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Yin Y, Zhu W, Xu Q. The systemic inflammation response index as a risk factor for hepatic fibrosis and long-term mortality among individuals with metabolic dysfunction-associated steatotic liver disease. Nutr Metab Cardiovasc Dis 2024; 34:1922-1931. [PMID: 38866613 DOI: 10.1016/j.numecd.2024.04.018] [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: 02/15/2024] [Revised: 04/15/2024] [Accepted: 04/30/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND AND AIMS The systemic inflammation response index (SIRI) is associated with various diseases with inflammatory components, but its relationship with the progression of hepatic fibrosis and survival outcomes in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) is still unclear. This study was designed to investigate the potential associations between the SIRI and advanced hepatic fibrosis (AHF) as well as between the SIRI and long-term outcomes in individuals with MASLD. METHODS AND RESULTS A prospective cohort study was conducted using data gathered from the National Health and Nutrition Examination Survey (NHANES) spanning from 2005 to 2016. Weighted binary logistic regression, the Cox proportional hazards model, and time-dependent receiver operating characteristic (ROC) analyses were employed to assess the relationships among the SIRI, AHF, and mortality in patients with MASLD. Our study included a total of 5126 patients with MASLD. A higher SIRI was significantly associated with increased odds of AHF (OR 1.55, 95% CI 1.22, 1.96). According to the survival analyses, a higher SIRI was associated with greater all-cause (HR 1.19, 95% CI 1.15, 1.22) and cardiovascular mortality (HR 1.25, 95% CI 1.19, 1.32) after adjustment. The time-dependent ROC analysis indicated that the SIRI had a modest predictive value for discriminating MASLD individuals at higher versus lower mortality risk over 3-year, 5-year, and 10-year follow-up. CONCLUSIONS The SIRI is a promising tool for identifying MASLD individuals at risk of progressing to AHF and for predicting mortality outcomes.
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Affiliation(s)
- Yufeng Yin
- Department of Rheumatology, The First Affiliated Hospital of Soochow University, Jiangsu Suzhou 215006, China
| | - Weijia Zhu
- Department of Gastroenterology, Wuxi Xinwu District Xinrui Hospital, Jiangsu Wuxi 214000, China
| | - Qingling Xu
- Department of Gastroenterology, Wuxi Xinwu District Xinrui Hospital, Jiangsu Wuxi 214000, China.
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Ou Y, Zheng Y, Wang D, Ren S, Liu Y. Analysis of preoperative nutrition, immunity and inflammation correlation index on the prognosis of upper tract urothelial carcinoma surgical patients: a retrospective single center study. BMC Surg 2024; 24:208. [PMID: 39010005 PMCID: PMC11251250 DOI: 10.1186/s12893-024-02496-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: 02/21/2024] [Accepted: 07/01/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND SII, PNI, SIRI, AAPR, and LIPI are prognostic scores based on inflammation, nutrition, and immunity. The purpose of this study was to examine the prognostic value of the SII, PNI, SIRI, AAPR, and LIPI in patients with UTUC who underwent radical nephroureterectomy with bladder cuff excision. MATERIALS AND METHODS Data of UTUC patients in Sichuan Provincial People's Hospital from January 2017 to December 2021 were collected. The optimal critical values of SII, PNI, SIRI, and AAPR were determined by ROC curve, and LIPI was stratified according to the dNLR and LDH. The Kaplan-Meier method was used to draw the survival curve, and Cox proportional hazard model was used to analyze the factors affecting the prognosis of UTUC patients. RESULTS A total of 81 patients with UTUC were included in this study. The optimal truncation value of PNI, SII, SIRI and AAPR were determined to be 48.15, 596.4, 1.45 and 0.50, respectively. Univariate Cox proportional hazard regression showed that low PNI, high SII, high SIRI, low AAPR and poor LIPI group were effective predictors of postoperative prognosis of UTUC patients. Multivariate Cox proportional hazard regression showed that high SII was an independent risk factor for postoperative prognosis of UTUC patients. According to ROC curve, the prediction efficiency of fitting indexes of PNI, SII, SIRI, AAPR and LIPI is better than that of using them alone. CONCLUSIONS The SII, PNI, SIRI, AAPR, and LIPI was a potential prognostic predictor in UTUC patients who underwent radical nephroureterectomy with bladder cuff excision.
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Affiliation(s)
- Yong Ou
- Department of Urology, Xichang People's Hospital, Xichang, Sichuan, China
| | - Yang Zheng
- Department of Robotic Minimally Invasive Surgery Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital and Affiliated Hospital of the University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Dong Wang
- Department of Robotic Minimally Invasive Surgery Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital and Affiliated Hospital of the University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Shangqing Ren
- Department of Robotic Minimally Invasive Surgery Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital and Affiliated Hospital of the University of Electronic Science and Technology of China, Chengdu, 610072, China.
| | - Yisha Liu
- Department of Pathology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China.
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Vamesu S, Ursica OA, Milea SE, Deacu M, Aschie M, Mitroi AF, Voinea F, Pundiche MB, Orasanu CI, Voda RI. Same Organ, Two Cancers: Complete Analysis of Renal Cell Carcinomas and Upper Tract Urothelial Carcinomas. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1126. [PMID: 39064555 PMCID: PMC11279004 DOI: 10.3390/medicina60071126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 07/06/2024] [Accepted: 07/10/2024] [Indexed: 07/28/2024]
Abstract
Background and Objectives: Renal cell carcinomas and upper tract urothelial carcinomas are types of malignancies that originate in the kidneys. Each of these examples shows an increasing trend in the frequency and the mortality rate. This study aims to comprehensively define carcinomas by analyzing clinical, paraclinical, and histological aspects to predict aggressiveness and mortality. Materials and Methods: We conducted a retrospective investigation on a group of patients suspected of kidney cancers. Results: We identified 188 cases. We observed a higher mortality rate and older age in individuals with urothelial carcinomas. Anemia, acute kidney injury, hematuria, and perineural invasion were the main risk factors that predicted their mortality. Tumor size in renal cell carcinomas correlates with the presence of necrosis and sarcomatoid areas. Factors that indicate a higher rate of death are older age, exceeding the renal capsule, a lesion that includes the entire kidney, lymphovascular invasion, acute kidney injury, and anemia. Conclusions: Even if they originate at the renal level, and the clinical-paraclinical picture is similar, the histopathological characteristics make the difference. In addition, to these are added the previously mentioned common parameters that can represent important prognostic factors. In conclusion, the characteristics commonly identified in one type of cancer may act as risk factors for the other tumor. The detected data include threshold values and risk factors, making a significant contribution to the existing literature.
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Affiliation(s)
- Sorin Vamesu
- Clinical Service of Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
| | - Oana Andreea Ursica
- Clinical Service of Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
| | - Serban Eduard Milea
- Clinical Service of Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
| | - Mariana Deacu
- Clinical Service of Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
| | - Mariana Aschie
- Clinical Service of Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Department of Anatomy, Academy of Medical Sciences of Romania, 030171 Bucharest, Romania
- Department of Medical Sciences, The Romanian Academy of Scientists, 030167 Bucharest, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, 900591 Constanta, Romania
| | - Anca Florentina Mitroi
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, 900591 Constanta, Romania
- Clinical Service of Pathology, Departments of Genetics, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
| | - Felix Voinea
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Urology Clinical Department, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
| | - Mihaela Butcaru Pundiche
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Clinical Department of General Surgery, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
| | - Cristian Ionut Orasanu
- Clinical Service of Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, 900591 Constanta, Romania
| | - Raluca Ioana Voda
- Clinical Service of Pathology, Departments of Pathology, “Sf. Apostol Andrei” Emergency County Hospital, 900591 Constanta, Romania
- Faculty of Medicine, “Ovidius” University of Constanta, 900470 Constanta, Romania
- Center for Research and Development of the Morphological and Genetic Studies of Malignant Pathology (CEDMOG), “Ovidius” University of Constanta, 900591 Constanta, Romania
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İpek G, Tanaçan A, Peker A, Ağaoğlu Z, Kara Ö, Şahin D. Systemic Inflammation Response Index as a diagnostic and prognostic predictor of intrahepatic cholestasis of pregnancy: A case-control study from a tertiary center. Int J Gynaecol Obstet 2024; 165:717-722. [PMID: 37922220 DOI: 10.1002/ijgo.15216] [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: 05/04/2023] [Revised: 09/15/2023] [Accepted: 10/12/2023] [Indexed: 11/05/2023]
Abstract
OBJECTIVE To investigate the diagnostic and prognostic value of the Systemic Inflammation Response Index (SIRI) in intrahepatic cholestasis of pregnancy (ICP). METHODS The present case-control study comprised 386 participants, including 192 women with ICP and 194 gestational age-matched pregnant women. Increased fasting biliary acid (FBA) levels (≥10 μmol/L) were accepted as ICP criteria. SIRI values were calculated for the first trimester (SIRI 1), time of diagnosis (SIRI 2), and time of delivery (SIRI 3). The ICP and control groups were compared based on SIRI values, and on obstetrical and neonatal outcomes. The ICP subgroups based on FBA levels (severe ICP [FBA ≥40 μmol/L] and mild ICP [FBA <40 μmol/L]) were also compared for SIRI and pregnancy outcomes. RESULTS Adverse outcomes were significantly higher in the ICP group (P < 0.001). SIRI 2 and SIRI 3 showed negative significant differences between the ICP and control groups, with P values of 0.001 and 0.009, respectively. A significant difference in ICP severity subgroups (P = 0.046) was observed for SIRI 3. In receiver operating characteristics curve analyses, optimal cut-off values for the prediction of ICP were found to be 2.01 and 2.08 for SIRI 2 and SIRI 3, respectively. A cut-off value 1.74 was determined to predict the disease severity for SIRI 3. CONCLUSION SIRI has clinical significance in accordance with the inflammatory etiology of ICP. SIRI might be used with other clinical and laboratory findings for ICP diagnosis and prediction.
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Affiliation(s)
- Göksun İpek
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Atakan Tanaçan
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Ayça Peker
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Zahid Ağaoğlu
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Özgür Kara
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
| | - Dilek Şahin
- Division of Perinatology, Department of Obstetrics and Gynecology, Turkish Ministry of Health Ankara City Hospital, Ankara, Turkey
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Ding Y, Liu Z, Li J, Niu W, Li C, Yu B. Predictive effect of the systemic inflammation response index (SIRI) on the efficacy and prognosis of neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer. BMC Surg 2024; 24:89. [PMID: 38481180 PMCID: PMC10935841 DOI: 10.1186/s12893-024-02384-5] [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: 07/11/2023] [Accepted: 03/06/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Inflammation is a part of tumours, and inflammatory cells can affect the proliferation, invasion, and development of tumour cells. An increasing number of peripheral blood inflammatory markers have been found to play very important roles in the treatment and prognosis of cancer patients. The systemic inflammatory response index (SIRI) is a newer inflammatory marker, and its role in colorectal cancer, especially in locally advanced rectal cancer, is still unclear. METHODS From 2015 to 2020, 198 patients with locally advanced rectal cancer (LARC) who underwent surgery following neoadjuvant chemoradiotherapy (Neo-CRT) were analysed. Patients were categorized into good- and poor- response groups according to their pathological results, and clinical characteristics and baseline parameters were compared between the two groups. The optimal cutoff values for inflammatory indicators were determined using receiver operating characteristic (ROC) analysis. Univariate and multivariate analyses were performed using the Cox proportional hazard model. Survival analysis was performed via the Kaplan‒Meier method. RESULTS After patients were grouped into good and poor response groups, indicator differences were found in CEA, neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and SIRI. According to the ROC analysis, the NLR (P = 0.015), SII (P = 0.001), and SIRI (P = 0.029) were significant prognostic factors. After univariate and multivariate analyses of the Cox proportional hazards regression model, only the SIRI was found to be an independent prognostic factor for overall survival (OS) and disease-free survival (DFS). Finally, Kaplan‒Meier survival curves also confirmed the ability of the SIRI to predict survival. CONCLUSION The preoperative SIRI can be used to predict the response to Neo-CRT in LARC patients and is an independent predictor of OS and DFS in postoperative patients. A high SIRI was associated with poor radiotherapy response and predicted poor OS and DFS.
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Affiliation(s)
- Yuanyi Ding
- The Second General Surgery, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumour Hospital, Hebei, 050011, China
| | - Zining Liu
- The Second General Surgery, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumour Hospital, Hebei, 050011, China
| | - Jing Li
- The Second General Surgery, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumour Hospital, Hebei, 050011, China
| | - Wenbo Niu
- The Second General Surgery, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumour Hospital, Hebei, 050011, China
| | - Chenhui Li
- The Second General Surgery, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumour Hospital, Hebei, 050011, China
| | - Bin Yu
- The Second General Surgery, Hebei Medical University Fourth Affiliated Hospital and Hebei Provincial Tumour Hospital, Hebei, 050011, China.
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Fang T, Yin X, Wang Y, Zhang L, Yang S, Jiang X, Xue Y. Clinical significance of systemic inflammation response index and platelet-lymphocyte ratio in patients with adenocarcinoma of the esophagogastric junction and upper gastric cancer. Heliyon 2024; 10:e26176. [PMID: 38420481 PMCID: PMC10900425 DOI: 10.1016/j.heliyon.2024.e26176] [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: 06/19/2023] [Revised: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 03/02/2024] Open
Abstract
Background Tumor immunity plays an important role in assessing the tumor progression. The purpose of this study was to investigate the prognostic value of combined systemic inflammation response index (SIRI) and platelet-lymphocyte ratio (PLR) of gastroesophageal junction cancer (AEG) and upper gastric cancer (UGC) patients. Methods In this retrospective study, patients from 2003 to 2014 were divided into training and validation sets. The prognostic accuracy of each variable was compared using time-independent ROC analysis. The scoring system was calculated by cut-off values of SIRI and PLR in 5-year. Kaplan-Meier and Log-rank tests were used to analyze overall survival (OS). Chi-square test was used to analyze the association between clinical characteristics and the scoring system. Univariate and multivariate analyses based on the competitive risk regression model were used to analyze independent predictors of death due to AGC and UGC. R software was used to construct the Nomogram model of risk assessment. Results Patients with SIRI-PLR = 2 had worse survival time than those with 0 and 1 (P < 0.001) and more suitable for postoperative adjuvant chemotherapy (P = 0.002). High PLR patients were more suitable for proximal gastrectomy (P = 0.049). SIRI-PLR were independent predictors in training set (P < 0.001), which could be combined with age, pTNM stage and postoperative chemotherapy to construct Nomogram for predicting OS. Conclusions Preoperative SIRI-PLR score was an independent predictor for patients with AEG and UGC. The Nomogram model constructed by age, SIRI-PLR, pTNM stage and postoperative chemotherapy can correctly predict the prognosis of patients.
