
| | - Bo-Guen Kim
- Department of Internal Medicine, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Tai Sun Park
- Department of Internal Medicine, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Hyun Lee
- Department of Internal Medicine, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Ji-Yong Moon
- Department of Internal Medicine, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Sang-Heon Kim
- Department of Internal Medicine, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Tae-Hyung Kim
- Department of Internal Medicine, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Seung-Jin Yoo
- Department of Radiology, Hanyang University College of Medicine, Seoul, South Korea
| | - Hae Jin Park
- Department of Radiation Oncology, Hanyang University College of Medicine, Seoul, South Korea
| | - Ho Joo Yoon
- Department of Internal Medicine, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Jang Won Sohn
- Department of Internal Medicine, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea
| | - Seung Hyeun Lee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University College of Medicine, Kyungheedae-ro 23, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
| | - Dong Won Park
- Department of Internal Medicine, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763, Republic of Korea.
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13
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Mao KY, Cao YC, Si MY, Rao DY, Gu L, Tang ZX, Zhu SY. Advances in systemic immune inflammatory indices in non-small cell lung cancer: A review. Medicine (Baltimore) 2024; 103:e37967. [PMID: 38701309 PMCID: PMC11062741 DOI: 10.1097/md.0000000000037967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/29/2024] [Indexed: 05/05/2024] Open
Abstract
Lung cancer is one of the most prevalent cancers globally, with non-small cell lung cancers constituting the majority. These cancers have a high incidence and mortality rate. In recent years, a growing body of research has demonstrated the intricate link between inflammation and cancer, highlighting that inflammation and cancer are inextricably linked and that inflammation plays a pivotal role in cancer development, progression, and prognosis of cancer. The Systemic Immunoinflammatory Index (SII), comprising neutrophil, lymphocyte, and platelet counts, is a more comprehensive indicator of the host's systemic inflammation and immune status than a single inflammatory index. It is widely used in clinical practice due to its cost-effectiveness, simplicity, noninvasiveness, and ease of acquisition. This paper reviews the impact of SII on the development, progression, and prognosis of non-small cell lung cancer.
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Affiliation(s)
- Kai-Yun Mao
- First Clinical Medical College, Gannan Medical University, Ganzhou, China
| | - Yuan-Chao Cao
- First Clinical Medical College, Gannan Medical University, Ganzhou, China
| | - Mao-Yan Si
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Ding-yu Rao
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Liang Gu
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Zhi-Xian Tang
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Shen-yu Zhu
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Gannan Medical University, Ganzhou, China
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14
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Gulturk E, Kapucu K. The Systemic Inflammation Index: A New Candidate Minor Criterion in the Diagnosis of Polycythemia Vera. J Pers Med 2024; 14:471. [PMID: 38793053 PMCID: PMC11122511 DOI: 10.3390/jpm14050471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/19/2024] [Accepted: 04/28/2024] [Indexed: 05/26/2024] Open
Abstract
AIM To investigate inflammation indices and erythropoietin levels for their potential role in distinguishing polycythemia vera from secondary polycythemia and to compare different parameter combinations in terms of the diagnostic accuracy. METHODS This retrospective cohort was created from patients assessed for polycythemia from January 2020 to December 2023. Polycythemia vera diagnosis was made according to the 2016 World Health Organization criteria (n = 145). Those who did not fulfill the criteria were defined as having secondary polycythemia (n = 84). RESULTS The neutrophil lymphocyte ratio, platelet lymphocyte ratio and systemic immune-inflammation index were significantly higher in the polycythemia vera group (p < 0.001 for all). Erythropoietin had the highest area under the curve in the analysis to distinguish groups, followed by the systemic immune-inflammation index. The platelet lymphocyte ratio (≥135) had the highest specificity to detect polycythemia vera, followed closely by the systemic immune-inflammation index. The sensitivity for polycythemia vera detection was highest with the erythropoietin and systemic immune-inflammation index combination, followed by erythropoietin and the neutrophil lymphocyte ratio. All the single and combinatory variables exhibited significant performance in predicting polycythemia vera after adjusting for age and sex. However, the erythropoietin and systemic immune-inflammation index combination had the highest odds ratio, followed by erythropoietin alone. CONCLUSION These are promising findings supporting the usability of these biomarkers, especially the systemic immune-inflammation index, as minor criteria in the diagnosis of polycythemia vera. It is especially crucial to note that using erythropoietin in combination with these markers may improve diagnostic accuracy.
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Affiliation(s)
- Emine Gulturk
- Department of Hematology, Bakirkoy Sadi Konuk Training and Research Hospital, 34147 Istanbul, Turkey;
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15
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Jiang Y, Bao X. Systemic immune-inflammatory indicators and bone mineral density in chronic kidney disease patients: A cross-sectional research from NHANES 2011 to 2018. PLoS One 2024; 19:e0302073. [PMID: 38662733 PMCID: PMC11045113 DOI: 10.1371/journal.pone.0302073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND The purpose of this study was to look at the relationship between the Systemic Immune Inflammatory Index (SII) and bone mineral density (BMD) in the pelvis, left upper and lower limbs, lumbar spine, thoracic spine, and trunk in a chronic kidney disease (CKD) population in the United States. METHODS The National Health and Nutrition Examination Survey (2011-2016) yielded 2302 people with CKD aged >18 years. CKD was defined as eGFR less than 90 ml/min/1.73 m2 or eGFR greater than 90 ml/min/1.73 m2 with urine ACR greater than 30 mg/L.SII was calculated as PC * (NC / LC) from platelet count (PC), neutrophil count (NC), and lymphocyte count (LC). Multiple logistic regression was used to examine the relationship between BMD and SII at different sites in CKD patients, smoothed curve-fitting and generalized weighting models were used to investigate non-linear relationships, and a two-tailed linear regression model was used to find potential inflection points in the model. RESULTS We discovered a negative correlation between SII and pelvic BMD among 2302 participants after controlling for gender, age, and race [β = -0.008; 95% confidence value -0.008; 95% confidence interval (CI) -0.014, -0.002]. Lower PEBMD was related to increasing SII (trend p = 0.01125). After additional correction, only pelvic BMD remained adversely linked with SII [value -0.006; 95% CI -0.012, -0.000, p = 0.03368]. Smoothed curve fitting revealed a consistent inverse relationship between SII and pelvic BMD. Further stratified analyses revealed a substantial positive negative connection between SII and pelvic BMD in individuals who did not have hypertension, diabetes, a BMI of more than 30 kg/m2, or stage 2 CKD. The connection between SII and PEBMD in people without diabetes revealed a strong inverted U-shaped curve. CONCLUSION In individuals with CKD in the United States, there was a negative connection between the systemic immunoinflammatory index (SII) and pelvic BMD. The SII might be a low-cost and simple test for CKD-related BMD loss.
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Affiliation(s)
- Yuying Jiang
- Department of Nephrology, Jinshan Hospital, Fudan University, Shanghai, China
| | - Xiaorong Bao
- Department of Nephrology, Jinshan Hospital, Fudan University, Shanghai, China
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16
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Zhang H, Liu X, Wang X, Jiang Y. Association of two novel systemic inflammatory biomarkers and frailty based on NHANES 2007-2018. Front Public Health 2024; 12:1377408. [PMID: 38655524 PMCID: PMC11036374 DOI: 10.3389/fpubh.2024.1377408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Accepted: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
Background Frailty is a significant concern in the field of public health. However, currently, there is a lack of widely recognized and reliable biological markers for frailty. This study aims to investigate the association between systemic inflammatory biomarkers and frailty in the older adult population in the United States. Methods This study employed data from the National Health and Nutrition Examination Survey (NHANES) spanning 2007 to 2018 and conducted a rigorous cross-sectional analysis. We constructed weighted logistic regression models to explore the correlation between the Systemic Immune-Inflammation Index (SII), Systemic Inflammatory Response Index (SIRI), and frailty in the population aged 40 to 80 years. Using restricted cubic spline (RCS), we successfully visualized the relationship between SII, SIRI, and frailty. Finally, we presented stratified analyses and interaction tests of covariates in a forest plot. Results This study involved 11,234 participants, 45.95% male and 54.05% female, with an average age of 64.75 ± 0.13 years. After adjusting for relevant covariates, the weighted logistic regression model indicated an odds ratio (OR) and 95% confidence interval(CI) for the correlation between frailty and the natural logarithm (ln) transformed lnSII and lnSIRI as 1.38 (1.24-1.54) and 1.69 (1.53-1.88), respectively. Subsequently, we assessed different levels of lnSII and lnSIRI, finding consistent results. In the lnSII group model, the likelihood of frailty significantly increased in the fourth quartile (OR = 1.82, 95% CI: 1.55-2.12) compared to the second quartile. In the lnSIRI group model, the likelihood of frailty significantly increased in the third quartile (OR = 1.30, 95% CI: 1.10-1.53) and fourth quartile (OR = 2.29, 95% CI: 1.95-2.70) compared to the second quartile. The interaction results indicate that age and income-to-poverty ratio influence the association between lnSIRI and frailty. RCS demonstrated a nonlinear relationship between lnSII, lnSIRI, and frailty. Conclusion The results of this cross-sectional study indicate a positive correlation between systemic inflammatory biomarkers (SII, SIRI) and frailty.
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Affiliation(s)
- Huiling Zhang
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Xinyu Liu
- Department of Cardiology, Linyi Traditional Chinese Medicine Hospital, Linyi, China
| | - Xiaoling Wang
- The First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Ya Jiang
- Department of Cardiology, Linyi Traditional Chinese Medicine Hospital, Linyi, China
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Bi YY, Chen Q, Yang MY, Xing L, Jiang HL. Nanoparticles targeting mutant p53 overcome chemoresistance and tumor recurrence in non-small cell lung cancer. Nat Commun 2024; 15:2759. [PMID: 38553451 PMCID: PMC10980692 DOI: 10.1038/s41467-024-47080-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 03/20/2024] [Indexed: 04/02/2024] Open
Abstract
Non-small cell lung cancer (NSCLC) shows high drug resistance and leads to low survival due to the high level of mutated Tumor Protein p53 (TP53). Cisplatin is a first-line treatment option for NSCLC, and the p53 mutation is a major factor in chemoresistance. We demonstrate that cisplatin chemotherapy increases the risk of TP53 mutations, further contributing to cisplatin resistance. Encouragingly, we find that the combination of cisplatin and fluvastatin can alleviate this problem. Therefore, we synthesize Fluplatin, a prodrug consisting of cisplatin and fluvastatin. Then, Fluplatin self-assembles and is further encapsulated with poly-(ethylene glycol)-phosphoethanolamine (PEG-PE), we obtain Fluplatin@PEG-PE nanoparticles (FP NPs). FP NPs can degrade mutant p53 (mutp53) and efficiently trigger endoplasmic reticulum stress (ERS). In this study, we show that FP NPs relieve the inhibition of cisplatin chemotherapy caused by mutp53, exhibiting highly effective tumor suppression and improving the poor NSCLC prognosis.
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Affiliation(s)
- Yu-Yang Bi
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China
| | - Qiu Chen
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China
| | - Ming-Yuan Yang
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China
| | - Lei Xing
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China
- Jiangsu Key Laboratory of Druggability of Biopharmaceuticals, China Pharmaceutical University, Nanjing, 210009, China
| | - Hu-Lin Jiang
- State Key Laboratory of Natural Medicines, China Pharmaceutical University, Nanjing, 210009, China.
- Jiangsu Key Laboratory of Druggability of Biopharmaceuticals, China Pharmaceutical University, Nanjing, 210009, China.
- College of Pharmacy, Yanbian University, No.977, Gongyan Road, Yanji, 133000, China.
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Wang C, Fang J, Jiang T, Hu S, Wang P, Liu X, Zou S, Yang J. Development and validation of a prognostic nomogram model in locally advanced NSCLC based on metabolic features of PET/CT and hematological inflammatory indicators. EJNMMI Phys 2024; 11:24. [PMID: 38441779 PMCID: PMC10914655 DOI: 10.1186/s40658-024-00626-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/27/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND We combined the metabolic features of 18F-FDG-PET/CT and hematological inflammatory indicators to establish a predictive model of the outcomes of patients with locally advanced non-small cell lung cancer (LA-NSCLC) receiving concurrent chemoradiotherapy. RESULTS A predictive nomogram was developed based on sex, CEA, systemic immune-inflammation index (SII), mean SUV (SUVmean), and total lesion glycolysis (TLG). The nomogram presents nice discrimination that yielded an AUC of 0.76 (95% confidence interval: 0.66-0.86) to predict 1-year PFS, with a sensitivity of 63.6%, a specificity of 83.3%, a positive predictive value of 83.7%, and a negative predictive value of 62.9% in the training set. The calibration curves and DCA suggested that the nomogram had good calibration and fit, as well as promising clinical effectiveness in the training set. In addition, survival analysis indicated that patients in the low-risk group had a significantly longer mPFS than those in the high-risk group (16.8 months versus 8.4 months, P < 0.001). Those results were supported by the results in the internal and external test sets. CONCLUSIONS The newly constructed predictive nomogram model presented promising discrimination, calibration, and clinical applicability and can be used as an individualized prognostic tool to facilitate precision treatment in clinical practice.