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Affiliation(s)
- Tianyi Fang
- Department of Gastroenterological Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, 150081, China
| | - Xin Yin
- Department of Gastroenterological Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, 150081, China
| | - Yufei Wang
- Department of Gastroenterological Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, 150081, China
| | - Lei Zhang
- Department of Pathology, Harbin Medical University, Harbin, 150081, China
| | - Shuo Yang
- Department of Pathology, Harbin Medical University, Harbin, 150081, China
| | - Xinju Jiang
- Department of Pathology, Harbin Medical University, Harbin, 150081, China
| | - Yingwei Xue
- Department of Gastroenterological Surgery, Harbin Medical University Cancer Hospital, Harbin Medical University, Harbin, 150081, China
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Yang M, Zhang J, Wei D, Yu T, Chen Z, Liu X, Zhu H. Inflammatory markers predict survival in patients with postoperative urothelial carcinoma receiving tislelizumab (PD-1 inhibitor) adjuvant therapy. BMC Cancer 2024; 24:196. [PMID: 38347460 PMCID: PMC10860305 DOI: 10.1186/s12885-024-11969-5] [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: 12/17/2023] [Accepted: 02/06/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND In the management of urothelial carcinoma, patient selection for immunotherapy, particularly with immune checkpoint inhibitors such as PD-1 (programmed cell death protein 1), is important for treatment efficacy. Inflammatory markers are useful for predicting treatment outcomes and immune-related adverse events (irAEs). This study aims to retrospectively explore the associations between inflammatory markers and outcomes in patients with postoperative urothelial carcinoma undergoing tislelizumab (PD-1 inhibitor) adjuvant therapy. METHODS A retrospective analysis was conducted on 133 patients with postoperative urothelial carcinoma who received tislelizumab adjuvant therapy at the Affiliated Hospital of Xuzhou Medical University from April 2020 to August 2023. The prognostic effects of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) on disease-free survival (DFS) and overall survival (OS) were assessed using Cox regression models. The correlation between inflammatory markers and the onset of irAEs was analyzed using logistic regression models. RESULTS NLR < 5 and MLR < 0.31 were significantly associated with better outcomes compared to NLR >5 and MLR >0.31, respectively. Multivariate analysis revealed that an NLR < 5 was independently associated with better DFS and OS. However, there was no significant effect on the DFS and OS between PLR < 135 and PLR >135. Patients who experienced irAEs had longer DFS and OS. Multivariate analysis demonstrated that irAEs were an independent prognostic risk factor for DFS and OS. There was no significant difference in the occurrence of irAEs among different NLR, PLR, and MLR groups. CONCLUSION In patients with postoperative urothelial carcinoma receiving tislelizumab adjuvant therapy, the assessment of NLR and MLR before treatment may serve as valuable predictive markers of clinical outcome.
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Affiliation(s)
- Meng Yang
- Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Jingwen Zhang
- Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Dongqun Wei
- Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Tianyi Yu
- Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zeyu Chen
- Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xin Liu
- Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
| | - Haitao Zhu
- Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
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Arı E, Köseoğlu H, Eroğlu T. Predictive value of SIRI and SII for metastases in RCC: a prospective clinical study. BMC Urol 2024; 24:14. [PMID: 38218876 PMCID: PMC10788028 DOI: 10.1186/s12894-024-01401-2] [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: 07/06/2023] [Accepted: 01/01/2024] [Indexed: 01/15/2024] Open
Abstract
OBJECTIVES In this prospective cross-sectional clinical study, we aimed to determine the efficiency of preoperative hematological markers namely SIRI (systemic inflammatory response index) and SII (systemic inflammatory index) for renal cell cancer to predict the possibility of postoperative metastases. METHODS Istanbul Education and Research Hospital, Clinic of Urology and Medical Oncology in the clinic between the dates of June 2022 to 2023 February, a diagnosis of renal cell cancer by surgical or medical oncology units imported into the treatment planning of 72 patients were included in the study. All cases with diagnoses of renal cell carcinoma were searched from hospital records. Patients with secondary malignancy, hematological or rheumatological disorders or ones with recent blood product transfusion or diagnoses of infection within the 1-month-time of diagnoses were excluded for data analyses. The data within complete blood counts (CBC) analyzed just before the time of renal biopsy or surgery were studied for SIRI and SII calculations. Twenty-two metastatic and 50 non-metastatic RCC patients were included. SIRI and SII values were compared among groups to seek change of values in case of metastasis and in non-metastatic patients a cut-off value were sought to indicate malignancy before pathological diagnosis. RESULTS Mean age of non-metastatic RCC patients were 60.12+/-11.55 years and metastatic RCC patients were 60.25+/-11.72. Histological sub-types of the RCC specimens were clear cell (72%), chromophobe cell (17%), papillary cell (7%) and others (4%). Median SIRI values for non-metastatic and metastatic groups were 1.26 and 2.1 (mean+/-S.D. 1.76 +/-1.9 and 3.12+/-4.22 respectively (p < 0.05). Median SII values for non-metastatic and metastatic groups were 566 and 1434 (mean+/-S.D. 870 +/-1019 and 1537+/-917) respectively (p < 0.001). AUC for detection of metastasis were 0.809 for SII and 0.737 for SIRI. CONCLUSIONS SIRI and SII indexes seem to show a moderate efficiency to show metastases in RCC.
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Affiliation(s)
- Emre Arı
- Hamidiye Faculty of Medicine, Istanbul Health Practice and Research Center, Department of Urology, Health Sciences University, Istanbul, Turkey
| | - Hikmet Köseoğlu
- Hamidiye Faculty of Medicine, Istanbul Health Practice and Research Center, Department of Urology, Health Sciences University, Istanbul, Turkey.
| | - Tolga Eroğlu
- Hamidiye Faculty of Medicine, Istanbul Health Practice and Research Center, Department of Urology, Health Sciences University, Istanbul, Turkey
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Xu M, Wang W, Chen R, Zhou L, Hu H, Qiao G, Wang L, Liu X, Wang Q, Ai Y, Ren H, Hu P. Individual and combined associations of estimated pulse wave velocity and systemic inflammation response index with risk of stroke in middle-aged and older Chinese adults: a prospective cohort study. Front Cardiovasc Med 2023; 10:1158098. [PMID: 38028467 PMCID: PMC10655141 DOI: 10.3389/fcvm.2023.1158098] [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: 02/03/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Background and aims Estimated pulse wave velocity (ePWV) and systemic inflammatory response index (SIRI) have been recently investigated as a marker of arterial stiffness and a novel systemic inflammatory indicator. This study aims to examine the independent and combined association of ePWV and SIRI with incident stroke and its subtypes. Methods Data of the Dongfeng-Tongji cohort study was analyzed for 9,154 middle-aged and older adults, who were free of cardiovascular disease and cancer and were followed up to document incident stroke. But their association with incident stroke events and its subtypes have not been well studied. Multivariable adjusted Cox regression models were used to determine the independent and combined association of ePWV and SIRI with incident stroke events. Results Over a 7.22-year follow-up, the cohort documented 491 stroke cases (387 ischemic stroke and 104 hemorrhagic stroke). The multivariate adjusted model showed that with each one-unit increase in the level of ePWV, the corresponding hazard ratios (HRs) (95% CI) for total stroke, ischemic stroke, and hemorrhagic stroke were 1.53 (95% CI, 1.23-1.90), 1.42 (95% CI, 1.11-1.83), and 1.92 (95% CI, 1.21-3.03), respectively. Similarly, with each one-unit increase in log-transformed levels of SIRI, the corresponding HRs (95% CI) for total stroke, ischemic stroke, and hemorrhagic stroke were 1.23 (95% CI,1.04-1.47), 1.16 (95% CI, 0.96-1.41), and 1.52 (95% CI, 1.05-2.20), respectively. There appeared to be a combined effect of ePWV and SIRI on stroke; Participants with high levels of both ePWV and SIRI had a higher risk of total stroke and hemorrhagic stroke, with multiple adjusted HR of 2.43 (95% CI, 1.09-5.42). Additionally, the incorporation of ePWV in addition to traditional cardiovascular risk factors significantly improved the predictive accuracy for total stroke with C statistic increased from 0.684 (95% CI, 0.661-0.707) to 0.687 (95% CI, 0.664-0.710; x2 = 6.65; p for difference = 0.010), and (suggestively) for ischemic stroke with C statistic increased from 0.684 (95% CI, 0.659-0.71) to 0.691(95% CI, 0.666-0.717; x2 = 3.13, p for difference = 0.077), respectively. Conclusions The presence of both high ePWV and SIRI individually, as well as together, was found to be associated with an increased incidence of stroke. The combined stroke risk assessment using these two indicators could potentially improve non-invasive assessment and treatment strategies for high-risk patients, as these indicators are easily accessible in clinical practice.
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Affiliation(s)
- Man Xu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenqiang Wang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Li Zhou
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Hui Hu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Guiyuan Qiao
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Ling Wang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | | | - Qiuhong Wang
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yating Ai
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Hairong Ren
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Ping Hu
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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10
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Tang Y, Shao Y, Hu X, Ren S, Li X. Validation and comparison of prognostic value of different preoperative systemic inflammation indices in non-metastatic renal cell carcinoma. Int Urol Nephrol 2023; 55:2799-2807. [PMID: 37501038 DOI: 10.1007/s11255-023-03724-9] [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: 06/18/2023] [Accepted: 07/21/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Several preoperative systemic inflammation indices have been proven to be correlated with the prognosis of patients diagnosed with non-metastatic renal cell carcinoma (RCC). However, these indices are currently not included in the main prognostic models, and few studies have compared the prognostic efficacy of different preoperative systemic inflammation indices. PATIENTS AND METHODS This retrospective study reviewed patients diagnosed with non-metastatic RCC who underwent nephrectomy at West China Hospital of Sichuan University from 2011 to 2013. Different preoperative systemic inflammation indices (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], monocyte-to-lymphocyte ratio [MLR], systemic immune-inflammation index [SII], and systemic inflammation response index [SIRI]) were calculated. Logistic regression was used to explore the relationship between systemic inflammation indices and clinical characteristics, and Cox regression was used to identify independent prognostic factors of overall survival (OS). The concordance index (c-index) was also calculated. RESULTS A total of 820 patients were included in the study, with a median follow-up of 78 months. Higher levels of NLR (> 3.04), PLR (> 147), MLR (> 0.32), SII (> 700), and SIRI (> 1.27) were found to be associated with more advanced tumor stage, higher Furman grade, and larger tumor size. In multivariate Cox regression, NLR, PLR, MLR, SII, and SIRI were identified as independent prognostic factors, and SII had the highest and most significant hazard ratio and the largest c-index. CONCLUSION In conclusion, various systemic inflammation indices were found to be associated with poorer OS. Among them, SII exhibited the highest predictive efficacy, suggesting its potential inclusion as a component in future prognostic models.
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Affiliation(s)
- Yaxiong Tang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yanxiang Shao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xu Hu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Shangqing Ren
- Department of Robotic Minimally Invasive Surgery Center, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, 610072, China
| | - Xiang Li
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, China.
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11
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Zhang Y, Wu W, Zhang Z. The predictive value of the systemic inflammatory response index for the occurrence of multiple organ dysfunction syndrome in patients with wasp sting injury. Toxicon 2023; 234:107269. [PMID: 37678579 DOI: 10.1016/j.toxicon.2023.107269] [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: 06/04/2023] [Revised: 08/13/2023] [Accepted: 08/28/2023] [Indexed: 09/09/2023]
Abstract
Wasp sting injuries pose a significant threat to public health, especially in areas with abundant trees. Mortality rates are alarmingly high, with reports indicating that up to 70% or more of cases result in multiple organ dysfunction syndrome (MODS). It is crucial for emergency and critical care physicians to promptly identify and implement effective measures to reduce the occurrence of MODS in patients who have been stung by wasps. Therefore, finding a reliable predictive indicator is of utmost importance. We conducted a retrospective study, and clinical data of 226 hospitalized patients with wasp sting from July 2013 to April 2023 in the First College of Clinical Medicine Science, China Three Gorges University were collected. The patients were divided into MODS group and non-MODS (NMODS) group, and the general data, clinical symptoms, laboratory indexes, and prognosis were compared between the two groups. The indicators with significant differences in univariate analysis were included in the multivariate Logistic regression analysis to analyze the independent risk factors for MODS. The value of systemic inflammatory response index (SIRI) in predicting the occurrence of MODS in wasp sting was analyzed by using the receiver operating characteristic curve (ROC curve). Of the 214 patients with wasp sting, 109 cases were in the NMODS group, and 105 cases were in the MODS group. The SIRI was 1.6 (0.7, 3.6) and 12.2 (5.2, 23.3) in the NMODS group and MODS group, respectively, with a significant difference between the two groups (P < 0.001). SIRI was an independent risk factor for MODS in patients with wasp sting; the AUC of SIRI in predicting MODS in wasp sting was 0.886 (P < 0.001), and the optimal cutoff value was 6.39, with a sensitivity of 71.43% and a specificity of 94.5%, which had prediction value. Allowing for early identification and enabling doctors to intervene and provide timely treatment. SIRI was defined as follows: SIRI = neutrophil count × monocyte count/lymphocyte count.
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Affiliation(s)
- Yupei Zhang
- Department of Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University and Yichang Central People's Hospital, Yichang, 443000, Hubei, China
| | - Wen Wu
- Department of Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University and Yichang Central People's Hospital, Yichang, 443000, Hubei, China.
| | - Zhaohui Zhang
- Department of Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University and Yichang Central People's Hospital, Yichang, 443000, Hubei, China.
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12
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Liu J, Wu P, Lai S, Wang J, Hou H, Zhang Y. Prognostic models for upper urinary tract urothelial carcinoma patients after radical nephroureterectomy based on a novel systemic immune-inflammation score with machine learning. BMC Cancer 2023; 23:574. [PMID: 37349696 DOI: 10.1186/s12885-023-11058-z] [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: 11/19/2022] [Accepted: 06/11/2023] [Indexed: 06/24/2023] Open
Abstract
PURPOSE This study aimed to evaluate the clinical significance of a novel systemic immune-inflammation score (SIIS) to predict oncological outcomes in upper urinary tract urothelial carcinoma(UTUC) after radical nephroureterectomy(RNU). METHOD The clinical data of 483 patients with nonmetastatic UTUC underwent surgery in our center were analyzed. Five inflammation-related biomarkers were screened in the Lasso-Cox model and then aggregated to generate the SIIS based on the regression coefficients. Overall survival (OS) was assessed using Kaplan-Meier analyses. The Cox proportional hazards regression and random survival forest model were adopted to build the prognostic model. Then we established an effective nomogram for UTUC after RNU based on SIIS. The discrimination and calibration of the nomogram were evaluated using the concordance index (C-index), area under the time-dependent receiver operating characteristic curve (time-dependent AUC), and calibration curves. Decision curve analysis (DCA) was used to assess the net benefits of the nomogram at different threshold probabilities. RESULT According to the median value SIIS computed by the lasso Cox model, the high-risk group had worse OS (p<0.0001) than low risk-group. Variables with a minimum depth greater than the depth threshold or negative variable importance were excluded, and the remaining six variables were included in the model. The area under the ROC curve (AUROC) of the Cox and random survival forest models were 0.801 and 0.872 for OS at five years, respectively. Multivariate Cox analysis showed that elevated SIIS was significantly associated with poorer OS (p<0.001). In terms of predicting overall survival, a nomogram that considered the SIIS and clinical prognostic factors performed better than the AJCC staging. CONCLUSION The pretreatment levels of SIIS were an independent predictor of prognosis in upper urinary tract urothelial carcinoma after RNU. Therefore, incorporating SIIS into currently available clinical parameters helps predict the long-term survival of UTUC.