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Affiliation(s)
- Congjie Wang
- Department of Pulmonary and Critical Care Medicine, Yantai Yuhuangding Hospital, Yantai, Shandong, China
| | - Jian Fang
- Department of thoracic surgery, Yantai Yuhuangding Hospital, Yantai, Shandong, China
| | - Tingshu Jiang
- Department of Pulmonary and Critical Care Medicine, Yantai Yuhuangding Hospital, Yantai, Shandong, China
| | - Shanliang Hu
- Department of Radiation Oncology, Yantai Yuhuangding Hospital, Yantai, Shandong, China
| | - Ping Wang
- Department of Radiology, Yantai Yuhuangding Hospital, Yantai, Shandong, China
| | - Xiuli Liu
- Department of Pulmonary and Critical Care Medicine, Yantai Yuhuangding Hospital, Yantai, Shandong, China
| | - Shenchun Zou
- Department of Pulmonary and Critical Care Medicine, Yantai Yuhuangding Hospital, Yantai, Shandong, China
| | - Jun Yang
- Department of Oncology, Yantai Yuhuangding Hospital, No.20 Yuhuangding East Road, Yantai, 250117, Shandong, China.
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Deng X, Liu D, Li M, He J, Fu Y. Association between systemic immune-inflammation index and insulin resistance and mortality. Sci Rep 2024; 14:2013. [PMID: 38263234 PMCID: PMC10806274 DOI: 10.1038/s41598-024-51878-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/10/2024] [Indexed: 01/25/2024] Open
Abstract
The role of inflammation in disease promotion is significant, yet the precise association between a newly identified inflammatory biomarker and insulin resistance (IR) and mortality remains uncertain. We aim to explore the potential correlation between systemic immune-inflammation index (SII) and these factors. We used data from 2011 to 2016 of National Health and Nutrition Examination Survey, and multivariate logistic regression and restricted cubic spline were employed. Subgroup and interaction analysis were conducted to recognize the consistency of the results. The association between SII and mortality was described by survival analysis. 6734 participants were enrolled, of whom 49.3% (3318) exhibited IR and 7.02% experienced mortality. Multivariate logistic regression revealed that individuals in the highest quartile (Q4) of SII had a significantly increased risk of IR compared to those in the lowest quartile (Q1). We then identified a linear association between SII and IR with an inflection point of 407, but may be influenced by gender. Similarly, compared to Q1, people whose SII at Q4 showed a higher all-cause and cardiovascular mortality. It showed a significant association between SII and both all-cause and cardiovascular mortality, but the results need to be interpreted with caution.
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Affiliation(s)
- Xiaoqi Deng
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Dichuan Liu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
| | - Miao Li
- Nursing Department, Beijing Tiantan Hospital, Beijing, 100070, China
| | - Jie He
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
| | - Yufan Fu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China
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20
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Zeng P, Jiang C, Liu A, Yang X, Lin F, Cheng L. Association of systemic immunity-inflammation index with metabolic syndrome in U.S. adult: a cross-sectional study. BMC Geriatr 2024; 24:61. [PMID: 38225566 PMCID: PMC10788994 DOI: 10.1186/s12877-023-04635-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/24/2023] [Indexed: 01/17/2024] Open
Abstract
BACKGROUND Metabolic syndrome (MetS) is a pathological condition characterized by the abnormal clustering of several metabolic components and has become a major public health concern. We aim to investigate the potential link of Systemic immunity-inflammation index (SII) on MetS and its components. METHODS AND RESULT Weighted multivariable logistic regression was conducted to assess the relationship between SII and MetS and its components. Restricted cubic spline (RCS) model and threshold effect analysis were also performed. A total of 6,999 U.S. adults were enrolled. Multivariate model found that SII were positively associated with MetS (OR = 1.18;95CI%:1.07-1.30) and hypertension (OR = 1.22; 95CI%:1.12-1.34) in a dose-dependent manner. When SII was converted into a categorical variable, the risk of MetS increased by 36% and the risk of hypertension increased by 53% in the highest quantile of SIIs. The RCS model confirmed linear associations between SII and MetS, as well as a non-linear association between SII and certain components of MetS, including hypertension, hyperglycemia, low HDL, and hyperlipidemia. Meanwhile, the relationship between SII and hypertension presents a J-shaped curve with a threshold of 8.27, above which the risk of hypertension increases. Furthermore, in MetS and hypertension, age, sex, body mass index (BMI), and race were not significantly associated with this positive association based on subgroup analyses and interaction tests(p for interaction > 0.05). CONCLUSIONS The present study indicated that there was a higher SII association with an increased risk of MetS and hypertension in adults. However, further prospective cohort studies are required to establish a causal relationship between SII and MetS, as well as its components.
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Affiliation(s)
- Peng Zeng
- Department of Cardiology, Shenzhen People's Hospital, Shenzhen, 518000, China
| | - Cheng Jiang
- Department of Cardiology, Shenzhen People's Hospital, Shenzhen, 518000, China
| | - Anbang Liu
- Shandong First Medical University, Central Hospital Affiliated to Shandong First Medical University, Jinan, 250000, China
| | - Xinyuan Yang
- Department of Cardiology, Shenzhen People's Hospital, Shenzhen, 518000, China
| | - Feng Lin
- Department of Cardiology, Shenzhen People's Hospital, Shenzhen, 518000, China.
| | - Lingli Cheng
- The Sixth Affiliated Hospital of Guangzhou Medical University, Qingyuan City People's Hospital, Qingyuan, 511518, Guangdong, China.
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Sun W, Fang Y, Zhou B, Mao G, Cheng J, Zhang X, Liu Y, Chen H. The association of systemic inflammatory biomarkers with non-alcoholic fatty liver disease: a large population-based cross-sectional study. Prev Med Rep 2024; 37:102536. [PMID: 38186662 PMCID: PMC10767190 DOI: 10.1016/j.pmedr.2023.102536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 01/09/2024] Open
Abstract
Purpose The aim of this study was to explore the relationship between non-alcoholic fatty liver disease (NAFLD) and the two blood inflammatory markers including the systemic immune-inflammation (SII) index, and the system inflammation response index (SIRI). Methods The National Health and Nutrition Examination Survey data between the year of 2017-2018 was used for this cross-sectional study. In order to analyze the association of SII index, and SIRI and risk of NAFLD, we used multivariable logistic regression models, restricted cubic spline (RCS) plot, and subgroup analysis to analyze the data. Results In total, there were 1,199 individuals who participated in the survey. As shown by the RCS plot, SII index, and SIRI were linked with NAFLD risk in a U-shaped pattern. With regard to known confounding variables, when comparing the lowest quartile, the odds ratio with 95 % confidence interval for prevalence of NAFLD across the quartiles of SII index and SIRI were (0.89 (0.57, 1.41), 0.56 (0.35, 0.89) and 1.01 (0.64, 1.59)), and (0.77 (0.48, 1.23), 0.79 (0.50, 1.24) and 0.94 (0.60, 1.47)), respectively. Additionally, SII index, and SIRI and NAFLD risk also were U-curve correlated among the participants in age ≥60 years, female, without hypertension, and BMI of ≥30 kg/m2. Conclusions There was a U-shaped association of SII index and SIRI with prevalence of NAFLD, indicating that SII index and SIRI should be monitored dynamically.
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Affiliation(s)
- Wu Sun
- Department of Pathology, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241000, China
| | - Yan Fang
- Department of Pathology, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241000, China
| | - Bing Zhou
- Department of Pathology, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241000, China
| | - Guoliang Mao
- Department of Pathology, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241000, China
| | - Jiao Cheng
- Department of Pathology, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241000, China
| | - Xinxin Zhang
- Department of Criminal Science and Technology, Shandong Police College, Jinan, Shandong 250014, China
| | - Yinhua Liu
- Department of Pathology, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui 241000, China
| | - Hao Chen
- Department of Pathology, School of Basic Medical Sciences, Wannan Medical College, Wuhu, Anhui 241002, China
- Postdoctoral Research Station of Clinical Medicine, Jinan University, Guangzhou, Guangdong 510632, China
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Topkan E, Kucuk A, Ozkan EE, Ozturk D, Besen AA, Mertsoylu H, Pehlivan B, Selek U. High pre-chemoradiotherapy pan-immune-inflammation value levels predict worse outcomes in patients with stage IIIB/C non-small-cell lung cancer. Discov Oncol 2023; 14:230. [PMID: 38091179 PMCID: PMC10719443 DOI: 10.1007/s12672-023-00851-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 12/11/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND AND OBJECTIVES We explored the prognostic usefulness of the pan-immune-inflammation value (PIV) in patients with stage IIIB/C non-small-cell lung cancer (NSCLC) who underwent concurrent chemoradiotherapy (CCRT). METHODS AND PATIENTS For all patients, the PIV was calculated using platelet (P), monocyte (M), neutrophil (N), and lymphocyte (L) measures obtained on the first day of CCRT: PIV = P × M × N ÷ L. Using receiver operating characteristic (ROC) curve analysis, we searched for the existence of an ideal cutoff that may partition patients into two groups with unique progression-free- (PFS) and overall survival (OS) results. The primary endpoint of this retrospective cohort research was to determine whether there were any significant relationships between pretreatment PIV measures and post-CCRT OS outcomes. RESULTS The present research included a total of 807 stage IIIB/C NSCLC patients. According to ROC curve analysis, the ideal PIV cutoff was 516 [area under the curve (AUC): 67.7%; sensitivity: 66.4%; specificity: 66.1%], which divided the whole cohort into two: low PIV (L-PIV: PIV < 516; N = 436) and high PIV (H-PIV: PIV ≥ 516; N = 371). The comparisons between the PIV groups indicated that either the median PFS (9.2 vs. 13.4 months; P < 0.001) or OS (16.7 vs. 32.7 months; P < 0.001) durations in the H-PIV group were substantially inferior to their L-PIV counterpart. Apart from the H-PIV (P < 0.001), the N3 nodal stage (P = 0.006), IIIC disease stage (P < 0.001), and receiving only one cycle of concurrent chemotherapy (P = 0.005) were also determined to be significant predictors of poor PFS (P < 0.05, for each) and OS (P < 0.05, for each) outcomes in univariate analysis. The multivariate analysis findings revealed that all four variables had independent negative impacts on PFS (P < 0.05, for each) and OS (P < 0.05, for each). CONCLUSIONS The findings of this hypothesis-generating retrospective analysis claimed that the novel PIV was an independent and steadfast predictor of PFS and OS in stage IIIB/C NSCLC patients.
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Affiliation(s)
- Erkan Topkan
- Department of Radiation Oncology, Baskent University Medical Faculty, 01120, Adana, Turkey.
| | - Ahmet Kucuk
- Clinic of Radiation Oncology, Mersin Education and Research Hospital, Mersin, Turkey
| | - Emine Elif Ozkan
- Department of Radiation Oncology, Suleyman Demirel University, Isparta, Turkey
| | - Duriye Ozturk
- Department of Radiation Oncology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Ali Ayberk Besen
- Department of Medical Oncology, Medical Park Hospital, Adana, Turkey
| | - Huseyin Mertsoylu
- Department of Medical Oncology, Istinye University, Istanbul, Turkey
| | - Berrin Pehlivan
- Department of Radiation Oncology, Bahcesehir University, Istanbul, Turkey
| | - Ugur Selek
- Department of Radiation Oncology, Koc University School of Medicine, Istanbul, Turkey
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Huai Q, Luo C, Song P, Bie F, Bai G, Li Y, Liu Y, Chen X, Zhou B, Sun X, Guo W, Gao S. Peripheral blood inflammatory biomarkers dynamics reflect treatment response and predict prognosis in non-small cell lung cancer patients with neoadjuvant immunotherapy. Cancer Sci 2023; 114:4484-4498. [PMID: 37731264 PMCID: PMC10728017 DOI: 10.1111/cas.15964] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/30/2023] [Accepted: 09/01/2023] [Indexed: 09/22/2023] Open
Abstract
Neoadjuvant immunotherapy has significantly changed the therapeutic approach for treating patients with surgically resectable non-small cell lung cancer (NSCLC). Here, peripheral blood inflammation-based biomarkers as well as previously less focused eosinophil fraction, modified Glasgow prognostic score (mGPS), and prognostic nutritional index (PNI) were systematically included to comprehensively analyze their potential in predicting neoadjuvant immunotherapy efficacy and prognosis. We enrolled 189 patients (94 in training and 95 in validation cohorts) with stage I-III B surgically resectable NSCLC treated with neoadjuvant immunotherapy from the National Cancer Center of China. Baseline and post-treatment eosinophils fraction, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), monocyte-to-lymphocyte ratio (MLR), PNI, mGPS, and their changes were calculated and analyzed for correlation with neoadjuvant immunotherapy efficacy and prognosis. In patients in the major pathological response (MPR) group, the post-treatment eosinophil fraction was significantly high, and NLR, PLR, SII, and MLR were significantly lower compared to the non-MPR group in both the training and validation cohorts. The receiver operating characteristic curve showed that post-treatment, eosinophil fraction and SII and their changing were two of the most important factors. Univariate and multivariate logistic regression analyses showed that post-treatment eosinophil fraction, SII, mGPS, and ΔSII could independently predict MPR in patients treated with neoadjuvant immunotherapy. Survival analysis showed a significant correlation between high post-treatment NLR, PLR, SII, mGPS, and their changes in ΔNLR and ΔSII elevation with poor overall survival and event-free survival of patients. Our results suggest that inflammatory biomarkers could predict the patient's response to neoadjuvant immunotherapy and prognosis.