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Affiliation(s)
- Jianyong Liu
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 DaHua Road, Dong Dan, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Beijing Hospital Continence Center, Beijing, China
| | - Pengjie Wu
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 DaHua Road, Dong Dan, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
- Beijing Hospital Continence Center, Beijing, China
| | - Shicong Lai
- Department of Urology, Peking University People's Hospital, 100044, Beijing, China
| | - Jianye Wang
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 DaHua Road, Dong Dan, Beijing, China.
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
- Beijing Hospital Continence Center, Beijing, China.
| | - Huimin Hou
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 DaHua Road, Dong Dan, Beijing, China.
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
- Beijing Hospital Continence Center, Beijing, China.
| | - Yaoguang Zhang
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, No. 1 DaHua Road, Dong Dan, Beijing, China.
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China.
- Beijing Hospital Continence Center, Beijing, China.
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13
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Bailey-Whyte M, Minas TZ, Dorsey TH, Smith CJ, Loffredo CA, Ambs S. Systemic Inflammation Indices and Association with Prostate Cancer Survival in a Diverse Patient Cohort. Cancers (Basel) 2023; 15:cancers15061869. [PMID: 36980755 PMCID: PMC10047449 DOI: 10.3390/cancers15061869] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
There is a lack of investigations assessing the performance of systemic inflammation indices as outcome predictive tools in African Americans with prostate cancer. This study aims to assess the relationships between neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation (SII), and systemic inflammation response index (SIRI) with survival outcomes among 680 diverse men with prostate cancer. Routine blood results were collected from self-identified African American and European American patients. We applied multivariable Cox regression modeling to examine the associations of systemic inflammation indices with overall and prostate cancer-specific survival. The median survival follow-up was 5.9 years, with 194 deaths. NLR, SII, and SIRI, but not PLR, showed associations with all-cause and prostate cancer-specific mortality when coded as dichotomized and continuous variables. NLR and SIRI were significantly associated with prostate cancer-specific mortality among all men (hazard ratio (HR) 2.56 for high vs. low NLR; HR 3.24 for high vs. low SIRI) and African American men (HR 2.96 for high vs. low NLR; HR 3.19 for high vs. low SIRI). Among European Americans, only SII showed an association with prostate cancer-specific survival. These observations suggest that inflammation indices merit further study as predictors of prostate cancer mortality.
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Affiliation(s)
- Maeve Bailey-Whyte
- School of Medicine, University of Limerick, V94 XD21 Limerick, Ireland
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Tsion Z Minas
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Tiffany H Dorsey
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Cheryl J Smith
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD 20892, USA
| | - Christopher A Loffredo
- Cancer Prevention and Control Program, Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA
| | - Stefan Ambs
- Laboratory of Human Carcinogenesis, Center for Cancer Research, National Cancer Institute (NCI), National Institutes of Health (NIH), Bethesda, MD 20892, USA
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Cinar NB, Yilmaz H, Avci IE, Cakmak K, Teke K, Dillioglugil O. Reporting perioperative complications of radical cystectomy: the influence of using standard methodology based on ICARUS and EAU quality criteria. World J Surg Oncol 2023; 21:58. [PMID: 36823517 PMCID: PMC9948374 DOI: 10.1186/s12957-023-02943-9] [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: 10/14/2022] [Accepted: 02/11/2023] [Indexed: 02/25/2023] Open
Abstract
PURPOSE We aimed to evaluate perioperative complications of radical cystectomy (RC) by using standardized methodology. Additionally, we identified independent risk factors associated with perioperative complications. MATERIALS AND METHODS We retrospectively analyzed 30-day and 90-day perioperative complications of 211 consecutive RC patients. The intraoperative and postoperative complications were defined according to Clavien-Dindo classification (CDC) and reported based on the ICARUS criteria, Martin, and EAU quality criteria. Age-adjusted Charlson comorbidity index (ACCI), systemic inflammatory response index (SIRI), body mass index (BMI) ≥ 25 kg/m2, and neoadjuvant chemotherapy (NAC) were also evaluated. Multivariable regression models according to severe (CDC ≥ IIIb grade) complications were tested. RESULTS Overall, 88.6% (187/211) patients experienced at least one intraoperative complication. Bleeding during cystectomy was the most common complication observed (81.5% [172/211]). Severe intraoperative complications (EAUiaiC grade > 2) were recorded in 8 patients. Overall, 521 postoperative complications were recorded. Overall, 69.6% of the patients experienced complications. Thirty-nine patients suffered from most severe (CDC ≥ IIIb grade) complications. ACCI (OR: 1.492 [1.144-1.947], p = 0.003), SIRI (OR: 1.279 [1.029-1.575], p = 0.031), BMI (OR: 3.62 [1.58-8.29], p = 0.002), and NAC (OR: 0.342 [0.133-0.880], p = 0.025) were significant independent predictive factors for 90-day most severe complications (CDC ≥ IIIb grade). CONCLUSIONS RC complications were reported within a standardized manner, concordant with the ICARUS and Martin criteria and EAU guideline recommendations. Complication reporting seems to be improved with the use of standard methodology. Our results showed that ACCI, SIRI, and BMI ≥ 25 kg/m2 and the absence of NAC were significant predictive factors for most severe complications.
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Affiliation(s)
- Naci Burak Cinar
- Department of Urology, Kocaeli University School of Medicine, 41380, Izmit, Kocaeli, Turkey.
| | - Hasan Yilmaz
- grid.411105.00000 0001 0691 9040Department of Urology, Kocaeli University School of Medicine, 41380 Izmit, Kocaeli Turkey
| | - Ibrahim Erkut Avci
- grid.411105.00000 0001 0691 9040Department of Urology, Kocaeli University School of Medicine, 41380 Izmit, Kocaeli Turkey
| | - Kutlucan Cakmak
- grid.411105.00000 0001 0691 9040Department of Urology, Kocaeli University School of Medicine, 41380 Izmit, Kocaeli Turkey
| | - Kerem Teke
- grid.411105.00000 0001 0691 9040Department of Urology, Kocaeli University School of Medicine, 41380 Izmit, Kocaeli Turkey
| | - Ozdal Dillioglugil
- grid.411105.00000 0001 0691 9040Department of Urology, Kocaeli University School of Medicine, 41380 Izmit, Kocaeli Turkey
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15
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Wang L, Qin X, Zhang Y, Xue S, Song X. The prognostic predictive value of systemic immune index and systemic inflammatory response index in nasopharyngeal carcinoma: A systematic review and meta-analysis. Front Oncol 2023; 13:1006233. [PMID: 36816962 PMCID: PMC9936064 DOI: 10.3389/fonc.2023.1006233] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023] Open
Abstract
Objective To study the predictive value of systemic immune index (SII) and systemic inflammatory response index (SIRI) in the prognosis of patients with nasopharyngeal carcinoma. Methods Two researchers independently searched PubMed, Cochrane, Embase, and Web of Science databases (until March 18, 2022) for all studies on SII, SIRI, and prognosis in patients with nasopharyngeal carcinoma. Quality assessment of included studies was assessed using the Newcastle-Ottawa Scale (NOS). In addition, a bivariate mixed-effects model was used to explore predictive value. Results A total of 9 studies that satisfied the requirements were included, involving, 3187 patients with nasopharyngeal carcinoma. The results of the meta-analysis showed that SII could be an independent predictor of OS (HR=1.78, 95%CI [1.44-2.20], Z=5.28, P<0.05), and SII could also be an independent predictor of PFS (HR=1.66, 95%CI [1.36-2.03], Z=4.94, P<0.05). In addition, SIRI could also serve as an independent predictor of OS (HR=2.88, 95%CI [1.97-4.19], Z=5.51, P<0.05). The ROC area was 0.63, the sensitivity was 0.68 (95%CI [0.55-0.78]), and the specificity was 0.55 (95%CI [0.47-0.62]), all of which indicated that SII had a certain predictive value for OS. Conclusion SII and SIRI can be used as independent predictors to predict the prognosis and survival status of patients with nasopharyngeal carcinoma and have certain predictive accuracy. Therefore, SII and SIRI should be considered in studies that update survival risk assessment systems. Systematic Review Registration https://www.ytyhdyy.com/, identifier PROSPERO (CRD42022319678).
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Affiliation(s)
- Li Wang
- Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Yantai Shandong, China,*Correspondence: Li Wang, ; Xicheng Song,
| | - Xianfei Qin
- School of Clinical Medicine, Binzhou Medical University, Yantai, China
| | - Yu Zhang
- Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Yantai Shandong, China
| | - Shouyu Xue
- Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Yantai Shandong, China
| | - Xicheng Song
- Otorhinolaryngology Head and Neck Surgery, Yantai Yuhuangding Hospital, Yantai Shandong, China,*Correspondence: Li Wang, ; Xicheng Song,
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16
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Keiner C, Meagher M, Patil D, Saito K, Walia A, Liu F, Dutt R, Miller N, Dhanji S, Saidian A, Wan F, Yasuda Y, Fujii Y, Tanaka H, Master V, Derweesh I. Association of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and De Ritis ratio with mortality in renal cell carcinoma: A multicenter analysis. Front Oncol 2022; 12:995991. [PMID: 36505802 PMCID: PMC9731093 DOI: 10.3389/fonc.2022.995991] [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: 07/16/2022] [Accepted: 10/19/2022] [Indexed: 11/25/2022] Open
Abstract
Background Several markers of inflammation have been associated with oncologic outcomes. Prognostic markers are not well-defined for renal cell carcinoma (RCC). We sought to investigate the association of preoperative neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and De Ritis ratio with mortality in RCC. Methods Multi-center retrospective analysis of patients undergoing surgery for RCC. Primary outcome of interest was all-cause mortality (ACM). Secondary outcomes were non-cancer mortality (NCM) and cancer-specific mortality (CSM). Elevated NLR was defined as ≥2.27, elevated PLR as ≥165, and elevated De Ritis ratio as ≥ 2.72. Multivariable cox regression analysis (MVA) was conducted to elucidate risk factors for primary and secondary outcomes, and Kaplan-Meier analysis (KMA) was used to evaluate survival outcomes comparing elevated and non-elevated NLR, PLR, and De Ritis ratio. Results 2656 patients were analyzed (874 patients had elevated NLR; 480 patients had elevated PLR and 932 patients had elevated De Ritis). Elevated NLR was a significant predictor of ACM (HR 1.32, 95% CI: 1.07-1.64, p=0.003) and NCM (HR 1.79, 95% CI: 1.30-2.46, p<0.001) in MVA. Elevated De Ritis was a significant predictor of ACM (HR 2.04, 95% CI: 1.65-2.52), NCM (HR 1.84, 95% CI: 1.33-2.55, p<0.001), and CSM (HR 1.97, 95% CI:1.48-2.63, p<0.001). KMA revealed significant difference in 5-year overall survival (OS) (48% vs. 68%, p<0.001), non-cancer survival (NCS) (69% vs. 87%, p<0.001), and cancer-specific survival (CSS) (60% vs. 73%, p<0.001) for elevated versus non-elevated NLR. For PLR, there was a difference in 5-year OS (51% vs. 61%, p<0.001) and CSS (60% vs. 73%, p<0.001) with KMA. Conclusions Elevated NLR was independently associated with worse ACM and NCM, while elevated De Ritis was predictive for CSM in addition to ACM and NCM. These differences may be useful in refining risk stratification with respect to cancer-related and non-cancer mortality in RCC patients and deserve further investigation.
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Affiliation(s)
- Cathrine Keiner
- Department of Urology, UC San Diego School of Medicine, La Jolla, CA, United States
| | - Margaret Meagher
- Department of Urology, UC San Diego School of Medicine, La Jolla, CA, United States
| | - Dattatraya Patil
- Department of Urology, Emory University School of Medicine, Atlanta, GA, United States
| | - Kazutaka Saito
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Arman Walia
- Department of Urology, UC San Diego School of Medicine, La Jolla, CA, United States
| | - Franklin Liu
- Department of Urology, UC San Diego School of Medicine, La Jolla, CA, United States
| | - Raksha Dutt
- Department of Urology, UC San Diego School of Medicine, La Jolla, CA, United States
| | - Nathan Miller
- Department of Urology, UC San Diego School of Medicine, La Jolla, CA, United States
| | - Sohail Dhanji
- Department of Urology, UC San Diego School of Medicine, La Jolla, CA, United States
| | - Ava Saidian
- Department of Urology, UC San Diego School of Medicine, La Jolla, CA, United States
| | - Fang Wan
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yosuke Yasuda
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yasuhisa Fujii
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hajime Tanaka
- Department of Urology, Tokyo Medical and Dental University, Tokyo, Japan
| | - Viraj Master
- Department of Urology, Emory University School of Medicine, Atlanta, GA, United States
| | - Ithaar Derweesh
- Department of Urology, UC San Diego School of Medicine, La Jolla, CA, United States,*Correspondence: Ithaar Derweesh,
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17
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Ethem Cakcak İ, Kula O. Predictive evaluation of SIRI, SII, PNI, and GPS in cholecystostomy application in patients with acute cholecystitis. ULUS TRAVMA ACIL CER 2022; 28:940-946. [PMID: 35775683 PMCID: PMC10493840 DOI: 10.14744/tjtes.2022.90249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/21/2022] [Indexed: 11/20/2022]
Abstract
BACKGROUND The aims of this study were to investigate the clinical significance of systemic inflammatory response index (SIRI), systemic inflammation index (SII), prognostic nutritional index (PNI), and Glasgow prognostic score (GPS) in deciding whether to perform cholecystostomy when determining if cholecystostomy is the right choice for acute cholecystitis (AC) patients. METHODS Between January 2018 and December 2020, 126 consecutive patients with AC with and without cholecystostomy were retrospectively recruited from the Trakya University in Edirne, Turkey. Group I included AC patients with cholecystostomy and Group II included AC patients without cholecystostomy. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and lymphocyte/monocyte ratio (LMR) were calculated. The PNI and SII were calculated RESULTS: There is significant difference between the two groups by the comparison of SIRI, SII, PNI, and GPS values (p<0.001). In Group I, SIRI, SII, and GPS values are higher than the Group II and PNI value in Group I is lower than the Group II. Furthermore, the NLR and PLR ratios in Group I are significantly higher than Group II, and the LMR ratio in Group I is significantly lower than Group II. CONCLUSION According to our study, we can say that NLR, PLR, SII, SIRI, and GPS are positive predictors and LMR and PNI are negative predictors for the severity of AC. Therefore, when we decide to treat AC medically, we may prefer the application of chole-cystostomy tube at the beginning of hospitalization by the help of evaluating NLR, PLR, LMR, SIRI, SII, GPS, and PNI values.
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Affiliation(s)
- İbrahim Ethem Cakcak
- Department of General Surgery, Trakya University Faculty of Medicine, Edirne-Türkiye
| | - Osman Kula
- Department of Radiology, Trakya University Faculty of Medicine, Edirne-Türkiye
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18
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Cakcak İE, Türkyılmaz Z, Demirel T. Relationship between SIRI, SII values, and Alvarado score with complications of acute appendicitis during the COVID-19 pandemic. ULUS TRAVMA ACIL CER 2022; 28:751-755. [PMID: 35652883 PMCID: PMC10443012 DOI: 10.14744/tjtes.2021.94580] [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: 08/12/2021] [Accepted: 11/23/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND The aim of the study was to investigate the clinical variations of Systemic Inflammatory Response Index (SIRI), Systemic Inflammation Index (SII), and Alvarado Score during the COVID-19 pandemic period. METHODS Between March 2019 and March 2021, 161 consecutive patients who had surgery due to acute appendicitis were ret-rospectively recruited from Trakya University in Edirne, Turkey. Group I included patients who had surgery during the COVID-19 pandemic and Group II included patients who had surgery before the COVID-19 pandemic period. A total of 80 patients volunteered for Group I and 81 patients for Group II. The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio, and lymphocyte/monocyte ratio were calculated. SII was calculated by the formula: platelet (P) × neutrophil (N)/lymphocyte (L). NLR was calculated by dividing the neutrophil count by the number of lymphocytes. SIRI was defined as follows: SIRI = (neutrophil × monocyte/lymphocyte). The Alvarado score was also calculated by using patient history, clinical examination, and laboratory findings. RESULTS There was a significant difference between the two groups in terms of displacing pain, nausea/vomiting, right lower quad-rant tenderness, rebound, hyperthermia, leukocytosis, and total Alvarado score (p<0.001). There was a significant difference between two groups in comparison of C-reactive protein, SIRI, and SII values (p<0.001). Group I patients had higher values of these parameters than Group II. CONCLUSION Based on the results obtained from this study, we conclude that COVID-19 pandemic has caused an increase in patients with acute appendicitis admitted to the hospital. This late diagnosis of acute appendicitis caused more complications during COVID-19 pandemic. Alvarado score, SIRI, and SII can be used as a marker to indicate whether complications of acute appendicitis occurred pre- or post-operatively. Therefore, Alvarado score, SIRI, and SII are directly proportional to the complication of acute appendicitis.
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Affiliation(s)
- İbrahim Ethem Cakcak
- Department of General Surgery, Trakya University Faculty of Medicine, Edirne-Turkey
| | - Zeliha Türkyılmaz
- Department of General Surgery, Trakya University Faculty of Medicine, Edirne-Turkey
| | - Tugrul Demirel
- Department of General Surgery, Trakya University Faculty of Medicine, Edirne-Turkey
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19
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Zhou Y, Zhang Y, Cui M, Zhang Y, Shang X. Prognostic value of the systemic inflammation response index in patients with acute ischemic stroke. Brain Behav 2022; 12:e2619. [PMID: 35588444 PMCID: PMC9226852 DOI: 10.1002/brb3.2619] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 04/21/2022] [Accepted: 04/27/2022] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Inflammation plays an essential role in acute ischemic stroke (AIS). Recent studies have recognized the systemic inflammation response index (SIRI) as a useful index to indicate inflammation status and predict the prognosis of multiple diseases. However, the relationship between SIRI and AIS prognosis is unclear. Our study is aimed to investigate the association between SIRI and the prognosis of AIS. METHODS Our study prospectively recruited 287 consecutive patients with first-ever stroke within 72 h after stroke. Demographic and clinical information was collected at baseline. The functional prognosis was assessed 3 months after AIS using the modified Rankin Scale (mRS). A poor outcome was defined as mRS > 2. SIRI was calculated as neutrophil × monocyte/lymphocyte count. Univariate and multivariate analyses were introduced to identify the association between SIRI and AIS prognosis. Receiver operating characteristic curve and reclassification analyses were used to evaluate the predictive value of SIRI for AIS prognosis. RESULTS The patients with poor prognosis account for 27.5% of all participants. After fully adjusting for all covariates, each standard deviation increment of SIRI caused 58.9% additional risk for poor prognosis after AIS. When dividing SIRI into quartiles, the fourth quartile had a 6.152 times risk than the first quartile. Moreover, after adding SIRI into established clinical risk factors, AUC showed a significant improvement (0.829 vs. 0.790, p for comparison = .016). Consistently, category-free net reclassification index (NRI, 0.761, 95% CI: 0.517-1.004, p < .001) and integrated discrimination index (IDI, 0.093, 95% CI: 0.0512-0.134, p < .001) confirmed the improvement by SIRI to predict poor prognosis of AIS, CONCLUSION: SIRI is an independent prognostic indicator for AIS. Elevated SIRI is associated with poor functional outcome of AIS. Our findings suggest the usefulness of SIRI to refine the risk stratification of unfavorable prognosis of AIS.
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Affiliation(s)
- Yaping Zhou
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China.,Department of Rehabilitation Medicine, Affiliated Tenth People's Hospital of Tongji University, Shanghai Tenth People's Hospital, Shanghai, China
| | - Yidi Zhang
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China
| | - Mingming Cui
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China
| | - Yuming Zhang
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China
| | - Xiuli Shang
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China
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20
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Wang Z, Li J, Yuan Y, Li T, Zuo M, Liu Y. Prognostic significance of preoperative systemic inflammation response index in newly diagnosed glioblastoma patients underwent gross total resection: a propensity score matching analysis. World J Surg Oncol 2022; 20:137. [PMID: 35488347 PMCID: PMC9052476 DOI: 10.1186/s12957-022-02588-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 04/02/2022] [Indexed: 02/08/2023] Open
Abstract
Background Glioblastoma (GBM) is the most frequent and lethal brain tumor, which possesses highly malignant characteristics and predominates in elder patients. Systemic inflammatory response index (SIRI) is a novel prognostic marker from peripheral blood, which is defined as neutrophil count × monocyte count/lymphocyte count. In the current research, we aim to explore the relationship between SIRI and newly diagnosed GBM underwent gross total resection (GTR). Methods A retrospective analysis was conducted on consecutive newly diagnosed GBM patients underwent operation at West China Hospital from March 2015 to January 2019. X-tile software was used to determine the optimal cut-off values of SIRI, and neutrophil to lymphocyte ratio (NLR). All statistical analyses were performed using SPSS software and R software. Propensity score matching (PSM) was conducted to adjust for imbalance of all potential confounding covariates. Results The current research included a total of 291 consecutive newly diagnosed GBM patients underwent gross total resection. Among them, 186 were male patients and 105 were female patients. In original cohort, only gender was evidently related to SIRI level. SIRI and NLR were independent prognostic indicators both in original cohort and PSM cohort. Prognostic models based on the independent prognostic factors were established, and prognostic capacity of Model SIRI was superior to Model NLR. Conclusion In the current research, SIRI was determined to be an independent prognostic indicator for GBM. And the prognostic predictive ability of SIRI was stronger than NLR. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-022-02588-0.
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Affiliation(s)
- Zhihao Wang
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Junhong Li
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Yunbo Yuan
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Tengfei Li
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Mingrong Zuo
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China
| | - Yanhui Liu
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, 610041, Sichuan Province, People's Republic of China.
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21
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Yanagisawa T, Mori K, Katayama S, Mostafaei H, Quhal F, Laukhtina E, Rajwa P, Motlagh RS, Aydh A, König F, Grossmann NC, Pradere B, Miki J, Schmidinger M, Egawa S, Shariat SF. Hematological prognosticators in metastatic renal cell cancer treated with immune checkpoint inhibitors: a meta-analysis. Immunotherapy 2022; 14:709-725. [DOI: 10.2217/imt-2021-0207] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Aim: We aimed to assess the prognostic value of pretreatment hematological biomarkers in patients with metastatic renal cell carcinoma (mRCC) treated with immune checkpoint inhibitors (ICIs). Methods: PubMed, Web of Science and Scopus databases were searched for articles according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Results: Fifteen studies comprising 1530 patients were eligible for meta-analysis. High levels of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein and lactate dehydrogenase were significantly associated with worse progression-free survival. High NLR and PLR were significantly associated with worse overall survival. Conclusion: High pretreatment NLR and PLR appear to be hematological prognostic factors of progression and overall mortality in mRCC patients treated with ICIs. These findings might help in the design of correlative biomarker studies to guide the clinical decision-making in the immune checkpoint inhibitor era.
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Affiliation(s)
- Takafumi Yanagisawa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Department of Urology, The Jikei University School of Medicine, Tokyo105-8461, Japan
| | - Keiichiro Mori
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Department of Urology, The Jikei University School of Medicine, Tokyo105-8461, Japan
| | - Satoshi Katayama
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Department of Urology, Okayama University Graduate School of Medicine, Dentistry & Pharmaceutical Sciences, Okayama, 700-8558, Japan
| | - Hadi Mostafaei
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, 5166, Iran
| | - Fahad Quhal
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Department of Urology, King Fahad Specialist Hospital, Dammam, 32253, Saudi Arabia
| | - Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Institute for Urology & Reproductive Health, Sechenov University, Moscow, 119991, Russia
| | - Pawel Rajwa
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Department of Urology, Medical University of Silesia, Zabrze, 41-808, Poland
| | - Reza S Motlagh
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Men's Health & Reproductive Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran , Iran
| | - Abdulmajeed Aydh
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Department of Urology, King Faisal Medical City, Abha, 614312, Saudi Arabia
| | - Frederik König
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Department of Urology, University Medical Centre Hamburg-Eppendorf, Hamburg, 20251, Germany
| | - Nico C Grossmann
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Department of Urology, University Hospital Zurich, Zurich, 8091, Switzerland
- Department of Urology, Luzerner Kantonsspital, Lucerne, 6004, Switzerland
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
| | - Jun Miki
- Department of Urology, The Jikei University School of Medicine, Tokyo105-8461, Japan
| | - Manuela Schmidinger
- Department of Medicine I & Comprehensive Cancer Center, Clinical Division of Oncology, Medical University of Vienna, Vienna, 1090, Austria
| | - Shin Egawa
- Department of Urology, The Jikei University School of Medicine, Tokyo105-8461, Japan
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, 1090, Austria
- Institute for Urology & Reproductive Health, Sechenov University, Moscow, 119991, Russia
- Division of Urology, Hourani Center for Applied Scientific Research, Al-Ahliyya Amman University, Amman, 19328, Jordan
- Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
- Department of Urology, Second Faculty of Medicine, Charles University, Prague, 11638, Czech Republic
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22
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Liu J, Wu P, Lai S, Song X, Wang M, Wang X, Liu S, Hou H, Zhang Y, Wang J. Clinicopathological and Prognostic Significance of Preoperative Prognostic Nutritional Index in Patients with Upper Urinary Tract Urothelial Carcinoma. Nutr Cancer 2022; 74:2964-2974. [PMID: 35297733 DOI: 10.1080/01635581.2022.2049829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
To investigate the prognostic value of preoperative prognostic nutritional index (PNI) to predict oncological outcome and intravesical recurrence (IVR) in upper tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU). This study involved the clinical data of 255 patients with UTUC who had undergone RNU from 2004 to 2019 at our institution. Patients were grouped according to an optimal value of preoperative PNI. Kaplan-Meier analyses and Cox proportional hazards models were used to analyze the associations of preoperative PNI with progression-free survival (PFS), cancer-specific survival (CSS), overall survival (OS), and IVR. Patients with low PNI were more likely to be older, have higher tumor stage, higher eGFR, and multifocal lesions. No significant association was found between PNI and CSS, IVR. In subgroup analysis according to the risk stratification, low PNI was associated with worse PFS, CSS, and OS for patients with higher risk. Multivariate analyses showed that elevated PNI was an independent prognostic indicator for PFS (P = 0.014) and OS (P = 0.048). A low PNI is an independent predictor of PFS and OS in patients with UTUC after RNU. By subgroup analysis, the prognostic value of PNI was limited to patients with higher risk. PNI may become a useful biomarker to predict oncological outcomes in patients with UTUC after RNU.
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Affiliation(s)
- Jianyong Liu
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Beijing Hospital Continence Center, Beijing, People's Republic of China
| | - Pengjie Wu
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Beijing Hospital Continence Center, Beijing, People's Republic of China
| | - Shicong Lai
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Xinda Song
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Miao Wang
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Beijing Hospital Continence Center, Beijing, People's Republic of China
| | - Xuan Wang
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Beijing Hospital Continence Center, Beijing, People's Republic of China
| | - Shengjie Liu
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Beijing Hospital Continence Center, Beijing, People's Republic of China
| | - Huimin Hou
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Beijing Hospital Continence Center, Beijing, People's Republic of China
| | - Yaoguang Zhang
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Beijing Hospital Continence Center, Beijing, People's Republic of China
| | - Jianye Wang
- Department of Urology, Beijing Hospital, Beijing, People's Republic of China.,National Center of Gerontology, Beijing, People's Republic of China.,Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, People's Republic of China.,Beijing Hospital Continence Center, Beijing, People's Republic of China
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23
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Xu Y, He H, Zang Y, Yu Z, Hu H, Cui J, Wang W, Gao Y, Wei H, Wang Z. Systemic inflammation response index (SIRI) as a novel biomarker in patients with rheumatoid arthritis: a multi-center retrospective study. Clin Rheumatol 2022; 41:1989-2000. [PMID: 35266094 DOI: 10.1007/s10067-022-06122-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 02/22/2022] [Accepted: 03/01/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To evaluate the potential ability of systemic inflammation response index (SIRI) as a novel biomarker in patients with rheumatoid arthritis (RA) and explore the mechanisms. METHOD Patients fulfilling the 2010 ACR/EULAR classification criteria for RA were enrolled in this study. Demographic, clinical, and laboratory characteristics of all subjects were collected. Neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), and SIRI were calculated. Statistical analysis was performed, and P-values < 0.05 were considered statistically significant. RESULTS One thousand four hundred ninety-nine RA patients from five hospitals were included, with 366 healthy volunteers served as controls. The NLR, MLR, PLR, and SIRI significantly increased in RA patients. Receiver operating characteristics (ROC) curve analysis showed SIRI, and NLR could distinguish RA from healthy controls. Correlation analysis and multiple linear regression analysis indicated that SIRI and PLR positively correlated with disease activity in RA. The NLR, MLR, and SIRI increased significantly in patients with RA-associated interstitial lung disease (ILD). There was a good accuracy of SIRI in differentiating RA-ILD from RA patients without ILD. SIRI was also found to be higher in RA patients with tumor and could differentiate them from RA patients without tumor. CONCLUSIONS SIRI could be evaluated as a novel, non-invasive, and suitable biomarker for assisting in the diagnosis process and demonstrating the disease activity of RA, as well as predicting RA-ILD and tumor development of RA patients. Key Points • As a novel biomarker, systemic inflammation response index (SIRI) may assist in the diagnosis process and indicate the disease activity of RA patients • SIRI may predict the development of RA-associated interstitial lung disease (RA-ILD) and tumor in RA patients • SIRI is more satisfactory than other blood cells-based indexes in the assessment of RA patients.