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Affiliation(s)
- Qilin Huai
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Chenyu Luo
- Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Peng Song
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Fenglong Bie
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Guangyu Bai
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Yuan Li
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Yang Liu
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Xiaowei Chen
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Bolun Zhou
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Xujie Sun
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Wei Guo
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
- Key Laboratory of Minimally Invasive Therapy Research for Lung CancerChinese Academy of Medical SciencesBeijingChina
| | - Shugeng Gao
- Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
- Key Laboratory of Minimally Invasive Therapy Research for Lung CancerChinese Academy of Medical SciencesBeijingChina
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Gao R, Zhou J, Zhang J, Zhu J, Wang T, Yan C. Quantitative CT parameters combined with preoperative systemic inflammatory markers for differentiating risk subgroups of thymic epithelial tumors. BMC Cancer 2023; 23:1158. [PMID: 38012604 PMCID: PMC10683274 DOI: 10.1186/s12885-023-11332-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 08/24/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Thymic epithelial tumors (TETs) are the most common primary neoplasms of the anterior mediastinum. Different risk subgroups of TETs have different prognosis and therapeutic strategies, therefore, preoperative identification of different risk subgroups is of high clinical significance. This study aims to explore the diagnostic efficiency of quantitative computed tomography (CT) parameters combined with preoperative systemic inflammatory markers in differentiating low-risk thymic epithelial tumors (LTETs) from high-risk thymic epithelial tumors (HTETs). METHODS 74 Asian patients with TETs confirmed by biopsy or postoperative pathology between January 2013 and October 2022 were collected retrospectively and divided into two risk subgroups: LTET group (type A, AB and B1 thymomas) and HTET group (type B2, B3 thymomas and thymic carcinoma). Statistical analysis were performed between the two groups in terms of quantitative CT parameters and preoperative systemic inflammatory markers. Multivariate logistic regression analysis was used to determine the independent predictors of risk subgroups of TETs. The area under curve (AUC) and optimal cut-off values were calculated by receiver operating characteristic (ROC) curves. RESULTS 47 TETs were in LTET group, while 27 TETs were in HTET group. In addition to tumor size and CT value of the tumor on plain scan, there were statistical significance comparing in CT value of the tumor on arterial phase (CTv-AP) and venous phase (CTv-VP), and maximum enhanced CT value (CEmax) of the tumor between the two groups (for all, P < 0.05). For systemic inflammatory markers, HTET group was significantly higher than LTET group (for all, P < 0.05), including platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR) and systemic immune-inflammation index (SII). Multivariate logistic regression analysis showed that NLR (odds ratio [OR] = 2.511, 95% confidence interval [CI]: 1.322-4.772, P = 0.005), CTv-AP (OR = 0.939, 95%CI: 0.888-0.994, P = 0.031) and CTv-VP (OR = 0.923, 95%CI: 0.871-0.979, P = 0.008) were the independent predictors of risk subgroups of TETs. The AUC value of 0.887 for the combined model was significantly higher than NLR (0.698), CTv-AP (0.800) or CTv-VP (0.811) alone. The optimal cut-off values for NLR, CTv-AP and CTv-VP were 2.523, 63.44 Hounsfeld Unit (HU) and 88.29HU, respectively. CONCLUSIONS Quantitative CT parameters and preoperative systemic inflammatory markers can differentiate LTETs from HTETs, and the combined model has the potential to improve diagnostic efficiency and to help the patient management.
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Affiliation(s)
- Rongji Gao
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, No.366, Taishan Street, Taian, Shandong Province, 271000, China
| | - Jian Zhou
- Department of Radiology, Taian City Central Hospital, No.29, Longtan Road, Taian, Shandong Province, 271000, China
| | - Juan Zhang
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, No.366, Taishan Street, Taian, Shandong Province, 271000, China
| | - Jianzhong Zhu
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, No.366, Taishan Street, Taian, Shandong Province, 271000, China
| | - Tiantian Wang
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, No.366, Taishan Street, Taian, Shandong Province, 271000, China.
| | - Chengxin Yan
- Department of Radiology, The Second Affiliated Hospital of Shandong First Medical University, No.366, Taishan Street, Taian, Shandong Province, 271000, China.
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Olmez OF, Bilici A, Gursoy P, Cubukcu E, Sakin A, Korkmaz T, Cil I, Cakar B, Menekse S, Demir T, Acikgoz O, Hamdard J. Impact of systemic inflammatory markers in patients with ALK-positive non-small cell lung cancer treated with crizotinib. Pulmonology 2023; 29:478-485. [PMID: 36564237 DOI: 10.1016/j.pulmoe.2022.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To evaluate the prognostic utility of inflammation-based prognostic scores in patients with ALK-positive metastatic or non-resectable non-small-cell lung cancer (NSCLC) treated with crizotinib. PATIENTS AND METHODS A total of 82 patients with ALK-positive metastatic or non-resectable NSCLC who received ALK TKI crizotinib were included. Pre-treatment modified Glasgow prognostic score (mGPS), prognostic nutritional index (PNI), and systemic immune-inflammation index (SII) were calculated. Multivariable logistic regression and Cox proportional hazards models were used to assess the impact of pretreatment mGPS, PNI, and SII on overall survival (OS), progression-free survival (PFS), and objective response rate (ORR). RESULTS The ORR was 77.2%, while 1-year OS and PFS rates were 95.0% and 93.5%, respectively. The univariate analysis revealed significantly higher 1-year PFS (89.4 vs. 64.4%, p=0.043) and OS (92.0 vs. 83.3%, p=0.01) rates in patients with low (<934.7) vs. high (≥934.7) SII scores. Multivariate analysis revealed that PNI ≥0.09 was a significant determinant of poorer 1-year OS rates (hazard ratio [HR]: 2.46, 95% confidence interval [CI] 0.88-4.85, p=0.035). No significant difference was observed in survival rates according to gender, age, smoking status, prior lines of therapy, or mGPS scores, while higher mGPS scores (odds ratio [OR]: 0.1, 95%CI 0.16-1.04; p=0.009) and higher PNI scores (OR: 0.16, 95% CI 0.02-0.55; p=0.035) were associated with poorer ORR. CONCLUSION Our findings indicate the prognostic significance of PNI and SII in terms of survival outcome and the impact of mGPS and PNI on treatment response in patients with ALK-positive NSCLC treated with crizotinib.
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Affiliation(s)
- O F Olmez
- Department of Medical Oncology, Medipol University Faculty of Medicine, Istanbul, Turkey
| | - A Bilici
- Department of Medical Oncology, Medipol University Faculty of Medicine, Istanbul, Turkey
| | - P Gursoy
- Ege University Faculty of Medicine, Izmir, Turkey
| | - E Cubukcu
- Uludag University Faculty of Medicine, Bursa, Turkey
| | - A Sakin
- University of Health Sciences Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - T Korkmaz
- Acıbadem University Faculty of Medicine, Istanbul, Turkey
| | - I Cil
- Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - B Cakar
- Ege University Faculty of Medicine, Izmir, Turkey
| | - S Menekse
- Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - T Demir
- Bezmialem University Faculty of Medicine, Istanbul; Turkey
| | - O Acikgoz
- Department of Medical Oncology, Medipol University Faculty of Medicine, Istanbul, Turkey
| | - J Hamdard
- Department of Medical Oncology, Medipol University Faculty of Medicine, Istanbul, Turkey.
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Luo Z, Yan Y, Jiao B, Huang T, Liu Y, Chen H, Guan Y, Ding Z, Zhang G. Prognostic value of the systemic immune-inflammation index in patients with upper tract urothelial carcinoma after radical nephroureterectomy. World J Surg Oncol 2023; 21:337. [PMID: 37880772 PMCID: PMC10601258 DOI: 10.1186/s12957-023-03225-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/14/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND To investigate the prognostic significance of the systemic immune-inflammation index (SII) for patients with upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU) and develop nomogram models for predicting overall survival (OS), intravesical recurrence (IVR), and extra-urothelial recurrence (EUR). METHODS We retrospectively studied the clinical and pathological features of 195 patients who underwent RNU for UTUC. All patients were randomly divided into a training cohort (99 cases) and a validation cohort (96 cases). The training cohort was used to develop nomogram models, and the models were validated by the validation cohort. The least absolute shrinkage and selection operator (LASSO) regression and Cox regression were performed to identify independent predictors. The concordance index (C-index), receiver operator characteristics (ROC) analysis, and calibration plot were used to evaluate the reliability of the models. The clinical utility compared with the pathological T stage was assessed using the net reclassification index (NRI), integrated discrimination improvement (IDI), and decision curve analysis (DCA). RESULTS SII was an independent risk factor in predicting OS and EUR. The C-index values of the nomogram predicting OS, IVR, and EUR were 0.675, 0.702, and 0.756 in the training cohort and 0.715, 0.756, and 0.713 in the validation cohort. A high level of SII was correlated with the invasion of the mucosa, muscle layer of the ureter, nerves, vessels, and fat tissues. CONCLUSION We developed nomogram models to predict the OS, IVR, and EUR of UTUC patients. The efficacy of these models was substantiated through internal validation, demonstrating favorable discrimination, calibration, and clinical utility. A high level of SII was associated with both worse OS and shorter EUR-free survival.
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Affiliation(s)
- Zhenkai Luo
- Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, No. 17 Nanli, Panjiayuan, Chaoyang District, Beijing, 100730, China
- Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 17 Nanli, Panjiayuan, Chaoyang District, Beijing, 100021, China
| | - Yangxuanyu Yan
- Department of Urology, China-Japan Friendship Hospital, Yinghuadong Road, Chaoyang District, Beijing, 100029, China
- Peking University China-Japan Friendship School of Clinical Medicine, Yinghuadong Road, Chaoyang District, Beijing, 100029, China
| | - Binbin Jiao
- Department of Urology, Beijing Chao-Yang Hospital, Capital Medical University, Gongren Tiyuchang Nanlu, Chaoyang District, Beijing, 100020, China
| | - Tao Huang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, No.300. Guangzhou Road, Nanjing, 210029, China
| | - Yuhao Liu
- Department of Urology, China-Japan Friendship Hospital, Yinghuadong Road, Chaoyang District, Beijing, 100029, China
- Peking University China-Japan Friendship School of Clinical Medicine, Yinghuadong Road, Chaoyang District, Beijing, 100029, China
| | - Haijie Chen
- Department of Urology, China-Japan Friendship Hospital, Yinghuadong Road, Chaoyang District, Beijing, 100029, China
- Peking University China-Japan Friendship School of Clinical Medicine, Yinghuadong Road, Chaoyang District, Beijing, 100029, China
| | - Yunfan Guan
- Department of Urology, China-Japan Friendship Hospital, Yinghuadong Road, Chaoyang District, Beijing, 100029, China
- Peking University China-Japan Friendship School of Clinical Medicine, Yinghuadong Road, Chaoyang District, Beijing, 100029, China
| | - Zhenshan Ding
- Department of Urology, China-Japan Friendship Hospital, Yinghuadong Road, Chaoyang District, Beijing, 100029, China.
| | - Guan Zhang
- Department of Urology, China-Japan Friendship Hospital, Yinghuadong Road, Chaoyang District, Beijing, 100029, China.
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Zhao Y, Shao W, Zhu Q, Zhang R, Sun T, Wang B, Hu X. Association between systemic immune-inflammation index and metabolic syndrome and its components: results from the National Health and Nutrition Examination Survey 2011-2016. J Transl Med 2023; 21:691. [PMID: 37794370 PMCID: PMC10548719 DOI: 10.1186/s12967-023-04491-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/30/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Metabolic syndrome (MetS), a worldwide public health problem, affects human health and quality of life in a dramatic manner. A growing evidence base suggests that MetS is strongly associated with levels of systemic immune inflammation. The present study aimed to investigate the possible relationship between the systemic immune-inflammation index (SII), a novel inflammatory marker, and MetS to provide data support for effective MetS prevention by reducing the systemic inflammatory response. METHODS We included adult participants with complete SII and MetS information from the 2011-2016 National Health and Nutrition Examination Survey (NHANES). MetS was defined as using the criteria developed by the Adult Treatment Program III of the National Cholesterol Education Program. The formula for SII was as follows: SII = platelet counts × neutrophil counts/ lymphocyte counts. Weighted linear regression was used to assess differences in variables across SII quartile groups after the SII score was divided into 4 quartiles. The independent interaction between SII and MetS was investigated using weighted multivariate logistic regression analysis and subgroup analysis, and the relationship between SII levels and 5 particular MetS items was further explored in depth. RESULTS A total of 12,402 participants, 3,489 of whom were diagnosed with MetS, were included in this study. After correcting for covariates, the results of a logistic regression of multistage weighted complex sampling data revealed that participants with higher SII scores had a higher chance of developing MetS (odds ratio (OR) = 1.33, 95% confidence interval (CI): 1.14-1.55) and that SII levels could be used as an independent risk factor to predict that likelihood of MetS onset. In the Q1-Q4 SII quartile group, the risk of developing MetS was 1.33 times higher in the Q4 group, which had the highest level of systemic immune inflammation than in the Q1 group. After adjusting for all confounding factors, SII scores were found to have a negative correlation with high-density lipoprotein cholesterol (OR = 1.29; 95% CI, 0.99-1.67, P = 0.056) and a significant positive correlation with waist circumference (OR = 2.17; 95% CI, 1.65-2.87, P < 0.001) and blood pressure (BP) (OR = 1.65; 95% CI, 1.20-2.27, P = 0.003). Gender, age, and smoking status were shown to alter the positive association between SII and MetS in subgroup analyses and interaction tests (p for interaction < 0.05). Additionally, we demonstrated a nonlinear correlation between SII and MetS. The findings of the restricted cubic spline indicated that there was an inverted U-shaped association between SII and MetS. CONCLUSIONS Our findings imply that increased SII levels are related to MetS, and SII may be a simple and cost-effective method to identify individuals with MetS. Therefore, protective measures such as early investigation and anti-inflammatory interventions are necessary to reduce the overall incidence of MetS.
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Affiliation(s)
- Yang Zhao
- Department of Nuclear Medicine, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Basic Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Wenyu Shao
- Department of Nuclear Medicine, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- Department of Basic Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Qihan Zhu
- Department of Basic Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Rui Zhang
- Department of Basic Medicine, Third Military Medical University (Army Medical University), Chongqing, China
| | - Tao Sun
- Department of Biomedical Engineering, Fourth Military Medical University, Xi'an, China.
| | - Bijia Wang
- Department of Neurology, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
| | - Xiaofei Hu
- Department of Nuclear Medicine, Southwest Hospital, Third Military Medical University (Army Medical University), Chongqing, China.
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Wu M, Wu S, Chen Y, Sun L, Zhou J. Immune Activation Effects at Different Irradiated Sites and Optimal Timing of Radioimmunotherapy in Patients with Extensive-Stage Small Cell Lung Cancer: a Real-World Analysis. Biol Proced Online 2023; 25:24. [PMID: 37710179 PMCID: PMC10503112 DOI: 10.1186/s12575-023-00217-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/17/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND In view of the limited data on radiotherapy (RT) combined with immunotherapy in patients with extensive-stage small cell lung cancer (ES-SCLC), this study aimed to identify the immune activation effect on different sites and the survival outcomes of radioimmunotherapy at different treatment stages. METHODS Forty-five patients diagnosed with ES-SCLC were included in this retrospective analysis. We collected the overall survival (OS) of the patients,, recorded the blood cell counts before, during, and after RT, and derived blood index ratios such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII). The datasets were analyzed using the Spearman rank correlation test, Kruskal-Wallis rank sum test and logistic regression. RESULTS Among the selected blood indices, the delta-NLR/PLR/Sll correlated with different irradiated organs, and the mean ranks of these three indices were the lowest in the brain-irradiated group during immunotherapy. Additionally, adjunct first-line immunotherapy with RT demonstrated a significant improvement compared to second- or third-line therapy and subsequent therapies. CONCLUSION Our findings suggest that compared to other organs, the strongest immune activation effect occurs with brain RT, and ES-SCLC patients who received radioimmunotherapy (RIT) earlier achieved higher OS rates.
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Affiliation(s)
- Min Wu
- Department of Radiation Oncology, Nanjing Medical University, Nanjing, Jiangsu, China
- Suzhou Cancer Center Core Laboratory, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Shihao Wu
- Medical School, Anhui University of Science and Technology, Huainan, China
| | - Yuetong Chen
- Suzhou Cancer Center Core Laboratory, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China
| | - Liangchao Sun
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China.
| | - Jundong Zhou
- Department of Radiation Oncology, Nanjing Medical University, Nanjing, Jiangsu, China.
- Suzhou Cancer Center Core Laboratory, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, Jiangsu, China.
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Topkan E, Selek U, Pehlivan B, Kucuk A, Ozturk D, Ozdemir BS, Besen AA, Mertsoylu H. The Prognostic Value of the Novel Global Immune-Nutrition-Inflammation Index (GINI) in Stage IIIC Non-Small Cell Lung Cancer Patients Treated with Concurrent Chemoradiotherapy. Cancers (Basel) 2023; 15:4512. [PMID: 37760482 PMCID: PMC10526430 DOI: 10.3390/cancers15184512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Revised: 09/01/2023] [Accepted: 09/09/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND We sought to determine the prognostic value of the newly developed Global Immune-Nutrition-Inflammation Index (GINI) in patients with stage IIIC non-small cell lung cancer (NSCLC) who underwent definitive concurrent chemoradiotherapy (CCRT). METHODS This study was conducted on a cohort of 802 newly diagnosed stage IIIC NSCLC patients who underwent CCRT. The novel GINI created first here was defined as follows: GINI = [C-reactive protein × Platelets × Monocytes × Neutrophils] ÷ [Albumin × Lymphocytes]. The receiver operating characteristic (ROC) curve analysis was used to determine the optimal pre-CCRT GINI cut-off value that substantially interacts with the locoregional progression-free (LRPFS), progression-free (PFS), and overall survival (OS). RESULTS The optimal pre-CCRT GINI cutoff was 1562 (AUC: 76.1%; sensitivity: 72.4%; specificity: 68.2%; Youden index: 0.406). Patients presenting with a GINI ≥ 1562 had substantially shorter median LRPFS (13.3 vs. 18.4 months; p < 0.001), PFS (10.2 vs. 14.3 months; p < 0.001), and OS (19.1 vs. 37.8 months; p < 0.001) durations than those with a GINI < 1562. Results of the multivariate analysis revealed that the pre-CCRT GINI ≥ 1562 (vs. <1562), T4 tumor (vs. T3), and receiving only 1 cycle of concurrent chemotherapy (vs. 2-3 cycles) were the factors independently associated with poorer LRPS (p < 0.05 for each), PFS (p < 0.05 for each), and OS (p < 0.05 for each). CONCLUSION The newly developed GINI index efficiently divided the stage IIIC NSCLSC patients into two subgroups with substantially different median and long-term survival outcomes.
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Affiliation(s)
- Erkan Topkan
- Department of Radiation Oncology, Baskent University Medical Faculty, Adana 01120, Turkey
| | - Ugur Selek
- Department of Radiation Oncology, Koc University School of Medicine, Istanbul 34010, Turkey;
| | - Berrin Pehlivan
- Department of Radiation Oncology, Bahcesehir University, Istanbul 34349, Turkey;
| | - Ahmet Kucuk
- Clinic of Radiation Oncology, Mersin Education and Research Hospital, Mersin 33160, Turkey;
| | - Duriye Ozturk
- Department of Radiation Oncology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar 03030, Turkey;
| | | | - Ali Ayberk Besen
- Department of Medical Oncology, Medical Park Hospital, Adana 07160, Turkey;
| | - Huseyin Mertsoylu
- Department of Medical Oncology, Istinye University, Istanbul 34010, Turkey;
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Zhao B, Liu Y, Yang Y, He J. Association of Systemic Immune-Inflammation Index with Non-Alcoholic Fatty Liver Disease: A Population-Based Cross-Sectional Study. Risk Manag Healthc Policy 2023; 16:1581-1592. [PMID: 37605743 PMCID: PMC10440121 DOI: 10.2147/rmhp.s419183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/18/2023] [Indexed: 08/23/2023] Open
Abstract
Background The aim of this study was to explore the relationship between systemic immune-inflammation (SII) index with non-alcoholic fatty liver disease (NAFLD) in the general population of the United States (U.S.). Methods We conducted a cross-sectional study of subjects in the National Health and Nutrition Examination Survey 2017-2018. For the analysis of the association between SII index and risk of NAFLD, the restricted cubic spline (RCS) plot, we performed multivariable logistic regression models and subgroup analysis. In addition, generalized additive models with smooth functions were conducted for the relationship between the SII index and the ZJU index, the BARD score, and the NAFLD fibrosis score. Results There were a total of 1197 individuals in our study. Taking into account known confounding variables, compared with the lowest quartiles, the odds ratios with 95% confidence intervals for NAFLD across the quartiles were 0.923 (0.585, 1.455), 0.563 (0.351, 0.901), and 1.061 (0.669, 1.682), respectively. As shown by the RCS plot, the SII index was linked with NAFLD risk in a U-shaped pattern. Based on the results of subgroup analysis, SII index and NAFLD risk were U-curve correlated among participants in all age groups, male or female, with or without hypertension, with diabetes mellitus, and with a BMI of <30 or >30 kg/m2. The SII index was linearly positive with the ZJU index but negative with the NAFLD fibrosis score. However, the SII index and BARD score showed a trend of first decreasing, then increasing, and then decreasing. Conclusion The U-shaped relationships exist between SII index and risk of NAFLD, which highlighted that we should focus on the dynamic change of SII index.
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Affiliation(s)
- Bi Zhao
- Department of Gastroenterology, Jinshan Branch of Shanghai Sixth People’s Hospital, Shanghai, 201500, People’s Republic of China
| | - Yuee Liu
- Department of Emergency, Changhai Hospital, Shanghai, 200433, People’s Republic of China
| | - Yi Yang
- Department of Emergency, Ruijin Hospital and Luwan Branch, School of Medicine, Shanghai Jiaotong University, Shanghai, 200020, People’s Republic of China
| | - Jihui He
- Department of Gastroenterology, Jinshan Branch of Shanghai Sixth People’s Hospital, Shanghai, 201500, People’s Republic of China
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Zhai WY, Duan FF, Lin YB, Lin YB, Zhao ZR, Wang JY, Rao BY, Zheng L, Long H. Pan-Immune-Inflammatory Value in Patients with Non-Small-Cell Lung Cancer Undergoing Neoadjuvant Immunochemotherapy. J Inflamm Res 2023; 16:3329-3339. [PMID: 37576157 PMCID: PMC10422963 DOI: 10.2147/jir.s418276] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 08/01/2023] [Indexed: 08/15/2023] Open
Abstract
Background We aimed to investigate the predictive value of a systematic serum inflammation index, pan-immune-inflammatory value (PIV), in pathological complete response (pCR) of patients treated with neoadjuvant immunotherapy to further promote ideal patients' selection. Methods The clinicopathological and baseline laboratory information of 128 NSCLC patients receiving neoadjuvant immunochemotherapy between October 2019 and April 2022 were retrospectively reviewed. We performed least absolute shrinkage and selection operator (LASSO) algorithm to screen candidate serum biomarkers for predicting pCR, which further entered the multivariate logistic regression model to determine final biomarkers. Accordingly, a diagnostic model for predicting individual pCR was established. Kaplan-Meier method was utilized to estimate curves of disease-free survival (DFS), and the Log rank test was analyzed to compare DFS differences between patients with and without pCR. Results Patients with NSCLC heterogeneously responded to neoadjuvant immunotherapy, and those with pCR had a significant longer DFS than patients without pCR. Through LASSO and the multivariate logistic regression model, PIV was identified as a predictor for predicting pCR of patients. Subsequently, a diagnostic model integrating with PIV, differentiated degree and histological type was constructed to predict pCR, which presented a satisfactory predictive power (AUC, 0.736), significant agreement between actual and our nomogram-predicted pathological response. Conclusion Baseline PIV was an independent predictor of pCR for NSCLC patients receiving neoadjuvant immunochemotherapy. A significantly longer DFS was achieved in patients with pCR rather than those without pCR; thus, the PIV-based diagnostic model might serve as a practical tool to identify ideal patients for neoadjuvant immunotherapeutic guidance.