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Affiliation(s)
- Yunyun Xu
- Department of Rheumatology and Immunology, Taixing People's Hospital, 98 Runtai South Road, Taixing, 225400, Jiangsu, China.
| | - Hongjun He
- Department of Rheumatology and Immunology, Taixing People's Hospital, 98 Runtai South Road, Taixing, 225400, Jiangsu, China
| | - Yinshan Zang
- Department of Rheumatology and Immunology, The Affiliated Suqian First People's Hospital of Nanjing Medical University, Suqian, Jiangsu, China
| | - Zhe Yu
- Department of Rheumatology and Immunology, The Affiliated Suqian First People's Hospital of Nanjing Medical University, Suqian, Jiangsu, China
| | - Huaixia Hu
- Department of Rheumatology and Immunology, Second People's Hospital of Lianyungang, Lianyungang, Jiangsu, China
| | - Jiajia Cui
- Department of Rheumatology and Immunology, Second People's Hospital of Lianyungang, Lianyungang, Jiangsu, China
| | - Wenwen Wang
- Department of Rheumatology and Immunology, Affiliated Hospital 2 of Nantong University and Nantong First People's Hospital, Nantong, Jiangsu, China
| | - Yingying Gao
- Department of Rheumatology and Immunology, Affiliated Hospital 2 of Nantong University and Nantong First People's Hospital, Nantong, Jiangsu, China
| | - Hua Wei
- Department of Rheumatology and Immunology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, China
| | - Zhuqing Wang
- Department of Laboratory Medicine, Taixing People's Hospital, Taixing, Jiangsu, China
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24
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Zhou X, Luo G. A meta-analysis of the platelet-lymphocyte ratio: A notable prognostic factor in renal cell carcinoma. Int J Biol Markers 2022; 37:123-133. [PMID: 35238678 DOI: 10.1177/03936155221081536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The platelet-lymphocyte ratio (PLR) has been assessed in some studies on renal cell carcinoma (RCC), but the results have been inconsistent. This meta-analysis aims to review and report the latest data regarding the prognostic role of the PLR in RCC patients. METHOD Articles were searched in the PubMed, EMBASE, and Cochrane Library electronic databases. Studies were filtered according to a selection strategy, and data corresponding to the index of interest were extracted. A fixed-effects model or random-effects model was selected based on heterogeneity. The sensitivity analysis was carried out by eliminating the studies one by one. Finally, funnel plots and Egger's test were used to assess publication bias, and the trim and fill method was used to assess the impact of bias on the results. RESULTS In total, 15,193 patients with RCC from 44 studies were included in this meta-analysis. The pooled analysis indicated that the higher the PLR was, the poorer the prognosis for RCC patients in terms of overall survival (hazard ratio (HR) = 1.01 (95% confidence interval (CI) 1.00, 1.02), P = 0.010), cancer-special survival (CSS) (HR = 1.21 (95% CI 1.00, 1.46), P = 0.05), progression-free survival (HR = 1.44 (95% CI 1.28, 1.62), P < 0.00001), recurrence-free survival (HR = 1.73 (95% CI 1.11, 2.71), P = 0.02), disease-free survival (HR = 1.63 (95% CI 0.91, 2.94), P = 0.01) and metastasis-free survival (HR = 1.223 (95% CI 0.712, 2.099), P = 0.466). In the subgroup analysis of high PLR, targeted treatment, TKI use, nivolumab use, surgical treatment, clear cell RCC, metastasis, Asian race, and high PLR were related to poor prognosis. CONCLUSION This study showed that a high PLR was associated with the poor prognosis of RCC patients, but more studies are needed to confirm the value of the PLR.
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Affiliation(s)
- Xiao Zhou
- Department of Urology, 66366Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
| | - Guangcheng Luo
- Department of Urology, 66366Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
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25
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Jiang C, Zhang S, Qiao K, Xiu Y, Yu X, Huang Y. The pre-treatment systemic inflammation response index as a useful prognostic factor is better than lymphocyte to monocyte ratio in breast cancer patients receiving neoadjuvant chemotherapy. Clin Breast Cancer 2022; 22:424-438. [DOI: 10.1016/j.clbc.2022.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 03/14/2022] [Accepted: 03/18/2022] [Indexed: 11/29/2022]
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26
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Li X, Liu B, Cui P, Zhao X, Liu Z, Qi Y, Zhang G. Integrative Analysis of Peripheral Blood Indices for the Renal Sinus Invasion Prediction of T1 Renal Cell Carcinoma: An Ensemble Study Using Machine Learning-Assisted Decision-Support Models. Cancer Manag Res 2022; 14:577-588. [PMID: 35210855 PMCID: PMC8857979 DOI: 10.2147/cmar.s348694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/27/2022] [Indexed: 11/25/2022] Open
Abstract
Purpose Renal sinus invasion is an attributive factor affecting the prognosis of renal cell carcinoma (RCC). This study aimed to construct a risk prediction model that could stratify patients with RCC and predict renal sinus invasion with the help of a machine learning (ML) algorithm. Patients and Methods We retrospectively recruited 1229 patients diagnosed with T1 stage RCC at the Baotou Cancer Hospital between November 2013 and August 2021. Iterative analysis was used to screen out predictors related to renal sinus invasion, after which ML-based models were developed to predict renal sinus invasion in patients with T1 stage RCC. The receiver operating characteristic curve (ROC), decision curve analysis (DCA), and clinical impact curve (CIC) were performed to evaluate the robustness and clinical practicability of each model. Results A total of 21 candidate variables were shortlisted for model building. Iterative analysis screened that neutrophil to albumin ratio (NAR), hemoglobin level * albumin level * lymphocyte count/platelet count ratio (HALP), prognostic nutrition index (PNI), body mass index*serum albumin/neutrophil-lymphocyte ratio (AKI), NAR, and fibrinogen (FIB) concentration (NARFIB), platelet to lymphocyte ratio (PLR), and R.E.N.A.L score was related to renal sinus invasion and contributed significantly to ML-based algorithm. The areas under the ROC curve (AUCs) of the random forest classifier (RFC) model, support vector machine (SVM), eXtreme gradient boosting (XGBoost), artificial neural network (ANN), and decision tree (DT) ranged from 0.797 to 0.924. The optimal risk probability of renal sinus invasion predicted was RFC (AUC = 0.924, 95% confidence interval [CI]: 0.414–1.434), which showed robust discrimination for identifying high-risk patients. Conclusion We successfully develop practical models for renal sinus invasion prediction, particularly the RFC, which could contribute to early detection via integrating systemic inflammatory factors and nutritional parameters.
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Affiliation(s)
- Xin Li
- Department of Thoracic Oncology, Baotou Cancer Hospital, Baotou, Inner Mongolia, People’s Republic of China
| | - Bo Liu
- Department of Thoracic Oncology, Baotou Cancer Hospital, Baotou, Inner Mongolia, People’s Republic of China
| | - Peng Cui
- Department of Thoracic Oncology, Baotou Cancer Hospital, Baotou, Inner Mongolia, People’s Republic of China
| | - Xingxing Zhao
- Department of Thoracic Oncology, Baotou Cancer Hospital, Baotou, Inner Mongolia, People’s Republic of China
| | - Zhao Liu
- Department of Thoracic Oncology, Baotou Cancer Hospital, Baotou, Inner Mongolia, People’s Republic of China
| | - Yanxiang Qi
- Department of Thoracic Oncology, Baotou Cancer Hospital, Baotou, Inner Mongolia, People’s Republic of China
| | - Gangling Zhang
- Department of Thoracic Oncology, Baotou Cancer Hospital, Baotou, Inner Mongolia, People’s Republic of China
- Correspondence: Gangling Zhang, Department of Thoracic Oncology, Baotou Cancer Hospital, Baotou, Inner Mongolia, 014030, People’s Republic of China, Tel +86-138-4827-8198, Email
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Zhou Q, Su S, You W, Wang T, Ren T, Zhu L. Systemic Inflammation Response Index as a Prognostic Marker in Cancer Patients: A Systematic Review and Meta-Analysis of 38 Cohorts. Dose Response 2022; 19:15593258211064744. [PMID: 34987341 PMCID: PMC8689621 DOI: 10.1177/15593258211064744] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Accepted: 11/17/2021] [Indexed: 12/26/2022] Open
Abstract
Background The systemic inflammation response index (SIRI), a novel and cost-effective serum biomarker, is associated with prognosis in patients with cancer. However, the prognostic value of the SIRI in cancer remains unclear. This study aimed to evaluate the potential role of the SIRI as a prognostic indicator in cancer. Methods Reports in which the prognostic value of the SIRI in cancer was evaluated were retrieved from electronic databases. The pooled hazard ratio (HR) and 95% confidence interval (CI) were calculated to evaluate the prognostic significance of the SIRI. The odds ratio (OR) was also calculated to explore the association between the SIRI and clinicopathological features. Results This study included 30 retrospective studies with 38 cohorts and 10 754 cases. The meta-analysis indicated that a high SIRI was associated with short overall survival (OS) (HR = 2.04, 95% CI = 1.82-2.29, P < .001) and disease-free survival (DFS)/recurrence-free survival (RFS)/progression-free survival (PFS) (HR = 2.08, 95% CI = 1.84-2.34, P < .001). Subgroup analysis showed that the prognostic value of the SIRI was significant in all kinds of cancer included. Moreover, the SIRI was significantly correlated with sex, tumor size, T stage, N stage, TNM stage, and lymphovascular invasion. Conclusion The pretreatment SIRI could be a promising universal prognostic indicator in cancer.
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Affiliation(s)
- Qian Zhou
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Si Su
- Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Wen You
- Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Tao Wang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
- Tao Wang, Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No. 1 Shuaifuyuan, Dongcheng District, Beijing 100730, China.
| | - Tong Ren
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
| | - Lan Zhu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
- National Clinical Research Center for Obstetric and Gynecologic Diseases, Beijing, China
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Zapała Ł, Kunc M, Sharma S, Biernat W, Radziszewski P. Low Lymphocyte-to-Monocyte Ratio Is the Potential Indicator of Worse Overall Survival in Patients with Renal Cell Carcinoma and Venous Tumor Thrombus. Diagnostics (Basel) 2021; 11:2159. [PMID: 34829506 PMCID: PMC8623560 DOI: 10.3390/diagnostics11112159] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 11/20/2021] [Indexed: 11/21/2022] Open
Abstract
The purpose of the study was to determine the influence of lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio (PLR), and neutrophil-to-lymphocyte ratio (NLR) values on the prognosis in patients with renal cell carcinoma (RCC) and venous tumor thrombus. The respective data of 91 patients treated with radical surgery in the years 2012-2021 in 2 tertiary referral urological centers were retrieved from local medical databases. Mean calculated 3-year overall survival (OS) reached 70% (mean follow-up 35.3 months). The association between lower LMR and the presence of tumor necrosis (p = 0.0004) was observed. Amongst systemic inflammatory markers, only LMR was selected as the sensitive marker predicting death with a calculated cut-off value of 2.53. OS was decreased in patients presenting with low LMR when compared to the high LMR group (39% vs. 82%, p = 0.0011). Neither NLR nor PLR were associated with survival rates. In multivariate analysis, LMR was identified as the independent prognostic factor (HR = 0.20, 95% CI 0.07-0.55, p = 0.001). Low values of LMR (<2.53) are independently connected with poorer OS in patients with RCC and coexisting tumor thrombus. The incorporation of the hematological variables into the prognostic model greatly increased its accuracy in predicting survival in the distinctive subpopulation of patients with RCC.
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Affiliation(s)
- Łukasz Zapała
- Clinic of General, Oncological and Functional Urology, Medical University of Warsaw, Lindleya 4, 02-005 Warsaw, Poland; (S.S.); (P.R.)
| | - Michał Kunc
- Department of Pathomorphology, Medical University of Gdansk, 80-214 Gdańsk, Poland;
| | - Sumit Sharma
- Clinic of General, Oncological and Functional Urology, Medical University of Warsaw, Lindleya 4, 02-005 Warsaw, Poland; (S.S.); (P.R.)
| | - Wojciech Biernat
- Department of Pathomorphology, Medical University of Gdansk, 80-214 Gdańsk, Poland;
| | - Piotr Radziszewski
- Clinic of General, Oncological and Functional Urology, Medical University of Warsaw, Lindleya 4, 02-005 Warsaw, Poland; (S.S.); (P.R.)
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Ni J, Wang K, Zhang H, Xie J, Xie J, Tian C, Zhang Y, Li W, Su B, Liang C, Song X, Peng B. Prognostic Value of the Systemic Inflammatory Response Index in Patients Undergoing Radical Cystectomy for Bladder Cancer: A Population-Based Study. Front Oncol 2021; 11:722151. [PMID: 34485155 PMCID: PMC8416169 DOI: 10.3389/fonc.2021.722151] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 07/22/2021] [Indexed: 12/22/2022] Open
Abstract
PURPOSE The aim of this study was to evaluate the prognostic significance of the systemic inflammatory response index (SIRI) in patients with bladder cancer (BCa) treated with radical cystectomy (RC) and develop a survival predictive model through establishing a nomogram. MATERIALS AND METHODS A total of 203 BCa patients who underwent RC were included in this study. The relationship between the SIRI and overall survival (OS), disease-free survival (DFS), and clinicopathological features were evaluated. Cox regression analysis was performed to investigate the effect of the factors on the OS and DFS. The results were applied in the establishment of a nomogram. Receiver operating characteristic (ROC) curves, decision curve analysis (DCA) curves, and calibration curves were performed to assess the predictive performance and accuracy of the nomogram, respectively. RESULTS According to the classification of the SIRI, 81 patients (39.9%) were assigned to SIRI grade 1, 94 patients (46.3%) to SIRI grade 2, and the remaining 28 patients (13.8%) to SIRI grade 3. Multivariate Cox regression revealed that a higher SIRI grade was significantly associated with a poor prognosis and served as an independent prognostic factor for the OS [Grade 2 vs Grade 1, odds ratio = 2.54, 95% confidence interval (CI),1.39-4.64, P = 0.002; Grade 3 vs Grade 1, odds ratio = 4.79, 95%CI: 2.41-9.50, P < 0.001] and DFS [Grade 2 vs Grade 1, odds ratio = 2.19, 95% CI, 1.12-4.31, P = 0.023; Grade 3 vs Grade 2, odds ratio = 3.36, 95%CI, 1.53-7.35, P = 0.002]. The ROC and DCA analysis indicated that the nomogram based on the SIRI contained a better predictive performance compared with the TNM stage (AUC = 0.750 and 0.791; all P < 0.05). The ROC analysis showed that nomograms can better predict the 3- and 5-year OS and DFS. The calibration curves exhibited a significant agreement between the nomogram and the actual observation. CONCLUSION SIRI as a novel independent prognostic index and potential prognostic biomarker can effectively improve the traditional clinicopathological analysis and optimize individualized clinical treatments for BCa patients after RC.
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Affiliation(s)
- Jinliang Ni
- Department of Urology, Shanghai Tenth People’s Hospital, Tongi University, Shanghai, China
- Shanghai Clinical College, Anhui Medical University, Hefei, China
| | - Keyi Wang
- Department of Urology, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Houliang Zhang
- Department of Urology, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jinbo Xie
- Department of Urology, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jun Xie
- Shanghai Clinical College, Anhui Medical University, Hefei, China
| | - Changxiu Tian
- Department of Urology, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yifan Zhang
- Department of Urology, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Weiyi Li
- Department of Urology, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Bin Su
- Department of Blood Transfusion, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Chaozhao Liang
- Department of Urology, First Affiliated Hospital of Anhui Medical University, Anhui Medical University, Hefei, China
| | - Xinran Song
- Department of Medical Ultrasound, Shanghai Tenth People’s Hospital, Ultrasound Research and Education Institute, Tongji University Cancer Center, Shanghai Engineering Research Center of Ultrasound Diagnosis and Treatment, Tongji University School of Medicine, Shanghai, China
| | - Bo Peng
- Department of Urology, Shanghai Tenth People’s Hospital, Tongi University, Shanghai, China
- Shanghai Clinical College, Anhui Medical University, Hefei, China
- Department of Urology, Shanghai Tenth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
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Association of Platelets and White Blood Cells Subtypes with Trauma Patients' Mortality Outcome in the Intensive Care Unit. Healthcare (Basel) 2021; 9:healthcare9080942. [PMID: 34442077 PMCID: PMC8391175 DOI: 10.3390/healthcare9080942] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/22/2021] [Accepted: 07/22/2021] [Indexed: 12/20/2022] Open
Abstract
Background: White blood cell (WBC) subtypes have been suggested to reflect patients’ immune-inflammatory status. Furthermore, the derived ratio of platelets and WBC subtypes, including monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), is proposed to be associated with patient outcome. Therefore, this study aimed to identify the association of platelets and white blood cells subtypes with the mortality outcome of trauma patients in the intensive care unit (ICU). Method: The medical information from 2854 adult trauma patients admitted to the ICU between 1 January 2009 and 31 December 2019 were retrospectively retrieved from the Trauma Registry System and classified into two groups: the survivors group (n = 2524) and the death group (n = 330). The levels of monocytes, neutrophils, lymphocytes, platelets, and blood-drawn laboratory data detected upon patient arrival to the emergency room and the derived MLR, NLR, and PLR were calculated. Multivariate logistic regression analysis was used to determine the independent effects of univariate predictive variables on mortality occurrence. Result: The results revealed the patients who died had significantly lower platelet counts (175,842 ± 61,713 vs. 206,890 ± 69,006/μL, p < 0.001) but higher levels of lymphocytes (2458 ± 1940 vs. 1971 ± 1453/μL, p < 0.001) than the surviving patients. However, monocyte and neutrophil levels were not significantly different between the death and survivor groups. Moreover, dead patients had a significantly lower PLR than survivors (124.3 ± 110.3 vs. 150.6 ± 106.5, p < 0.001). However, there was no significant difference in MLR or NLR between the dead patients and the survivors. Multivariate logistic regression revealed that male gender, old age, pre-existing hypertension, coronary artery disease and end-stage renal disease, lower Glasgow Coma Scale (GCS), higher Injury Severity Score (ISS), higher level of lymphocytes and lower level of red blood cells and platelets, longer activated partial thromboplastin time (aPTT), and lower level of PLR were independent risk factors associated with higher odds of trauma patient mortality outcome in the ICU. Conclusion: This study revealed that a higher lymphocyte count, lower platelet count, and a lower PLR were associated with higher risk of death in ICU trauma patients.
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Liu H, Tang K, Chen Z, Li Z, Meng X, Xia D. Comparison and development of preoperative systemic inflammation markers-based models for the prediction of unfavorable pathology in newly diagnosed clinical T1 renal cell carcinoma. Pathol Res Pract 2021; 225:153563. [PMID: 34371466 DOI: 10.1016/j.prp.2021.153563] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/18/2021] [Accepted: 07/20/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND We sought to investigate the preoperative risk factors associated with the unfavorable pathology (UP) of clinical T1 (cT1) renal lesions. The aims of this study were to develop and compare several novel models capable of accurately identifying those patients at high risk of harboring occult adverse histopathological characteristics. METHODS The clinical parameters and preoperative laboratory test results from 1281 cT1 renal cell carcinomas (RCCs) patients who underwent partial nephrectomy (PN) or radical nephrectomy (RN) were collected. The data was randomly split into training (70%) and testing (30%) datasets. We performed univariable and multivariable logistic regression analyses for significant predictors and, subsequently, constructed predictive models based on those significant risk factors. Receiver operating characteristic (ROC) analysis was used to determine the model with the highest discrimination power with corresponding area under the curve (AUC). Calibration curves were plotted and decision curve analyses (DCAs) were applied to explore clinical net benefit. RESULTS UP was identified in 21.1% (n = 270), 21.0% (n = 188) and 21.3% (n = 82) patients in the total population, training cohort and validation cohort, respectively. R.E.N.A.L. (radius, exophytic/endophytic properties, nearness of tumor to collecting system or sinus, anterior/posterior, location relative to the polar lines) nephrometry score, tumor size, neutrophil-to-lymphocyte ratio (NLR) and albumin-to-globulin ratio (AGR) were independent predictors of UP. Among those predictive models, the model that consisted of tumor size, hemoglobin, NLR and AGR performs best according to the highest AUC of 0.70 and the highest net benefit. When tumor histology was added to the biomarker-based model, including tumor size, hemoglobin, NLR and AGR, the AUC improved from 0.60 to 0.63 in the validation cohort. CONCLUSIONS In this analytical model study, our findings verified that systemic inflammation response markers showed high potential for identifying UP. Our biomarker-based models well predicted occult aggressive histopathological characteristics among patients with cT1 renal lesions, and the use of models may be greatly beneficial to urologists in tailoring precise management and therapy for patients. Robust validation is warranted prior to adoption into clinical practice.
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Affiliation(s)
- Hailang Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Kun Tang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Zhiqiang Chen
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Zhen Li
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Xiaoyan Meng
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
| | - Ding Xia
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China.
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Liu H, Wang Z, Peng E, Chen Z, Tang K, Xia D. Added Value of Systemic Inflammation Markers in Predicting Clinical Stage T1 Renal Cell Carcinoma Pathologically Upstaged to T3a. Front Oncol 2021; 11:679536. [PMID: 34136403 PMCID: PMC8202414 DOI: 10.3389/fonc.2021.679536] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/03/2021] [Indexed: 12/25/2022] Open
Abstract
Objectives We aimed to determine preoperative risk factors associated with pathologic T3a (pT3a) upstaging of clinical T1 (cT1) renal cell carcinomas (RCCs) and develop a novel model capable of accurately identifying those patients at high risk of harboring occult pT3a characteristics. Methods A retrospective analysis of 1324 cT1 RCC patients who underwent partial nephrectomy (PN) or radical nephrectomy (RN) was performed. The study cohort was divided into training and testing datasets in a 70:30 ratio for further analysis. Univariable and multivariable logistic regression analyses were performed to identify predictors associated with cT1 to pT3a upstaging and subsequently, those significant risk factors were used to construct models. We used the area under the curve (AUC) to determine the model with the highest discrimination power. Decision curve analyses (DCAs) were applied to evaluate clinical net benefit associated with using the predictive models. Results The rates of upstaging were 6.1% (n = 81), 5.8% (n = 54) and 6.8% (n = 27) in the total population, training cohort and validation cohort, respectively. Tumor size, clinical T stage, R.E.N.A.L. (radius, exophytic/endophytic properties, nearness of tumor to collecting system or sinus, anterior/posterior) nephrometry score, lymphocyte to monocyte ratio (LMR), prognostic nutrition index (PNI) and albumin to globulin ratio (AGR) were significantly associated with pT3a upstaging. The model that consisted of R.E.N.A.L. score, LMR, AGR and PNI achieved the highest AUC of 0.70 in the validation cohort and yielded the highest net benefit. In the subpopulation with complete serum lipid profile, the inclusion of low-density lipoprotein cholesterol (LDL-C) and Castelli risk index-I (CRI-I) significantly improved the discrimination of model (AUC = 0.86). Conclusions Our finding highlights the importance of systemic inflammation response markers and serum lipid parameters in predicting pT3a upstaging. Our model had relatively good discrimination in predicting occult pT3a disease among patients with cT1 renal lesions, and the use of the model may be greatly beneficial to urologists in risk stratification and management decisions.
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Affiliation(s)
- Hailang Liu
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhixian Wang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ejun Peng
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhiqiang Chen
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Kun Tang
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ding Xia
- Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Saroul N, Puechmaille M, Lambert C, Hassan AS, Biau J, Lapeyre M, Mom T, Bernadach M, Gilain L. Prognosis in Head and Neck Cancer: Importance of Nutritional and Biological Inflammatory Status. Otolaryngol Head Neck Surg 2021; 166:118-127. [PMID: 33845660 DOI: 10.1177/01945998211004592] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine the importance of nutritional status, social status, and inflammatory status in the prognosis of head and neck cancer. STUDY DESIGN Single-center retrospective study of prospectively collected data. SETTING Tertiary referral center. METHODS Ninety-two consecutive patients newly diagnosed for cancer of the upper aerodigestive tract without metastases were assessed at time of diagnosis for several prognostic factors. Nutritional status was assessed by the nutritional risk index, social status by the EPICES score, and inflammatory status by the systemic inflammatory response index. The primary endpoint was overall survival. RESULTS In multivariable analysis, the main prognostic factors were the TNM classification (hazard ratio [HR] = 3.34, P = .002, for stage T3-4), malnutrition as assessed by the nutritional risk index (HR = 3.64, P = .008, for severe malnutrition), and a systemic inflammatory response index score ≥1.6 (HR = 3.32, P = .02). Social deprivation was not a prognostic factor. CONCLUSION Prognosis in head and neck cancer is multifactorial; however, malnutrition and inflammation are important factors that are potentially reversible by early intervention.
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Affiliation(s)
- Nicolas Saroul
- Otolaryngology-Head and Neck Surgery Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Mathilde Puechmaille
- Otolaryngology-Head and Neck Surgery Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Céline Lambert
- Biostatistics Unit (DRCI), Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Achraf Sayed Hassan
- Otolaryngology-Head and Neck Surgery Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Julian Biau
- Radiation Oncology Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Michel Lapeyre
- Radiation Oncology Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Thierry Mom
- Otolaryngology-Head and Neck Surgery Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
| | - Maureen Bernadach
- Medical Oncology Department, Centre Jean Perrin, Clermont-Ferrand, France
| | - Laurent Gilain
- Otolaryngology-Head and Neck Surgery Department, Clermont-Ferrand University Hospital, Clermont-Ferrand, France
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Chen CX, Chen DN, Sun XL, Ke ZB, Lin F, Chen H, Tao X, Huang F, Wei Y, Xu N. Identification of vital prognostic genes related to tumor microenvironment in pheochromocytoma and paraganglioma based on weighted gene co-expression network analysis. Aging (Albany NY) 2021; 13:9976-9990. [PMID: 33795528 PMCID: PMC8064173 DOI: 10.18632/aging.202754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 02/16/2021] [Indexed: 01/12/2023]
Abstract
Pheochromocytoma and paraganglioma (PCPG) is a rare neuroendocrine tumor. This study aims to identify vital prognostic genes which were associated with PCPG tumor microenvironment (TME). We downloaded transcriptome data of PCPG from TCGA database and calculated the immune scores and stromal scores by using the ESTIMATE algorithm. DEGs related to TMB were then identified. We conducted WGCNA to further extract the TME-related modules. GO, KEGG pathway analysis, and PPI network were performed. Survival analysis was conducted to identify the hub genes associated with the prognosis of PCPG. A total of 150 PCPG samples were included in this study. We obtained 1507 and 2067 DEGs based on immune scores and stromal scores, respectively. WGCNA analysis identified the red module and brown module were correlated with immune sores while the turquoise module and red module were significantly associated with stromal scores. Functional enrichments analysis revealed that 307 TME-related genes were correlated with the inflammation or immune response. Survival analysis showed that three TME-relate genes (ADGRE1, CCL18, and LILRA6) were associated with PCPG prognosis. These three hub genes including ADGRE1, CCL18, and LILRA6 might be involved in the progression of PCPG and could serve as potential biomarkers and novel therapeutic targets.
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Affiliation(s)
- Chun-Xian Chen
- Department of General Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Dong-Ning Chen
- Department of Urology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Xiong-Lin Sun
- Department of Urology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Zhi-Bin Ke
- Department of Urology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Fei Lin
- Department of Urology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Hang Chen
- Department of Urology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Xuan Tao
- Department of Pathology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Fei Huang
- Central Lab, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Yong Wei
- Department of Urology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
| | - Ning Xu
- Department of Urology, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, China
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Fan X, Wang D, Zhang W, Liu J, Liu C, Li Q, Ma Z, Li H, Guan X, Bai Y, Yang J, Lou C, Li X, Wang G, Li Z. Inflammatory Markers Predict Survival in Patients With Advanced Gastric and Colorectal Cancers Receiving Anti-PD-1 Therapy. Front Cell Dev Biol 2021; 9:638312. [PMID: 33791296 PMCID: PMC8005614 DOI: 10.3389/fcell.2021.638312] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 02/10/2021] [Indexed: 12/16/2022] Open
Abstract
There is a lack of useful biomarkers for predicting the efficacy of anti-programmed death-1 (PD-1) therapy for advanced gastric and colorectal cancer. To address this issue, in this study we investigated the correlation between inflammatory marker expression and survival in patients with advanced gastric and colorectal cancer. Data for 111 patients with advanced gastric and colorectal cancer treated with anti-PD-1 regimens were retrospectively analyzed. Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), and clinical characteristics of each patient were selected as the main variables. Overall response rate, disease control rate, and progression-free survival were primary endpoints, and overall survival and immune-related adverse events (irAEs) were secondary endpoints. The chi-squared test and Fisher's exact test were used to evaluate relationships between categorical variables. Uni- and multivariate Cox regression analyses were performed, and median progression-free survival and overall survival were estimated with the Kaplan-Meier method. The overall response rate and disease control rate of anti-PD-1therapy in advanced gastric and colorectal tumors were 12.61 and 66.66%, respectively. The patients with MLR < 0.31, NLR < 5, and PLR < 135 had a significantly higher disease control rate than those with MLR > 0.31, NLR > 5, and PLR > 135 (P < 0.05). The multivariate analysis revealed that MLR < 0.31, BMI > 18.5, and anti-PD-1 therapy in first-line were associated with prolonged PFS. MLR < 0.31 and BMI > 18.5 were associated with prolonged overall survival. The irAE rate differed significantly between PLR groups, and PLR < 135 was associated with an increased rate of irAEs (P = 0.028). These results indicate that the inflammatory markers NLR, MLR, and PLR have clinical utility for predicting survival or risk of irAEs in patients with advanced gastric cancer and colorectal cancer.
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Affiliation(s)
- Xiaona Fan
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Dan Wang
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Wenjing Zhang
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Jinshuang Liu
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Harbin, China
| | - Chao Liu
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Qingwei Li
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Zhigang Ma
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Hengzhen Li
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Xin Guan
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China.,Translational Medicine Research and Cooperation Center of Northern China, Heilongjiang Academy of Medical Sciences, Harbin, China
| | - Yibing Bai
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Jiani Yang
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Changjie Lou
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Xiaobo Li
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Guangyu Wang
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
| | - Zhiwei Li
- Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, China
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Prechemoradiotherapy Systemic Inflammation Response Index Stratifies Stage IIIB/C Non-Small-Cell Lung Cancer Patients into Three Prognostic Groups: A Propensity Score-Matching Analysis. JOURNAL OF ONCOLOGY 2021; 2021:6688138. [PMID: 33552158 PMCID: PMC7847338 DOI: 10.1155/2021/6688138] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/18/2021] [Indexed: 12/25/2022]
Abstract
Purpose We explored the prognostic influence of the systemic inflammation response index (SIRI) on the survival outcomes of stage IIIB/C non-small-cell lung cancer (NSCLC) patients who underwent concurrent chemoradiotherapy. Methods Present propensity score-matching (PSM) analysis comprised 876 stage IIIB/C NSCLC patients who received 1–3 cycles of platinum-based doublets concurrent with thoracic radiotherapy from 2007 to 2017. The primary and secondary objectives were the relationships between the SIRI values and overall (OS) and progression-free survival, respectively. Propensity scores were calculated for SIRI groups to adjust for confounders and to facilitate well-balanced comparability between the SIRI groups by creating 1 : 1 matched study groups. Results The receiver operating characteristic curve analysis identified an optimal SIRI cutoff at 1.9 for OS (AUC: 78.8%; sensitivity: 73.7%; specificity: 70.7%) and PFS (AUC: 80.5%; sensitivity: 75.8%; specificity: 72.9%) and we grouped the patients into two PSM cohorts: SIRI < 1.9 (N = 304) and SIRI ≥ 1.9 (N = 304), respectively. The SIRI ≥ 1.9 cohort had significantly worse median OS (P < 0.001) and PFS (P < 0.001) than their SIRI < 1.9 companions. The further combination of SIRI with disease stage exhibited that the SIRI-1 (IIIB and SIRI < 1.9) and SIRI-3 (IIIC and SIRI ≥ 1.9) cohorts had the best and worst outcomes, respectively, with SIRI-2 cohort (IIIB and SIRI ≥ 1.9 or IIIC and SIRI < 1.9) being remained in between (P < 0.001 for OS and PFS, separately). In multivariate analysis, the two- and three-laddered stratifications per the 1.9 cutoffs and SIRI groups retained their independent significance, individually. Conclusions The SIRI ≥ 1.9 independently prognosticated significantly worse OS and PFS results and plated the stage IIIB/C patients into three fundamentally distinct prognostic groups.