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Affiliation(s)
- Wen-Yu Zhai
- Department of Thoracic Surgery, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China
- Lung Cancer Research Center, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Fang-Fang Duan
- Department of Medical oncology, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China
| | - Yao-Bin Lin
- Department of Thoracic Surgery, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China
- Lung Cancer Research Center, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Yong-Bin Lin
- Department of Thoracic Surgery, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China
- Lung Cancer Research Center, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Ze-Rui Zhao
- Department of Thoracic Surgery, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China
- Lung Cancer Research Center, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Jun-Ye Wang
- Department of Thoracic Surgery, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China
- Lung Cancer Research Center, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Bing-Yu Rao
- Department of Thoracic Surgery, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China
- Lung Cancer Research Center, Sun Yat-Sen University, Guangzhou, People’s Republic of China
| | - Lie Zheng
- Medical Imaging Division, Department of Medical Imaging and Interventional Radiology, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China
| | - Hao Long
- Department of Thoracic Surgery, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, People’s Republic of China
- Lung Cancer Research Center, Sun Yat-Sen University, Guangzhou, People’s Republic of China
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Arıkan R, Alkış H, Işık S, Yaşar A, Çelebi A, Majidova N, Sever N, Adlı M, Demircan NC. Evaluation of Predictive and Prognostic Importance of Lung Immune Prognostic Index in Locally Advanced Rectal Cancer Patients Treated With Neoadjuvant Chemoradiotherapy. Cureus 2023; 15:e40548. [PMID: 37465788 PMCID: PMC10350655 DOI: 10.7759/cureus.40548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/16/2023] [Indexed: 07/20/2023] Open
Abstract
OBJECTIVE The systemic inflammatory response (SIR) is known as an important factor associated with tumorigenesis and tumor progression, and can be reflected by inflammatory markers. One of the markers that reflect this is the lung immune prognostic index (LIPI). It is based on a derived neutrophil-to-lymphocyte ratio (dNLR) and lactate dehydrogenase (LDH) level. We aimed to investigate the significance of LIPI in locally advanced rectal cancer (LARC) patients treated with neoadjuvant chemoradiotherapy (NACRT). METHODS In this retrospective study, we stratified the patients according to LIPI score as good LIPI and intermediate (int)/poor LIPI. According to pathological response to NACRT, we divided the patients into two groups as those with complete response (CR) or near-CR, and those with partial response (PR) or poor/no response. We classified CR and near-CR as good response. We evaluated the predictive and prognostic significance of LIPI for NACRT response, disease-free survival (DFS), and overall survival (OS) by univariate and multivariate analyses. RESULTS We included 137 patients in the results, with 72 (52.6%) having good LIPI and 65 (47.4%) having int/poor LIPI. The median follow-up period was 44.7 months (range: 10-105 months). Thirteen patients (18.0%) in the good LIPI group and 22 patients (34.0%) in the int/poor LIPI group achieved good response. In multivariate analysis, we found only the LIPI score as an independent risk factor (hazard ratio (HR): 2.4, p = 0.04) for NACRT response. Median DFS was 89.2 months (95% CI: 11.4-167.0) in the int/poor LIPI group; however, the DFS of all study populations and patients in the good LIPI group did not reach the median value. In multivariate analysis for DFS, we identified abdominoperineal resection (APR) (HR: 2.21, p = 0.02), presence of tumor deposit (HR: 2.96, p = 0.003), and int/poor LIPI score (HR: 2.07, p = 0.02) as separate risk variables. OS of all study populations and the patients in the LIPI groups did not reach the median value. In multivariate analysis for OS, we identified APR (HR: 2.74, p = 0.02), surgical margin positivity (HR: 12.94, p < 0.001), and adjuvant CT (HR: 0.20, p = 0.002) as separate risk variables for OS. CONCLUSION This is the first study investigating the predictive and prognostic significance of LIPI in LARC patients treated with NACRT. The results revealed that int/poor LIPI was associated with a higher rate of good response but shorter DFS compared to good LIPI. The baseline LIPI score serves as an easily accessible and useful prognostic index, and it has significant potential for making appropriate treatment decisions in LARC.
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Affiliation(s)
- Rukiye Arıkan
- Department of Medical Oncology, Marmara University School of Medicine, Istanbul, TUR
| | - Hilal Alkış
- Department of Radiation Oncology, Marmara University School of Medicine, Istanbul, TUR
| | - Selver Işık
- Department of Medical Oncology, Marmara University School of Medicine, Istanbul, TUR
| | - Alper Yaşar
- Department of Medical Oncology, Marmara University School of Medicine, Istanbul, TUR
| | - Abdussamet Çelebi
- Department of Medical Oncology, Marmara University School of Medicine, Istanbul, TUR
| | - Nargiz Majidova
- Department of Medical Oncology, Marmara University School of Medicine, Istanbul, TUR
| | - Nadiye Sever
- Department of Medical Oncology, Marmara University School of Medicine, Istanbul, TUR
| | - Mustafa Adlı
- Department of Radiation Oncology, Marmara University School of Medicine, Istanbul, TUR
| | - Nazım C Demircan
- Department of Medical Oncology, Erzurum Education and Training Hospital, Erzurum, TUR
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Wei C, Zhang W, Chen J, He Q, Cao L, Zhang P, Deng C, Xiong M, Huang Y, Guo H, Wang M, Chen Z. Systematic analysis between inflammation-related index and sex hormones in American adults: cross-sectional research based NHANES 2013-2016. Front Immunol 2023; 14:1175764. [PMID: 37304307 PMCID: PMC10250748 DOI: 10.3389/fimmu.2023.1175764] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/15/2023] [Indexed: 06/13/2023] Open
Abstract
Background A series of novel inflammation-related indexes has been confirmed to be efficient indicators of human immune and inflammatory status, with great potential as predictors for a variety of diseases. However, the association between inflammation-related indexes and sex hormones in the general population remained uncertain. Methods We incorporated data from the NHANES 2013-2016 survey of American adults. On the basis of distribution and comparison analysis, we chose to undertake separate analyses of men and women (including premenopausal and postmenopausal groups). Multivariable weighted linear regression models, eXtreme Gradient Boosting (XGBoost) models, generalized linear analysis, stratified models, logistic regression models and sensitivity analysis were utilized to assess the relationships between inflammation-related indexes and sex hormones. Results Total 9372 participants out of 20146 were fitted into our research. We conducted separate gender analysis due to different distribution. Multivariable weighted linear regression indicated every component of the inflammation-related index was negatively correlated with at least one component of the male hormone indexes. However, SII, NLR, PPN, and NC were associated positively with female estradiol. XGBoost identify SII, PLR and NLR were the critical indexes on sex hormones. Inflammation-related indexes was associated with Testosterone deficiency in male and postmenstrual group and associated with Excessive Estradiol in premenstrual group. Finally, the subgroup analysis revealed that the association between sex hormones and inflammatory indicators was prominent in American adults over the age of 60 or those with BMI (>28 kg/m2). Conclusion In all, inflammation-related indexes act as independent risks associated with sex hormone alterations and metabolic disorder in both genders. Using multiple models, we revealed the relative importance of inflammation-related indexes. Subgroup analysis also identified the high-risk population. More prospective and experimental research should be conducted to validate the results.
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Affiliation(s)
- Chengcheng Wei
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Wenting Zhang
- Department of Obstetrics and Gynecology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jiabi Chen
- Department of Urology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Qingliu He
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Department of Urology, The Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Li Cao
- Department of Orthopaedic, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Pu Zhang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Changqi Deng
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ming Xiong
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yu Huang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Haixin Guo
- Department of Ultrasound, the Second Affiliated Hospital of Fujian Medical University, Quanzhou, China
| | - Miao Wang
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zhaohui Chen
- Department of Urology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Deck J, Hartley M, Akhter M, Wang D, Bogart JA, Mix MD. Effect of Lymphopenia on Tumor Response and Clinical Outcomes Following Chemoradiotherapy in Stage III Non-Small Cell Lung Cancer. LUNG CANCER (AUCKLAND, N.Z.) 2023; 14:47-55. [PMID: 37228390 PMCID: PMC10204762 DOI: 10.2147/lctt.s386344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 04/27/2023] [Indexed: 05/27/2023]
Abstract
Background Prior studies suggest lymphopenia, systemic immune-inflammatory index, and tumor response all impact clinical outcomes in Stage III NSCLC. We hypothesized that tumor response after CRT would be associated with hematologic metrics and might predict clinical outcomes. Materials and Methods Patients with stage III NSCLC treated at a single institution between 2011 and 2018 were retrospectively reviewed. Pre-treatment gross tumor volume (GTV) was recorded then reassessed at 1-4 months post-CRT. Complete blood counts before, during and after treatment were recorded. Systemic immune-inflammation index (SII) was defined as neutrophil × platelet/lymphocyte. Overall survival (OS) and progression free survival (PFS) were calculated using Kaplan-Meier estimates, and compared with Wilcoxon tests. A multivariate analysis of hematologic factors impacting restricted mean survival was then performed using pseudovalue regression, accounting for other baseline factors. Results 106 patients were included. After median follow-up of 24 months, median PFS and OS were 16 and 40 months, respectively. Within the multivariate model, baseline SII was associated with OS (p = 0.046) but not PFS (p = 0.09), and baseline ALC correlated with both PFS and OS (p = 0.03 and p = 0.02, respectively). Nadir ALC, nadir SII, and recovery SII were not associated with PFS or OS. Conclusion In this cohort of patients with stage III NSCLC, baseline hematologic factors were associated with clinical outcomes including baseline ALC, baseline SII and recovery ALC. Disease response was not well correlated with hematologic factors or clinical outcomes.
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Affiliation(s)
- Jared Deck
- Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Marissa Hartley
- Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Mohammad Akhter
- Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Dongliang Wang
- Department of Public Health and Preventive Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jeffrey A Bogart
- Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Michael D Mix
- Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, NY, USA
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Bu F, Cao S, Deng X, Zhang Z, Feng X. Evaluation of C-reactive protein and fibrinogen in comparison to CEA and CA72-4 as diagnostic biomarkers for colorectal cancer. Heliyon 2023; 9:e16092. [PMID: 37215813 PMCID: PMC10196578 DOI: 10.1016/j.heliyon.2023.e16092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 05/24/2023] Open
Abstract
Carcinoembryonic antigen (CEA) and carbohydrate antigen 72-4 (CA72-4) are commonly used markers for colorectal cancer (CRC) in clinical applications. However, low positivity rate and sensitivity limits their clinical effectiveness. In this study, we explored the potential of C-reactive protein (CRP) and fibrinogen to improve the diagnostic efficiency of traditional biomarkers of CRC. The concentrations of CRP and fibrinogen in plasma were significantly higher in CRC patients compared with benign or healthy controls. The area under the ROC curves (AUCs) showed that the diagnostic efficacy of CRP and fibrinogen was 0.745 (95% CI: 0.712-0.779) and 0.699 (95% CI: 0.663-0.734), respectively. AUC increased to 0.750 (95% CI: 0.716-0.784) when CRP and fibrinogen were combined. It also further improved to 0.889 (95% CI: 0.866-0.913) when CRP and fibrinogen were integrated with CEA and CA72-4. Moreover, this combination increased the maximum area under AUC to 0.857 (95% CI: 0.830-0.883), which effective differentiated CRC from benign disease. Overall, this study found that CRP and fibrinogen were highly expressed in the plasma of CRC patients, suggesting their potential to improve the diagnostic efficiency of traditional biomarkers of CRC.