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Garcia-Rojo D, Prera A, Muñoz-Rodriguez J, Oliva JC, Dominguez A, Prats J. Prognostic value of lymphocyte-to-monocyte ratio previously determined to surgery in patients with non-metastatic renal cell carcinoma: A systematic review and a prisma-compliant meta-analysis. Medicine (Baltimore) 2021; 100:e24152. [PMID: 33546029 PMCID: PMC7837977 DOI: 10.1097/md.0000000000024152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 11/06/2020] [Accepted: 12/06/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The prognostic value of pretreatment lymphocyte to monocyte ratio in patients with renal cell carcinoma and, especially, in non-metastatic patients remains controversial. METHODS We conducted a PRISMA-compliant meta-analysis to systematically assess the prognostic value of LMR in patients with non-metastatic RCC. Overall survival, cancer-specific survival, and disease-free survival were analyzed. Pooled hazard ratios and 95% confidence intervals were calculated. RESULTS Seven studies comprising 4666 patients were included in the analysis. Unlike those observed in a previous meta-analysis, a lower lymphocyte to monocyte ratio was associated with poorer cancer-specific survival (fix-effect model, hazard ratio 3.04, 95% confidence intervals 2.05-4.51, P < .05). Heterogeneity Chi-squared value Q exp = 0. (P = .82) (I2 = 0%). However, the association between a low lymphocyte to monocyte ratio and overall survival or disease-free survival did not obtain significance. CONCLUSION A lower lymphocyte to monocyte ratio implied poor cancer-specific survival in patients with non-metastatic renal cell carcinoma. Prospective studies are required to confirm our findings. REGISTRATION NUMBER ClinicalTrials.gov (identifier: NCT04213664).
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Affiliation(s)
| | | | | | - Joan Carles Oliva
- Statistics Department, Consorcio Corporacion Sanitaria Parc Taulí, Universitat Autònoma de Barcelona, Sabadell, Spain, Catalunya, Spain
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The Influence of Systemic Inflammation Response Index on Survival Outcomes of Limited-Stage Small-Cell Lung Cancer Patients Treated with Concurrent Chemoradiotherapy. JOURNAL OF ONCOLOGY 2021; 2020:8832145. [PMID: 33381177 PMCID: PMC7759417 DOI: 10.1155/2020/8832145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 12/04/2020] [Accepted: 12/08/2020] [Indexed: 12/25/2022]
Abstract
Background Recent studies have indicated that the systemic inflammation response index (SIRI) can efficiently predict survival outcomes in various tumor types. Thusly, in absence of comparable investigations in limited-stage small-cell lung cancers (LS-SCLCs), we aimed to retrospectively evaluate the prognostic utility of SIRI in LS-SCLC patients treated with concurrent chemoradiotherapy (CRT). Patients and Methods. Present multi-institutional retrospective analysis incorporated LS-SCLC patients treated with CRT at three academic radiation oncology centers between January 2007 and December 2018. The SIRI was calculated by using the peripheral blood neutrophil (N), monocyte (M), and lymphocyte (L) counts acquired in the last ≤7 days before the commencement of the CRT: SIRI = N × M/L. Accessibility of pretreatment SIRI cutoff that may stratify the study population into two gatherings with distinctive overall survival (OS) results was evaluated by utilizing the receiver operating characteristic (ROC) curve analysis. Primary objective was the association between the SIRI values and the OS results. Results Search for the availability of an ideal SIRI cutoff that may stratify the entire patients' population into two particular groups with distinctive OS outcomes identified the 1.93 value (area under the curve (AUC): 72.9%; sensitivity: 74.6%; specificity: 70.1%): Group 1: SIRI <1.93 (N = 71) and Group 2: SIRI ≥1.93 (N = 110), respectively. At a median follow-up of 17.9 (95% CI: 13.2-22.6) months, 47 (26.0%) patients were still alive (47.9% for SIRI <1.93 versus 18.3% for SIRI ≥1.93; p < 0.001). Kaplan-Meier comparisons between the two SIRI groups showed that the SIRI <1.93 cohort had significantly longer median OS (40.5 versus 14.2 months; p < 0.001) than the SIRI ≥1.93 cohort. Similarly, the 3- (54% versus 12.6%) and 5-year (33% versus 9.9%) OS rates were also numerically superior in the SIRI <1.93 cohort. Results of the multivariate analyses uncovered that the prognostic significance of the SIRI on OS outcomes was independent of the other confounding variables. Conclusions The results of this retrospective multi-institutional cohort analysis suggested that a pre-CRT SIRI was a strong and independent prognostic biomarker that reliably stratified LS-SCLC patients into two cohorts with significantly different OS outcomes.
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Abstract
BACKGROUND This meta-analysis aimed to evaluate the prognostic value of the systemic inflammation response index (SIRI) in malignancy based on existing evidence. METHODS We searched for relevant literature published in the electronic databases PubMed, Web of Science, Cochrane Library, and Embase before April 10, 2020. Hazard ratios (HR) and corresponding 95% confidence intervals (CI) were calculated and pooled to evaluate the relationship between SIRI and malignancy outcomes. RESULTS We included 14 articles, describing 6,035 patients. Our findings revealed that patients with high SIRI had worse overall survival (OS) (HR = 2.20, 95% CI: 1.85-2.62, P < .001), disease-free survival (DFS) (HR: 1.92, 95% CI: 1.49-2.48, P < .001), time-to-progression (TTP) (HR: 2.00, 95% CI: 1.55-2.58, P < .001), progression-free survival (PFS) (HR: 1.73, 95% CI: 1.38-2.16, P < .001), cancer-specific survival (CSS) (HR: 3.57, 95% CI: 2.25-5.68, P < 0.001), disease-specific survival (DSS) (HR: 1.99, 95% CI: 1.46 - 2.72, P < .001), and metastasis-free survival (MFS) (HR: 2.26, 95% CI: 1.28-3.99, P = .005) than patients with low SIRI. The correlation between SIRI and OS did not change in a subgroup analysis. Meta-regression indicated that heterogeneity may be related to differences in primary therapy strategies. Sensitivity analysis suggested that our results were reliable. CONCLUSIONS SIRI could be used as a useful predictor of poor prognosis during malignancy treatment.
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Affiliation(s)
- Lishuang Wei
- Geriatric Respiratory Disease Ward, The First Affiliated Hospital of Guangxi Medical University
| | - Hailun Xie
- Department of Colorectal and Anal Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, PR China
| | - Ping Yan
- Geriatric Respiratory Disease Ward, The First Affiliated Hospital of Guangxi Medical University
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Systemic Inflammation Response Index Predicts Survival Outcomes in Glioblastoma Multiforme Patients Treated with Standard Stupp Protocol. J Immunol Res 2020; 2020:8628540. [PMID: 33274245 PMCID: PMC7683150 DOI: 10.1155/2020/8628540] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 11/03/2020] [Indexed: 01/13/2023] Open
Abstract
Objectives We endeavored to retrospectively assess the prognostic merit of pretreatment systemic immune response index (SIRI) in glioblastoma multiforme (GBM) patients who underwent postoperative partial brain radiotherapy (RT) and concurrent plus adjuvant temozolomide (TMZ), namely, the Stupp protocol. Methods The records of 181 newly diagnosed GBM patients who received the postoperative Stupp protocol were retrospectively analyzed. The SIRI value for each eligible patient was calculated by utilizing the platelet, neutrophil, and lymphocyte measures obtained on the first day of treatment: SIRI = Neutrophils × Monocytes/Lymphocytes. The ideal cutoff values for SIRI connected with the progression-free- (PFS) and overall survival (OS) results were methodically searched through using the receiver operating characteristic (ROC) curve analysis. Primary and secondary end-points constituted the potential OS and PFS distinctions among the SIRI groups, respectively. Results The ROC curve analysis labeled the ideal SIRI cutoffs at 1.74 (Area under the curve (AUC): 74.9%; sensitivity: 74.2%; specificity: 71.4%) and 1.78 (AUC: 73.6%; sensitivity: 73.1%; specificity: 70.8%) for PFS and OS status, individually. The SIRI cutoff of 1.78 of the OS status was chosen as the common cutoff for the stratification of the study population (Group 1: SIRI ≤ 1.78 (N = 96) and SIRI > 1.78 (N = 85)) and further comparative PFS and OS analyses. Comparisons between the two SIRI cohorts manifested that the SIRI ≤ 1.78 cohort had altogether significantly superior median PFS (16.2 versus 6.6 months; P < 0.001) and OS (22.9 versus 12.2 months; P < 0.001) than its SIRI > 1.78 counterparts. The results of multivariate Cox regression analyses ratified the independent and significant alliance between a low SIRI and longer PFS (P < 0.001) and OS (P < 0.001) durations, respectively. Conclusions Present results firmly counseled the pretreatment SIRI as a novel, sound, and independent predictor of survival outcomes in newly diagnosed GBM patients intended to undergo postoperative Stupp protocol.
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Chuang HC, Tsai MH, Lin YT, Chou MH, Huang TL, Chiu TJ, Lu H, Fang FM, Chien CY. The Clinical Impacts of Pretreatment Peripheral Blood Ratio on Lymphocytes, Monocytes, and Neutrophils Among Patients with Laryngeal/Hypopharyngeal Cancer Treated by Chemoradiation/Radiation. Cancer Manag Res 2020; 12:9013-9021. [PMID: 33061596 PMCID: PMC7524172 DOI: 10.2147/cmar.s275635] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 09/04/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose This study aimed to investigate the clinical impacts of the pretreatment peripheral blood ratios of lymphocytes, monocytes and neutrophils among patients with hypopharyngeal cancer/laryngeal cancer. Patients and Methods A total of 141 people with cases of hypopharyngeal cancer/laryngeal cancer were enrolled to evaluate the clinical impacts of the systemic inflammation response index (SIRI), neutrophil-lymphocyte ratio (NLR) and lymphocyte-monocyte ratio (LMR) in pretreatment blood among patients with laryngeal/hypopharyngeal cancer between January 2012 and December 2014. Results Those patients with higher pretreatment LMR (>2.99) showed a significantly higher 5-year complete response rate (CR) (69% vs 31%) than those with lower LMR (≤2.99, p = 0.006). Additionally, those patients with lower pretreatment SIRI (<3.26) showed a significantly higher 5-year CR (90% vs 10%) than those with higher SIRI (≥3.26, p < 0.001). Patients with higher LMR had better 5-year overall survival (OS) (p = 0.01) and 5-year progression-free (PFS) (p = 0.005) rates than those with lower LMR in univariate analysis. Patients with lower SIRI had better 5-year OS (p < 0.001) and 5-year PFS (p < 0.001) than those with higher SIRI in univariate analysis. In the Cox regression analysis, SIRI (HR = 1.941, [95% CI: 1.223-3.081], p = 0.005) and N classification (HR = 2.203, [95% CI: 1.327-3.657], p = 0.002) were independent variables of 5-year OS. In addition, SIRI (HR= 2.127, [95% CI: 1.214-3.725], p = 0.008), T classification (HR = 2.18, [95% CI: 1.072-4.433], p = 0.031), and N classification (HR = 2.329, [95% CI: 1.395-3.889], p = 0.001) were independent variables of 5-year PFS. Conclusion Pretreatment SIRI is superior to LMR in predicting treatment response and clinical outcomes among patients with laryngeal/hypopharyngeal cancer treated by CRT/RTO. SIRI may be adopted in the treatment of laryngeal/hypopharyngeal cancer by CRT/RTO.
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Affiliation(s)
- Hui-Ching Chuang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Ming-Hsien Tsai
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Yu-Tsai Lin
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Ming-Huei Chou
- The Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Center for General Education, Cheng-Shiu University, Kaohsiung, Taiwan
| | - Tai-Lin Huang
- Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tai-Jan Chiu
- Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Hui Lu
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Fu-Min Fang
- Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Yen Chien
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Kaohsiung Chang Gung Head and Neck Oncology Group, Cancer Center, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.,Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
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Liu J, Wu P, Lai S, Song X, Fu C, Wang X, Liu S, Hou H, Liu M, Wang J. Preoperative Monocyte-to-lymphocyte Ratio Predicts for Intravesical Recurrence in Patients With Urothelial Carcinoma of the Upper Urinary Tract After Radical Nephroureterectomy Without a History of Bladder Cancer. Clin Genitourin Cancer 2020; 19:e156-e165. [PMID: 33121908 DOI: 10.1016/j.clgc.2020.09.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 08/28/2020] [Accepted: 09/07/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND This study aimed to investigate the preoperative monocyte-to-lymphocyte ratio (MLR) as a biomarker for intravesical recurrence (IVR) in upper urinary tract urothelial carcinoma (UTUC) after radical nephroureterectomy (RNU) for the first time. PATIENTS AND METHODS This study involved the clinical data of 255 patients with UTUC without a history of bladder cancer who had undergone RNU from March 2004 to February 2019 at an academic institution. The associations between MLR and IVR were assessed with Kaplan-Meier method and Cox regression analysis. RESULTS The median follow-up was 43.93 months. Of the 255 patients, 37 developed IVR during the follow-up period. Kaplan-Meier analysis revealed that patients with high MLR (> 0.22) had poor IVR-free survival (P = .001); this prognostic value was in accordance with patients with high grade and more advanced stage UTUC. Cox regression preoperative models showed that ureteral tumor site (hazard ratio [HR], 2.784; P = .005), surgical approach (HR, 2.745; P = .008), and high MLR (HR, 4.085; P < .001) were an independent risk factor for IVR. These factors were used as a signature to establish a prognostic risk model, which revealed significant differences among the 3 subgroups of patients with low, intermediate, and high risk (P < .001). CONCLUSION Ureteral tumor site, surgical approach, and preoperative MLR are significant predictors for IVR in patients with UTUC after RNU. MLR may become a useful biomarker to predict IVR in patients with UTUC after RNU.
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Affiliation(s)
- Jianyong Liu
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China; Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Pengjie Wu
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Shicong Lai
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China; Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Xinda Song
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China; Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Chunlong Fu
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China; Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Xuan Wang
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Shengjie Liu
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Huimin Hou
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China
| | - Ming Liu
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China; Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P. R. China.
| | - Jianye Wang
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of the Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P. R. China; Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, P. R. China.