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Affiliation(s)
- Fan Bu
- Department of Clinical Laboratory, The Affiliated Taian City Central Hospital of Qingdao University, Taian, 271000, China
| | - Shenyun Cao
- Department of Clinical Laboratory, The Affiliated Taian City Central Hospital of Qingdao University, Taian, 271000, China
| | - Xiangzhu Deng
- Department of Clinical Laboratory, Qingdao Youfu Hospital, Qingdao, 266075, China
| | - Zhijun Zhang
- Department of Clinical Laboratory, The Affiliated Taian City Central Hospital of Qingdao University, Taian, 271000, China
| | - Xiaodong Feng
- Department of Clinical Laboratory, Central Hospital Affiliated to Shandong First Medical University, Jinan, 250013, China
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Fan R, Chen Y, Xu G, Pan W, Lv Y, Zhang Z. Combined systemic immune-inflammatory index and prognostic nutritional index predict outcomes in advanced non-small cell lung cancer patients receiving platinum-doublet chemotherapy. Front Oncol 2023; 13:996312. [PMID: 37077828 PMCID: PMC10106714 DOI: 10.3389/fonc.2023.996312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 03/15/2023] [Indexed: 04/05/2023] Open
Abstract
Background Systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI) could evaluate the therapeutic efficacy and prognosis in different tumors. However, no studies investigated the SII-PNI score to predict outcomes in non-small cell lung cancer (NSCLC) patients treated with platinum-doublet chemotherapy. The aim of this study was to investigate the SII-PNI score in predicting outcomes in non-small cell lung cancer (NSCLC) patients treated with platinum-doublet chemotherapy. Materials and methods Our study retrospectively analyzed clinical data from 124 patients with advanced NSCLC receiving platinum-doublet chemotherapy. The SII and PNI were calculated based on peripheral blood cell counts and serum albumin, and the optimal cut-off values were determined using receiver operating characteristic (ROC). All patients were divided into three groups according to the SII-PNI score. The association between the SII-PNI score and the clinicopathological characteristics of the patients was examined. The Kaplan-Meier and Cox regression models were used to assess progression-free survival (PFS)and overall survival (OS). Results There was no significant correlation between SII, PNI at baseline and chemotherapy response in patients with advanced NSCLC (p>0.05). However, after receiving 4 cycles of platinum-doublet chemotherapy, the SII of the SD group (p=0.0369) and PD group (p=0.0286) was significantly higher than that of the PR group. At the same time, the PNI of the SD group (p=0.0112) and the PD group (p=0.0007) was significantly lower than that of the PR group. The PFS of patients with SII-PNI scores of 0, 1, and 2 were 12.0, 7.0, and 5.0 months, and the OS of patients with SII-PNI scores of 0, 1, and 2 were 34.0, 17.0, and 10.5 months, respectively. There was statistical significance among the three groups (all p <0.001). Multivariate analyses showed that the chemotherapy response of progressive disease (PD) (HR, 3.508; 95% CI, 1.546-7.960; p=0.003) and SII-PNI score of 2 (HR, 4.732; 95% CI, 2.561-8.743; p < 0.001) were independently associated with a shorter OS. The uses of targeted drugs (HR, 0.543; 95% CI, 0.329-0.898; p=0.017) and immune checkpoint inhibitors (HR, 0.218; 95% CI, 0.081-0.584; p=0.002) were protective factors for OS in patients with NSCLC. Conclusion Compared with baseline parameters, the correlation between SII, PNI after 4 cycles of chemotherapy and the chemotherapy effect was more significant. The SII-PNI score after 4 cycles of chemotherapy is an effective prognostic biomarker for advanced NSCLC patients treated with platinum-doublet chemotherapy. Patients with a higher SII-PNI score had a worse prognosis.
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Affiliation(s)
| | | | | | | | | | - Zhongwei Zhang
- Department of Pulmonary and Critical Care, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, China
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Gao SJ, Jin L, Meadows HW, Shafman TD, Gross CP, Yu JB, Aerts HJWL, Miccio JA, Stahl JM, Mak RH, Decker RH, Kann BH. Prediction of Distant Metastases After Stereotactic Body Radiation Therapy for Early Stage NSCLC: Development and External Validation of a Multi-Institutional Model. J Thorac Oncol 2023; 18:339-349. [PMID: 36396062 DOI: 10.1016/j.jtho.2022.11.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/03/2022] [Accepted: 11/06/2022] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Distant metastases (DMs) are the primary driver of mortality for patients with early stage NSCLC receiving stereotactic body radiation therapy (SBRT), yet patient-level risk is difficult to predict. We developed and validated a model to predict individualized risk of DM in this population. METHODS We used a multi-institutional database of 1280 patients with cT1-3N0M0 NSCLC treated with SBRT from 2006 to 2015 for model development and internal validation. A Fine and Gray (FG) regression model was built to predict 1-year DM risk and compared with a random survival forests model. The higher performing model was evaluated on an external data set of 130 patients from a separate institution. Discriminatory performance was evaluated using the time-dependent area under the curve (AUC). Calibration was assessed graphically and with Brier scores. RESULTS The FG model yielded an AUC of 0.71 (95% confidence interval [CI]: 0.57-0.86) compared with the AUC of random survival forest at 0.69 (95% CI: 0.63-0.85) in the internal test set and was selected for further testing. On external validation, the FG model yielded an AUC of 0.70 (95% CI: 0.57-0.83) with good calibration (Brier score: 0.08). The model identified a high-risk patient subgroup with greater 1-year DM rates in the internal test (20.0% [3 of 15] versus 2.9% [7 of 241], p = 0.001) and external validation (21.4% [3 of 15] versus 7.8% [9 of 116], p = 0.095). A model nomogram and online application was made available. CONCLUSIONS We developed and externally validated a practical model that predicts DM risk in patients with NSCLC receiving SBRT which may help select patients for systemic therapy.
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Affiliation(s)
- Sarah J Gao
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut
| | - Lan Jin
- Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut
| | - Hugh W Meadows
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, Massachusetts; Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | | | - Cary P Gross
- Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, Connecticut
| | - James B Yu
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut; Cancer Outcomes, Public Policy and Effectiveness Research (COPPER) Center, Yale School of Medicine, New Haven, Connecticut
| | - Hugo J W L Aerts
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, Massachusetts; Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts; Radiology and Nuclear Medicine, CARIM & GROW, Maastricht University, Maastricht, the Netherlands
| | - Joseph A Miccio
- Department of Radiation Oncology, Penn State Milton S. Hershey Medical Center, Camp Hill, Pennsylvania
| | - John M Stahl
- Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Raymond H Mak
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, Massachusetts; Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
| | - Roy H Decker
- Department of Therapeutic Radiology, Yale School of Medicine, New Haven, Connecticut
| | - Benjamin H Kann
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, Massachusetts; Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts.
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Cesur IB, Özçelik Z. Systemic Immune-Inflammation Index May Predict Mortality in Neuroblastoma. Cureus 2023; 15:e35705. [PMID: 36875247 PMCID: PMC9982472 DOI: 10.7759/cureus.35705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2023] [Indexed: 03/06/2023] Open
Abstract
INTRODUCTION Neuroblastomas (NB) are among the most frequent childhood solid tumors. The link between inflammation and cancer is well understood. Many research studies have been conducted to determine the prognostic importance of inflammatory markers in cancer patients. C-reactive protein (CRP), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) are all potential inflammation indicators. The purpose of this study is to assess the efficacy of NLR and SII as inflammatory indicators in predicting NB patient survival. MATERIALS AND METHODS Patients with NB diagnosed between January 1, 2012 and December 31, 2021 were studied retrospectively, and death was documented. By dividing the number of neutrophils by the number of lymphocytes, the NLR was obtained. The SII was calculated by multiplying the NLR by the platelet count. RESULTS 46 patients with NB were included in the study with a mean age of 57.58 months (4.14-170.05). When the patients were analyzed based on mortality the NLR and SII values were statistically significantly increased in the dead group (2.71 (1.22-4.1 ) vs. 1.7 (0.16-5.1); p=0.02; and 677.8 (215-1322) vs. 294.6 (69.49-799.1), respectively; p=0.012). Analysis of the receiver operating curve found that 328.49 is the ideal cutoff value for SII to predict mortality with a sensitivity of 83% and a specificity of 68% (area under the receiver operating characteristic curve = 0.814 (95% confidence interval: 0.671-0.956), p=0.005 ). Analyzing the influence of risk factors on survival using Cox regression analysis, SII was discovered as a significant predictor of survival in the study (HR =1.001, 95% CI =1-1.20; p=0.049). CONCLUSION SII may be used to predict the overall survival of NB patients.
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Affiliation(s)
| | - Zerrin Özçelik
- Pediatric Surgery, Adana City Training Hospital, Adana, TUR
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Association between Systemic Immunity-Inflammation Index and Hyperlipidemia: A Population-Based Study from the NHANES (2015-2020). Nutrients 2023; 15:nu15051177. [PMID: 36904176 PMCID: PMC10004774 DOI: 10.3390/nu15051177] [Citation(s) in RCA: 75] [Impact Index Per Article: 75.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 02/23/2023] [Accepted: 02/25/2023] [Indexed: 03/03/2023] Open
Abstract
The systemic immunity-inflammation index (SII) is a novel inflammatory marker, and aberrant blood lipid levels are linked to inflammation. This study aimed to look at the probable link between SII and hyperlipidemia. The current cross-sectional investigation was carried out among people with complete SII and hyperlipidemia data from the 2015-2020 National Health and Nutrition Examination Survey (NHANES). SII was computed by dividing the platelet count × the neutrophil count/the lymphocyte count. The National Cholesterol Education Program standards were used to define hyperlipidemia. The nonlinear association between SII and hyperlipidemia was described using fitted smoothing curves and threshold effect analyses. A total of 6117 US adults were included in our study. A substantial positive correlation between SII and hyperlipidemia was found [1.03 (1.01, 1.05)] in a multivariate linear regression analysis. Age, sex, body mass index, smoking status, hypertension, and diabetes were not significantly correlated with this positive connection, according to subgroup analysis and interaction testing (p for interaction > 0.05). Additionally, we discovered a non-linear association between SII and hyperlipidemia with an inflection point of 479.15 using a two-segment linear regression model. Our findings suggest a significant association between SII levels and hyperlipidemia. More large-scale prospective studies are needed to investigate the role of SII in hyperlipidemia.
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You Y, Chen Y, Fang W, Li X, Wang R, Liu J, Ma X. The association between sedentary behavior, exercise, and sleep disturbance: A mediation analysis of inflammatory biomarkers. Front Immunol 2023; 13:1080782. [PMID: 36713451 PMCID: PMC9880546 DOI: 10.3389/fimmu.2022.1080782] [Citation(s) in RCA: 57] [Impact Index Per Article: 57.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/09/2022] [Indexed: 01/14/2023] Open
Abstract
Background Two related lifestyle behaviors associated with sleep disturbance are sedentary behavior and physical exercise participation. We aimed to use a population-based study to disentangle the relationships between sedentary behavior, exercise, and sleep disturbance based on blood-cell-based inflammatory biomarkers. Methods A total of 22,599 participants from the National Health and Nutrition Examination Survey (NHANES) were included in the analyses. Sleep disturbance was assessed according to the NHANES questionnaire. Exercise participation ansd sedentary behavior were evaluated by the global physical activity questionnaire. The inflammatory biomarkers in the examination were white blood cell (WBC) count, neutrophil count (NEU), neutrophil-to-lymphocyte ratio (NLR), and systemic immune inflammation index (SII). A complex multistage sampling design and weighted multivariable logistic regression were applied for further analysis. Mediation models were constructed to figure out the mediating role of inflammatory biomarkers. Results The weighted prevalence of sleep disturbance was 24.17%. Sedentary behavior and exercise were associated with sleep disturbance after full adjustment [for sedentary behavior, OR (95% CI): 1.261 (1.154, 1.377); for exercise, OR (95% CI): 0.849 (0.757, 0.953)]. In severe sedentary behavior groups, the mitigation effect of exercise on sleep disturbance was observed [OR (95% CI): 0.687 (0.551, 0.857)]. For the mechanism, strong associations were detected between inflammatory biomarkers and sleep disturbance. Mediation analysis showed that WBC, NEU, NLR, and SII mediated the statistical association between sedentary behavior and sleep disturbance with proportions (%) of 2.09, 2.27, 1.76, and 0.82, respectively. Conclusions Our data suggested that sedentary behavior was a risk factor for sleep disturbance. Blood-cell-based inflammatory biomarkers were an easily accessible and cost-effective strategy for identifying sleep disturbance and also significantly mediated the association between sedentary behavior and sleep disturbance. Exercise was proved to be effective in severe sedentary behavior groups to improve sleep disturbance symptoms, while the internal mechanism needed further exploration.
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Affiliation(s)
- Yanwei You
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China,School of Social Sciences, Tsinghua University, Beijing, China
| | - Yuquan Chen
- Institute of Medical Information/Medical Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wen Fang
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China,School of Social Sciences, Tsinghua University, Beijing, China
| | - Xingtian Li
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China,School of Social Sciences, Tsinghua University, Beijing, China
| | - Rui Wang
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China,School of Social Sciences, Tsinghua University, Beijing, China
| | - Jianxiu Liu
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China,Vanke School of Public Health, Tsinghua University, Beijing, China,*Correspondence: Jianxiu Liu, ; Xindong Ma,
| | - Xindong Ma
- Division of Sports Science and Physical Education, Tsinghua University, Beijing, China,IDG/McGovern Institute for Brain Research, Tsinghua University, Beijing, China,*Correspondence: Jianxiu Liu, ; Xindong Ma,
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Chen L, Xia S, Zuo Y, Lin Y, Qiu X, Chen Q, Feng T, Xia X, Shao Q, Wang S. Systemic immune inflammation index and peripheral blood carbon dioxide concentration at admission predict poor prognosis in patients with severe traumatic brain injury. Front Immunol 2023; 13:1034916. [PMID: 36700228 PMCID: PMC9868584 DOI: 10.3389/fimmu.2022.1034916] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/22/2022] [Indexed: 01/11/2023] Open
Abstract
Background Recent studies have shown that systemic inflammation responses and hyperventilation are associated with poor outcomes in patients with severe traumatic brain injury (TBI). The aim of this retrospective study was to investigate the relationships between the systemic immune inflammation index (SII = platelet × neutrophil/lymphocyte) and peripheral blood CO2 concentration at admission with the Glasgow Outcome Score (GOS) at 6 months after discharge in patients with severe TBI. Methods We retrospectively analyzed the clinical data for 1266 patients with severe TBI at three large medical centers from January 2016 to December 2021, and recorded the GOS 6 months after discharge. The receiver operating characteristic (ROC) curve was used to determine the best cutoff values for SII, CO2, neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lymphocyte to monocyte ratio (LMR), and chi-square tests were used to evaluate the relationships among SII, CO2 and the basic clinical characteristics of patients with TBI. Multivariate logistic regression analysis was used to determine the independent prognostic factors for GOS in patients with severe TBI. Finally, ROC curve, nomogram, calibration curve and decision curve analyses were used to evaluate the value of SII and coSII-CO2 in predicting the prognosis of patients with severe TBI. And we used the multifactor regression analysis method to build the CRASH model and the IMPACT model. The CRASH model included age, GCS score (GCS, Glasgow Coma Scale) and Pupillary reflex to light: one, both, none. The IMPACT model includes age, motor score and Pupillary reflex to light: one, both, none. Results The ROC curves indicated that the best cutoff values of SII, CO2, PLR, NLR and LMR were 2651.43×109, 22.15mmol/L, 190.98×109, 9.66×109 and 1.5×109, respectively. The GOS at 6 months after discharge of patients with high SII and low CO2 were significantly poorer than those with low SII and high CO2. Multivariate logistic regression analysis revealed that age, systolic blood pressure (SBP), pupil size, subarachnoid hemorrhage (SAH), SII, PLR, serum potassium concentration [K+], serum calcium concentration [Ca2+], international normalized ratio (INR), C-reactive protein (CRP) and co-systemic immune inflammation index combined with carbon dioxide (coSII-CO2) (P < 0.001) were independent prognostic factors for GOS in patients with severe TBI. In the training group, the C-index was 0.837 with SII and 0.860 with coSII-CO2. In the external validation group, the C-index was 0.907 with SII and 0.916 with coSII-CO2. Decision curve analysis confirmed a superior net clinical benefit with coSII-CO2 rather than SII in most cases. Furthermore, the calibration curve for the probability of GOS 6 months after discharge showed better agreement with the observed results when based on the coSII-CO2 rather than the SII nomogram. According to machine learning, coSII-CO2 ranked first in importance and was followed by pupil size, then SII. Conclusions SII and CO2 have better predictive performance than NLR, PLR and LMR. SII and CO2 can be used as new, accurate and objective clinical predictors, and coSII-CO2, based on combining SII with CO2, can be used to improve the accuracy of GOS prediction in patients with TBI 6 months after discharge.
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Affiliation(s)
- Li Chen
- Department of Neurosurgery, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China
| | - Shaohuai Xia
- Department of Neurosurgery, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China
| | - Yi Zuo
- Department of Geriatrics, Affiliated Huai’an No.2 People’s Hospital of Xuzhou Medical University, Huai’an, Jiangsu, China
| | - Yinghong Lin
- Department of Neurosurgery, 900th Hospital, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Xianshen Qiu
- Department of Neurosurgery, Ganzhou People's Hospital, No.16 Meiguan Avenue, Zhanggong District, Ganzhou, Jiangxi, China
| | - Qizuan Chen
- Department of Neurosurgery, 900th Hospital, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Tianshun Feng
- Department of Neurosurgery, 900th Hospital, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China
| | - Xuewei Xia
- Department of Neurosurgery, Affiliated Hospital of Guilin Medical University, Guilin, Guangxi, China,*Correspondence: Xuewei Xia, ; Qixiang Shao, ; Shousen Wang,
| | - Qixiang Shao
- Institute of Medical Genetics and Reproductive Immunity, School of Medical Science and Laboratory Medicine, Jiangsu College of Nursing, No.2 the Yellow River West Road Huai'an, Jiangsu, China,*Correspondence: Xuewei Xia, ; Qixiang Shao, ; Shousen Wang,
| | - Shousen Wang
- Department of Neurosurgery, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, Fujian, China,Department of Neurosurgery, 900th Hospital, Fuzong Clinical Medical College of Fujian Medical University, Fuzhou, China,*Correspondence: Xuewei Xia, ; Qixiang Shao, ; Shousen Wang,
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Chen D, Qin H, Deng G, Wang Q, Wang H, Liu X. Pre-radiotherapy systemic immune inflammation index associated with overall survival in patients with advanced EGFR mutant non-small cell lung cancer receiving thoracic radiotherapy. Clin Transl Oncol 2023; 25:226-235. [PMID: 36070068 PMCID: PMC9813231 DOI: 10.1007/s12094-022-02936-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/22/2022] [Indexed: 01/09/2023]
Abstract
PURPOSE This study aimed to investigate the prognostic potential of the pre-radiotherapy systemic immune-inflammation index (SII) for the survival of advanced lung adenocarcinoma patients with epidermal growth factor receptor (EGFR) mutations, which might provide a basis for optimizing the comprehensive treatment scheme. METHODS A total of 111 lung adenocarcinoma patients with EGFR mutations, who received thoracic radiotherapy, were included in this retrospective study. The primary endpoint of the study was based on the overall survival (OS) of patients. The receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off value of each immune inflammation index. Kaplan-Meier analysis was performed for the comparison of OS. The Cox proportional-hazard model was used for the multivariate and univariate regression analyses to determine the correlations of prognostic factors with the disease. RESULTS SII was divided into the high SII group (≥ 620.2; 45.95%) and the low SII group (SII < 620.2; 54.05%) based on the optimal cutoff values. The median OS rates were 53.3 and 33.3 months in the low and high SII groups, respectively, showing statistically significant differences ( hazard ratio (HR) = 0.459; 95% CI 0.286-0.736; P < 0.001). The multivariate analysis showed that, after adjusting for the significant covariates, the SII values were independently associated with the improved OS of the patients (adjusted HR = 0.444; 95% CI 0.279-0.709; P = 0.001). The low NLR values were associated with the better OS of patients (HR = 0.509; 95% CI 0.326-0.792; P = 0.005) and vice versa (HR = 0.422; 95% CI 0.213-0.836; P < 0.001). The patients in the low LMR group before radiotherapy exhibited longer OS as compared to those in the high LMR group (HR = 0.497; 95% CI 0.308-0.802; P = 0.001). CONCLUSIONS This study showed that these inflammatory indices might have an important prognostic potential for advanced lung adenocarcinoma patients with EGFR mutations, receiving thoracic radiotherapy and might provide a basis for the individualized treatment of these patients.
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Affiliation(s)
- Dujuan Chen
- Dongming People’s Hospital, Heze, Shandong Province China
| | - Hongyue Qin
- grid.410587.fShandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117 Shandong Province China ,grid.440144.10000 0004 1803 8437Department of Radiation Oncology, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong Cancer Hospital and Institute, Jinan, 250117 Shandong Province China
| | - Guangchuan Deng
- grid.410587.fShandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117 Shandong Province China ,grid.440144.10000 0004 1803 8437Department of Radiation Oncology, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong Cancer Hospital and Institute, Jinan, 250117 Shandong Province China
| | - Qi Wang
- grid.410587.fShandong First Medical University and Shandong Academy of Medical Sciences, Jinan, 250117 Shandong Province China ,grid.440144.10000 0004 1803 8437Department of Radiation Oncology, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong Cancer Hospital and Institute, Jinan, 250117 Shandong Province China
| | - Haiyong Wang
- grid.440144.10000 0004 1803 8437Department of Internal Medicine-Oncology, Department of Radiation Oncology, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong Cancer Hospital and Institute, Jinan, 250117 Shandong Province China
| | - Xijun Liu
- grid.440144.10000 0004 1803 8437Department of Radiation Oncology, Shandong First Medical University and Shandong Academy of Medical Sciences, Shandong Cancer Hospital and Institute, Jinan, 250117 Shandong Province China
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Liu E, Liu C, Jin L, Zhou H, Tan X, Zhang G, Tao W, Gao X, Zhao H, Luo C, Li X, Yang S. Clinical value of the systemic immune-inflammation index in moyamoya disease. Front Neurol 2023; 14:1123951. [PMID: 37153657 PMCID: PMC10157187 DOI: 10.3389/fneur.2023.1123951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 03/21/2023] [Indexed: 05/10/2023] Open
Abstract
Background Moyamoya disease (MMD) is a rare cerebrovascular disorder with unknown etiology. The underlying pathophysiological mechanism of moyamoya disease remains to be elucidated, but recent studies have increasingly highlighted that abnormal immune response may be a potential trigger for MMD. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) are inflammatory markers that can reflect the immune-inflammation state of the disease. Objective The purpose of this study was to investigate SII, NLR, and PLR in patients with moyamoya disease. Methods A total of 154 patients with moyamoya disease (MMD group) and 321 age- and sex-matched healthy subjects (control group) were included in this retrospective case-control study. Complete blood count parameters were assayed to calculate the SII, NLR, and PLR values. Results The SII, NLR, and PLR values in the moyamoya disease group were significantly higher than those in the control group [754 ± 499 vs. 411 ± 205 (P < 0.001), 2.83 ± 1.98 vs. 1.81 ± 0.72 (P < 0.001), and 152 ± 64 vs. 120 ± 42 (P < 0.001), respectively]. The SII in the medium-moyamoya vessels of moyamoya disease was higher than that in the high-moyamoya vessels and low-moyamoya vessels (P = 0.005). Using the receiver operating characteristic (ROC) curve analysis to predict MMD, the highest area under the curve (AUC) was determined for SII (0.76 for SII, 0.69 for NLR, and 0.66 for PLR). Conclusion Based on the results of this study, patients with moyamoya disease admitted for inpatient care due to acute or chronic stroke have significantly higher SII, NLR, and PLR when compared to blood samples drawn from completely healthy controls in a non-emergent outpatient setting. While the findings may suggest that inflammation plays a role in moyamoya disease, further studies are warranted to corroborate such an association. In the middle stage of moyamoya disease, there may be a more intense imbalance of immune inflammation. Further studies are needed to determine whether the SII index contributes to the diagnosis or serves as a potential marker of an inflammatory response in patients with moyamoya disease.
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Affiliation(s)
- Erheng Liu
- Department of Neurosurgery, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Department of Neurosurgery, The First People's Hospital of Yunnan Province, Kunming, China
| | - Chengyuan Liu
- Department of Neurosurgery, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Department of Neurosurgery, The First People's Hospital of Yunnan Province, Kunming, China
| | - Lide Jin
- Department of Neurosurgery, The First People's Hospital of Yunnan Province, Kunming, China
| | - Hu Zhou
- Department of Neurosurgery, The First People's Hospital of Yunnan Province, Kunming, China
| | - Xueyi Tan
- Department of Neurosurgery, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Department of Neurosurgery, The First People's Hospital of Yunnan Province, Kunming, China
| | - Guibo Zhang
- Department of Neurosurgery, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China
- Department of Neurosurgery, The First People's Hospital of Yunnan Province, Kunming, China
| | - Weihua Tao
- Department of Neurosurgery, The First People's Hospital of Yunnan Province, Kunming, China
| | - Xiang Gao
- Department of Neurosurgery, The First People's Hospital of Yunnan Province, Kunming, China
| | - Heng Zhao
- Department of Neurosurgery, The First People's Hospital of Yunnan Province, Kunming, China
| | - Chao Luo
- Department of Neurosurgery, The First People's Hospital of Yunnan Province, Kunming, China
| | - Xuehua Li
- Department of AIDS/STDs Prevention and Control, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China
- *Correspondence: Xuehua Li
| | - Shuaifeng Yang
- Department of Neurosurgery, The First People's Hospital of Yunnan Province, Kunming, China
- Shuaifeng Yang
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Preoperative Immunocite-Derived Ratios Predict Surgical Complications Better when Artificial Neural Networks Are Used for Analysis-A Pilot Comparative Study. J Pers Med 2023; 13:jpm13010101. [PMID: 36675762 PMCID: PMC9861480 DOI: 10.3390/jpm13010101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/24/2022] [Accepted: 12/27/2022] [Indexed: 01/04/2023] Open
Abstract
We aimed to comparatively assess the prognostic preoperative value of the main peripheral blood components and their ratios-the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR)-to the use of artificial-neural-network analysis in determining undesired postoperative outcomes in colorectal cancer patients. Our retrospective study included 281 patients undergoing elective radical surgery for colorectal cancer in the last seven years. The preoperative values of SII, NLR, LMR, and PLR were analyzed in relation to postoperative complications, with a special emphasis on their ability to accurately predict the occurrence of anastomotic leak. A feed-forward fully connected multilayer perceptron network (MLP) was trained and tested alongside conventional statistical tools to assess the predictive value of the abovementioned blood markers in terms of sensitivity and specificity. Statistically significant differences and moderate correlation levels were observed for SII and NLR in predicting the anastomotic leak rate and degree of postoperative complications. No correlations were found between the LMR and PLR or the abovementioned outcomes. The MLP network analysis showed superior prediction value in terms of both sensitivity (0.78 ± 0.07; 0.74 ± 0.04; 0.71 ± 0.13) and specificity (0.81 ± 0.11; 0.69 ± 0.03; 0.9 ± 0.04) for all the given tasks. Preoperative SII and NLR appear to be modest prognostic factors for anastomotic leakage and overall morbidity. Using an artificial neural network offers superior prognostic results in the preoperative risk assessment for overall morbidity and anastomotic leak rate.
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Smith D, Raices M, Cayol F, Corvatta F, Caram L, Dietrich A. Is the neutrophil-to-lymphocyte ratio a prognostic factor in non-small cell lung cancer patients who receive adjuvant chemotherapy? Semin Oncol 2022; 49:482-489. [PMID: 36775797 DOI: 10.1053/j.seminoncol.2023.01.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 02/08/2023]
Abstract
Inflammation plays a key role in malignant tumor progression. Neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation and, as such, high isolated pretreatment NLR has been shown in some studies to be associated with worse long-term outcomes. We summarize the data regarding the utility of NLR as a prognosis factor and present results of a single institution study assessing the usefulness of high preoperative NLR as a prognosis factor for patients with successfully resected NSCLC who receive adjuvant cisplatin-based chemotherapy. While largely supportive of the value of NLR as a prognostic factor, the literature is not consistent and suggest a more nuanced association. Our single institution study adds to the exiting literature. We conclude preoperative NLR can be used as a reliable, cost-effective biomarker to estimate prognosis in NSCLC patients who have undergone lung lobectomy with curative intent followed by cisplatin-based adjuvant chemotherapy.
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Affiliation(s)
- David Smith
- Department of Thoracic Surgery and Pulmonary Transplantation of Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Micaela Raices
- Department of General Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Federico Cayol
- Department of Oncology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Franco Corvatta
- Department of General Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
| | - Lucas Caram
- Department of General Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - Agustín Dietrich
- Department of Oncology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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Role of systemic immune-inflammatory index in early diagnosis of sepsis in newborns with CHD. Cardiol Young 2022; 32:1826-1832. [PMID: 35550698 DOI: 10.1017/s1047951122001202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Congenital heart diseases (CHD) are the most common causes of birth defects that have increased the risk of infections. Neonatal sepsis is a life-threatening condition and early diagnosis can be life-saving. We aimed to evaluate the potential role of the systemic immune-inflammatory index in the early diagnosis of neonatal sepsis. METHODS A retrospective cohort study was conducted on 166 newborns with a diagnosis of neonatal sepsis who were admitted to our hospital with CHD between January 2017 and June 2021. Haematological indices including neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, and systemic immune-inflammatory index were calculated for all patients at the time of diagnosis of neonatal sepsis (sepsis). The sepsis values of these indices were compared with the admission values (pre-sepsis) of the patients. RESULTS The mean gestational age and birth weight of the patients were 38.36 ± 1.42 weeks and 3057.75 ± 484.68 g. It was found that absolute neutrophil count, systemic immune-inflammatory index, neutrophil/lymphocyte ratio, but not platelet/lymphocyte ratio were significantly increased at the time of sepsis. The receiver operating characteristic curve showed that systemic immune-inflammatory index, neutrophil/lymphocyte ratio, and absolute neutrophil count have predictive ability to define neonatal sepsis among newborns with CHD. The systemic immune-inflammatory index produced an area under the curve receiver operating characteristic curve of 0.76 (70% sensitivity, 70.5% specificity). To discriminate neonatal sepsis, the cut-off values of systemic immune-inflammatory index, neutrophil/lymphocyte ratio, and absolute neutrophil count were 517.19, 2.62, and 9210/mm3, respectively. CONCLUSION As an easily accessible and reliable indicator, systemic immune-inflammatory index may be used in combination with the other parameters in the early diagnosis of neonatal sepsis.
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Sokolov DA, Kozlov IA. Information Value of Calculated Hematological Indices in the Assessment of Cardiac Risk in Oncological Surgery. MESSENGER OF ANESTHESIOLOGY AND RESUSCITATION 2022. [DOI: 10.21292/2078-5658-2022-19-5-6-13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
The objective: to study information value of the neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) in the cardiac risk assessment in abdominal oncological surgery.Subjects and Methods. 94 patients of 68 [62‒73] years old who underwent elective surgery were examined.Results. Cardiovascular comortbidity was diagnosed in 69 (73.4%) patients. 11 (11.7%) perioperative cardiovascular complications were registered. Cardiac mortality was 4.3%. Hematological indices were not associated with cardiovascular diseases (NLR: OR = 0.59‒1.42; 95% CI 0.14‒2.60; p = 0.29‒0.74, PLR: OR = 0.99‒1.00; 95% CI 0.97‒1.01; p = 0.31‒0.99). NLR and PLR were not predictors of cardiovascular complications (OR = 0.67; 95% CI 0.19‒2.37; p = 0.46 and OR = 1.00; 95% CI 0.99‒1.01; p = 0.68) and cardiac death (OR = 0.21; 95% CI 0.01‒8.05; p = 0.23 and OR = 0.99; 95% CI 0.98‒1.01; p = 0.79).Conclusion. NLR and PLR cannot be recommended for the cardiac risk assessment in abdominal oncological surgery.
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Affiliation(s)
- D. A. Sokolov
- Yaroslavl State Medical University; Regional Clinical Hospital
| | - I. A. Kozlov
- M. F. Vladimirsky Moscow Regional Research Clinical Institute
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The relationship between systemic immune inflammation index and survival in patients with metastatic renal cell carcinomatreated withtyrosine kinase inhibitors. Sci Rep 2022; 12:16559. [PMID: 36192500 PMCID: PMC9529965 DOI: 10.1038/s41598-022-20056-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Accepted: 09/08/2022] [Indexed: 11/25/2022] Open
Abstract
This study aims to investigate the prognostic value of the systemic immune-inflammation index (SII)and its impact on survival in patients with metastatic renal cell carcinoma (mRCC). A total of 706patients with mRCC treated with tyrosine kinase inhibitors (TKIs)between January 2007 and June 2020 (i.e., sunitinib, pazopanib) were included in this study. SII was calculated in 621 patients with the following formula:[neutrophil (cellsx109/L) x platelet (cellsx109/L)] / lymphocyte (cellsx109/L).All patients were classified into SII-high and SII-low groups based on the cut-off value of SII at 756, which was the median SII level of our study group. The minimal follow-up duration was 10 months in all cohorts. The median age of patients was 60 (interquartile range (IQR):53–67) years. Three out of four patients were male. The majority of patients (85.7%) had clear cell histology, and sarcomatoid differentiation was observed in 16.9% of all patients. There were 311 and 310 patients in the SII-low and SII-high groups, respectively. In general, baseline characteristics were similar in each group. However, the rate of patients treated with sunitinib (63.3% vs. 49.0%, p < 0.001) and those who underwent nephrectomy (83.6% vs. 64.2%, p < 0.001) was higher in the SII-low group than in the SII-high group. On the other hand, patients with the IMDC poorrisk (31.6% vs. 8.0%, p < 0.001), those with bone (51.8% vs. 32.2%, p < 0.001) or central nervous system (12.9% vs. 5.8%, p = 0.026) metastasis, and those with Eastern Cooperative Oncology Group(ECOG) 2–4 performance score (28.1% vs.17.7%, p = 0.002) were more common in the SII-high group than in the SII-low group. The median overall survival (OS) was longer in the SII-low group than in the SII-high group (34.6 months vs. 14.5 months, p < 0.001). Similarly, the median progression-free survival (PFS) was longer in the SII-low group than in the SII-high group (18.0 months vs. 7.7 months, p < 0.001).In multivariableanalysis, SII was an independent prognostic factor for OS (hazard ratio (HR):1.39, 95% confidence interval (CI):1.05–1.85, p = 0.01) and PFS (HR:1.60, 95% CI:1.24–2.05, p < 0.001).Pre-treatment level of high SII might be considered a predictor of poor prognosisin patients with mRCC treated with TKIs.
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Zhang B, Yao W. Prognostic role of the systemic immune-inflammation index in biliary tract cancers: a meta-analysis of 3,515 patients. World J Surg Oncol 2022; 20:320. [PMID: 36171621 PMCID: PMC9519406 DOI: 10.1186/s12957-022-02783-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 09/12/2022] [Indexed: 11/10/2022] Open
Abstract
Background The systemic immune-inflammation index (SII) is an inflammatory parameter calculated as platelet count × neutrophil count/lymphocyte count in the peripheral blood. In recent years, the prognostic role of the SII in patients with biliary tract cancer (BTC) has been gradually investigated. However, the results were controversial. This meta-analysis aimed to illustrate the prognostic value of the SII in BTC. Methods The electronic databases of PubMed, the Web of Science, Embase, and the Cochrane Library were thoroughly retrieved up to April 15, 2022. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were used to evaluate the prognostic value of the SII for clinical outcomes. The association between the SII and overall survival (OS) and recurrence-free survival (RFS)/progression-free survival (PFS) was evaluated. Results Thirteen studies involving 3515 patients were included in this meta-analysis. The pooled results indicated that an elevated SII was significantly associated with poor OS (HR, 1.77; 95% CI, 1.47–2.14; p<0.001) and RFS/PFS (HR, 1.66; 95% CI, 1.38–1.99; p<0.001) in patients with BTC. Subgroup analysis stratified by country, sample size, and cutoff value showed similar results. The sensitivity analysis and publication bias test confirmed the reliability of our results. Conclusions An elevated pretreatment SII was significantly associated with worse OS and RFS/PFS in patients with BTC. Our results suggest that the SII is a valuable and cost-effective prognostic parameter for the treatment of patients with BTC. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-022-02783-z.
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Affiliation(s)
- Buwen Zhang
- Department of Oncology, Changxing People's Hospital, Huzhou, 313100, Zhejiang, China
| | - Weiyun Yao
- Department of Hepatobiliary Surgery, Changxing People's Hospital, Huzhou, 313100, Zhejiang, China.
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Lai Y, Wang C, Yang X, He S, Wang Y, Chen Y. The impairment of induction chemotherapy for stage II nasopharyngeal carcinoma treated with intensity-modulated radiotherapy with or without concurrent chemotherapy: A propensity score-matched analysis. Cancer Med 2022; 12:2970-2978. [PMID: 36114787 PMCID: PMC9939148 DOI: 10.1002/cam4.5199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 08/16/2022] [Accepted: 08/23/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES To explore the efficacy of induction chemotherapy (IC) plus concurrent chemoradiotherapy (CCRT) in stage II nasopharyngeal carcinoma (NPC) treated with intensity-modulated radiotherapy (IMRT). METHODS Totally, 450 eligible patients with staged II NPC on the basis of the 8th edition of the AJCC/UICC TNM staging system were eventually included from January 2010 to September 2020. The one-to-one propensity score-matched (1:1 PSM) analysis was employed to balance variables. We conducted univariate and multivariate analysis of survival to identify prognostic factors and demonstrated the findings in the matching cohort. RESULTS In total, 141 pairs were selected by 1:1 PSM. IC + CCRT group in the matched data decreased 5-year progression-free survival (PFS, 75.5% vs. 88.0%, p = 0.032) and distant metastasis-free survival (DMFS, 86.0% vs. 96.5%, p = 0.009). There was no significant difference in 5-year overall survival (OS, 93.8% vs. 95.6%, p = 0.192) and locoregional relapse-free survival (LRRFS, 87.1% vs. 94.3%, p = 0.169) compared with RT/CCRT. Multivariate analysis indicated that IC + CCRT was associated with significantly poor PFS (p = 0.024) and DMFS (p = 0.010). High neutrophil-to-lymphocyte ratio (>4.1) was negatively associated with OS (p = 0.034), PFS (p = 0.017) and DMFS (p = 0.001). CONCLUSION Adding IC to CCRT or IMRT alone has decreased PFS and DMFS, therefore, IC should not be recommended in stage II NPC patients. No significant differences in OS and LRRFS were observed in stage II disease.
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Affiliation(s)
- YuLin Lai
- Department of Radiation Oncology, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
| | - ChengTao Wang
- Department of Radiation Oncology, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
| | - XingLi Yang
- Department of Radiation Oncology, Sun Yat‐sen University Cancer Center, State Key Laboratory of Oncology in South ChinaCollaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapyGuangzhouPeople's Republic of China
| | - ShaSha He
- Department of Radiation Oncology, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Yan Wang
- Department of Radiation Oncology, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
| | - Yong Chen
- Department of Radiation Oncology, The First Affiliated HospitalSun Yat‐sen UniversityGuangzhouChina
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