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Evidence of the Prognostic Value of Pretreatment Systemic Inflammation Response Index in Cancer Patients: A Pooled Analysis of 19 Cohort Studies. DISEASE MARKERS 2020; 2020:8854267. [PMID: 32934755 PMCID: PMC7479458 DOI: 10.1155/2020/8854267] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 05/24/2020] [Accepted: 08/04/2020] [Indexed: 12/13/2022]
Abstract
Objective Systemic inflammation response index (SIRI) is a new inflammation-based evaluation system that has been reported for predicting survival in multiple tumors, but the prognostic significance of SIRI in cancers has not been evinced. Methods Eligible studies updated on December 31, 2019, were selected according to inclusion criteria, the literature searching was performed in PubMed, Web of Science, Google Scholar, and Cochrane. Hazard ratios (HRs), and 95% confidence intervals (CIs) were extracted and pooled by using Stata/SE 14.1. Results 11 publications involving 19 cohort studies with a total of 5,605 subjects were included. Meta-analysis results evinced that high SIRI was associated with worse OS (HR = 2.30, 95% CI: 1.87-2.83, p ≤ 0.001), poor CSS/DSS (HR = 2.83, 95% CI: 1.98-4.04, p ≤ 0.001), and inferior MFS/DFS/PFS/RFS/TTP (HR = 1.88, 95% CI: 1.65-2.15, p ≤ 0.001). The association of SIRI with OS was not significantly affected when stratified by diverse confounding factors. It was suggested that tumor patients with high pretreatment SIRI levels would suffer from adverse outcomes. Conclusion High SIRI is associated with unfavorable clinical outcomes in human malignancies; pretreatment SIRI level might be a useful and promising predictive indicator of prognosis in cancers.
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Low Systemic Inflammation Response Index Predicts Good Prognosis in Locally Advanced Pancreatic Carcinoma Patients Treated with Concurrent Chemoradiotherapy. Gastroenterol Res Pract 2020; 2020:5701949. [PMID: 32802045 PMCID: PMC7414371 DOI: 10.1155/2020/5701949] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 07/15/2020] [Indexed: 12/19/2022] Open
Abstract
Background We investigated the prognostic significance of pretreatment systemic inflammation response index (SIRI) in locally advanced pancreatic carcinoma (LAPC) patients treated with concurrent chemoradiotherapy (CRT). Methods Present retrospective cohort analysis investigated consecutive 154 LAPC patients who received radical CRT. The SIRI was defined as: SIRI = neutrophil × monocyte/lymphocyte counts. Ideal SIRI cutoff(s) influencing overall survival (OS) and progression-free survival (PFS) results were sought by using receiver operating characteristic (ROC) curve analysis. The primary endpoint was the interaction between the SIRI and OS results. Results The median follow-up, PFS, and OS durations were 14.3 (range: 2.9-74.6), 7.9 [%95 confidence interval (CI): 5.7-10.1), and 14.7 months (%95 CI: 11.4-18.0) for the entire cohort, respectively. ROC curve analyses determined the ideal SIRI cutoff that exhibiting a significant link with OS and PFS outcomes at the rounded 1.6 point (AUC: 74.3%; sensitivity: 73.8%; specificity: 70.1%).The SIRI <1.6 patients (N = 58) had significantly superior median PFS (13.8 versus 6.7 months; P < 0.001) and OS (28.6 versus 12.6 months; P < 0.001) lengths than SIRI ≥1.6 patients (N = 96), respectively. Although the N0 (versus N1; P < 0.05) and CA 19-9 ≤90 U/mL (versus >90 U/mL) appeared as the other significant associates of better OS and PFS in univariate analyses, yet the results of multivariate analyses confirmed the SIRI <1.6 as the independent indicator of superior OS and PFS (P < 0.001 for each). Conclusion Pretreatment SIRI is a novel independent prognosticator that may further enhance the conventional tumor-node-metastases staging system in a more precise prediction of the OS and PFS outcomes of LAPC patients after radical CRT.
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Shao Y, Wu B, Jia W, Zhang Z, Chen Q, Wang D. Prognostic value of pretreatment neutrophil-to-lymphocyte ratio in renal cell carcinoma: a systematic review and meta-analysis. BMC Urol 2020; 20:90. [PMID: 32631294 PMCID: PMC7339475 DOI: 10.1186/s12894-020-00665-8] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 06/30/2020] [Indexed: 12/11/2022] Open
Abstract
Background Numerous studies show that the pretreatment neutrophil-to-lymphocyte ratio (NLR) is associated with the prognosis of patients with RCC. However, their findings are inconsistent, urging us to explore the prognostic value of NLR in RCC patients. Methods This study was pre-registered in PROSPERO (CRD42020167131). Two reviewers independently performed a systematical search of PubMed, Web of Science, EMBASE, and Cochrane Library databases for prospective or retrospective cohort studies investigating the prognostic value of pretreatment NLR. Hazard ratios with 95% confidence intervals for overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), cancer-specific survival (CSS), and other useful clinicopathological features were extracted and analyzed with fixed or random-effect models by using Review Manager 5.3 and Stata 12.0 software. Heterogeneity was estimated on the basis of Cochran’s Q test and I2 value. Sensitivity analyses and subgroup analyses were also performed to explore the potential sources of heterogeneity. Publication bias was assessed with funnel plots and precisely assessed by Egger’s tests. The quality of the evidence was evaluated in accordance with the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results Overall, 6461 RCC patients from 24 retrospective studies and 1 prospective study were included. In overall population, elevated pretreatment NLR was associated with poorer OS (pooled HR = 1.90, 95% CI = 1.56–2.30, p < 0.001; I2 = 87%), DFS/PFS (pooled HR = 2.09, 95% CI: 1.49–2.94, p < 0.001; I2 = 99%), and CSS (pooled HR = 2.31, 95% CI: 1.61–3.33, p < 0.001; I2 = 14%). Furthermore, this negative association was further confirmed in patients with nonmetastatic and metastatic RCC patients, respectively. We also investigated the predictive role of NLR in metastatic RCC patients treated with immune checkpoint inhibitors (ICIs). The results indicated that the level of NLR was significantly associated with OS (pooled HR = 3.92, 95% CI: 2.00–7.69, p < 0.001; I2 = 0%) and PFS (pooled HR = 2.20, 95% CI: 95% CI: 1.61–3.01, p < 0.001; I2 = 20%). Conclusions This study demonstrated that elevated pretreatment NLR was significantly associated with poor prognosis of RCC patients. NLR could be helpful as a potential prognostic biomarker to guide clinical decision-making and select individualized treatment strategies for RCC patients.
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Affiliation(s)
- Yuan Shao
- Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Bo Wu
- Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Wei Jia
- Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Zikuan Zhang
- Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Qian Chen
- Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Dongwen Wang
- Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China. .,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, 518116, People's Republic of China.
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Yesil Cinkir H, Elboga U. The effect of systemic inflammation indexes and 18FDG PET metabolic parameters on survival in advanced lung adenocarcinoma. TUMORI JOURNAL 2020; 106:312-318. [PMID: 32326835 DOI: 10.1177/0300891620915789] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To determine the effect of systemic inflammation indexes and fluorine-18 fluorodeoxyglucose (18FDG) positron emission tomography (PET) metabolic parameters on survival in advanced lung adenocarcinoma. METHODS A total of 133 patients who underwent 18FDG PET for initial staging were investigated retrospectively. Baseline patient characteristics, routine blood test results, 18FDG PET metabolic parameters, and treatment history were examined. Overall survival (OS) was demonstrated by Kaplan-Meier analysis, and the curves were compared by the log-rank test. Systemic inflammation response index (SIRI) was defined as neutrophil x monocyte/lymphocyte count. RESULTS Lymphocyte/monocyte ratio (LMR) and SIRI were found to be significant for OS. The cutoff point was 2.25 for LMR. Median OS was 8 months for ⩽2.25 and 14 months for >2.25 (p = 0.005). For SIRI, the cutoff point was 2. SIRI ⩽2 was associated with a median OS of 16 months compared to 10 months for patients with SIRI >2 (p = 0.043). Maximum of standardized uptake value, total lesion glycolysis, and metabolic tumor volume were not found to be significant for OS (p = 0.225, p = 0.061, p = 0.355, respectively). No correlation was found between inflammatory indexes and PET metabolic parameters. CONCLUSION Age and LMR parameters were prognostic for survival in Cox regression analysis. There was no correlation between 18FDG PET parameters and inflammatory indexes.
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Affiliation(s)
- Havva Yesil Cinkir
- Department of Medical Oncology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Umut Elboga
- Department of Nuclear Medicine, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
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Ishihara H, Tachibana H, Takagi T, Kondo T, Fukuda H, Yoshida K, Iizuka J, Kobayashi H, Okumi M, Ishida H, Tanabe K. Predictive Impact of Peripheral Blood Markers and C-Reactive Protein in Nivolumab Therapy for Metastatic Renal Cell Carcinoma. Target Oncol 2020; 14:453-463. [PMID: 31359231 DOI: 10.1007/s11523-019-00660-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Predictive factors that can be routinely used in clinical practice are critically needed for immune checkpoint inhibitor therapy in metastatic renal cell carcinoma (mRCC). OBJECTIVE To comprehensively analyze the predictive impact of peripheral blood markers and C-reactive protein (CRP) in nivolumab therapy for mRCC. METHODS Fifty-eight patients were retrospectively evaluated. We evaluated neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), platelet-to-lymphocyte ratio (PLR), absolute eosinophil count (AEC), and absolute monocyte count (AMC) as peripheral blood markers as well as serum CRP levels. The primary endpoints were progression-free survival (PFS) and overall survival (OS) after nivolumab initiation. RESULTS Median PFS was significantly shorter in patients with high NLR (≥ 3) versus low NLR (p = 0.0356), high MLR (≥ 0.3) versus low MLR (p = 0.0013), or high PLR (≥ 160) versus low PLR (p = 0.0073), and median OS was significantly shorter in patients with high NLR versus low NLR (p = 0.0025), high MLR versus low MLR (p = 0.0025), high PLR versus low PLR (p = 0.0256), or high CRP (≥ 1.0 mg/dl) versus low CRP (p = 0.0006). Multivariate analyses showed that MLR (HR 2.65, p = 0.0068) was an independent factor for PFS and that NLR (HR 3.34, p = 0.0218), MLR (HR 3.42, p = 0.0381), and CRP (HR 4.98, p = 0.0108) were independent factors for OS. CONCLUSIONS The systemic inflammatory factors NLR, MLR, and CRP were predictive factors in nivolumab therapy for mRCC. These easily monitored factors can contribute to effective treatment and follow-up.
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Affiliation(s)
- Hiroki Ishihara
- Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Hidekazu Tachibana
- Department of Urology, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan
| | - Toshio Takagi
- Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Tsunenori Kondo
- Department of Urology, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan.
| | - Hironori Fukuda
- Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Kazuhiko Yoshida
- Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Junpei Iizuka
- Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Hirohito Kobayashi
- Department of Urology, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo, 116-8567, Japan
| | - Masayoshi Okumi
- Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Hideki Ishida
- Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Kazunari Tanabe
- Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan
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Identification of Four Pathological Stage-Relevant Genes in Association with Progression and Prognosis in Clear Cell Renal Cell Carcinoma by Integrated Bioinformatics Analysis. BIOMED RESEARCH INTERNATIONAL 2020; 2020:2137319. [PMID: 32309427 PMCID: PMC7142335 DOI: 10.1155/2020/2137319] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 03/09/2020] [Indexed: 12/13/2022]
Abstract
Clear cell renal cell carcinoma (ccRCC) is a major histological subtype of renal cell carcinoma and can be clinically divided into four stages according to the TNM criteria. Identifying clinical stage-related genes is beneficial for improving the early diagnosis and prognosis of ccRCC. By using bioinformatics analysis, we aim to identify clinical stage-relevant genes that are significantly associated with the development of ccRCC. First, we analyzed the gene expression microarray data sets: GSE53757 and GSE73731. We divided these data into five groups by staging information-normal tissue and ccRCC stages I, II, III, and IV-and eventually identified 500 differentially expressed genes (DEGs). To obtain precise stage-relevant genes, we subsequently applied weighted gene coexpression network analysis (WGCNA) to the GSE73731 dataset and KIRC data from The Cancer Genome Atlas (TCGA). Two modules from each dataset were identified to be related to the tumor TNM stage. Several genes with high inner connection inside the modules were considered hub genes. The intersection results between hub genes of key modules and 500 DEGs revealed UBE2C, BUB1B, RRM2, and TPX2 as highly associated with the stage of ccRCC. In addition, the candidate genes were validated at both the RNA expression level and the protein level. Survival analysis also showed that 4 genes were significantly correlated with overall survival. In conclusion, our study affords a deeper understanding of the molecular mechanisms associated with the development of ccRCC and provides potential biomarkers for early diagnosis and individualized treatment for patients at different stages of ccRCC.
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Zhou S, Yuan H, Wang J, Hu X, Liu F, Zhang Y, Jiang B, Zhang W. Prognostic value of systemic inflammatory marker in patients with head and neck squamous cell carcinoma undergoing surgical resection. Future Oncol 2020; 16:559-571. [PMID: 32166977 DOI: 10.2217/fon-2020-0010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Aim: To explore the prognostic value of the systemic inflammatory marker (SIM) based on neutrophil, lymphocyte and monocyte counts in head and neck squamous cell carcinoma (HNSCC) patients. Patients & methods: We retrospectively collected the data of 367 patients with HNSCC who underwent surgery. The Kaplan-Meier survival analysis and Cox regression analysis were conducted on disease-free survival and overall survival. Results: A high SIM (>1.34) was associated with larger tumor size, advanced clinical stage and shorter survival time. The survival analysis showed that only clinical stage and SIM were independent prognostic indicators of disease-free survival and overall survival. Conclusion: The SIM positively correlated with tumor progression and might be a powerful prognostic indicator of poor outcome in patients with HNSCC.
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Affiliation(s)
- Shichao Zhou
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201900, PR China
| | - Haihua Yuan
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201900, PR China
| | - Jiongyi Wang
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201900, PR China
| | - Xiaohua Hu
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201900, PR China
| | - Feng Liu
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201900, PR China
| | - Yanjie Zhang
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201900, PR China
| | - Bin Jiang
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201900, PR China
| | - Wenying Zhang
- Department of Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 201900, PR China
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50
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Valero C, Zanoni DK, McGill MR, Ganly I, Morris LGT, Quer M, Shah JP, Wong RJ, León X, Patel SG. Pretreatment peripheral blood leukocytes are independent predictors of survival in oral cavity cancer. Cancer 2019; 126:994-1003. [PMID: 31809562 DOI: 10.1002/cncr.32591] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 10/02/2019] [Accepted: 10/02/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Inflammation and immune surveillance evasion are cancer hallmarks. Peripheral blood leukocytes (PBLs) represent both. The aim of the current study was to examine PBLs as predictors of outcomes in oral cavity squamous cell carcinoma (OSCC), and to find specific cutoffs with the goal of including PBLs as host factor in patients' preoperative risk assessment. METHODS Previously established head and neck squamous cell carcinoma (HNSCC) cutoffs were examined in an independent cohort of 1369 OSCC patients. Then optimal OSCC cutoffs were found and validated in the subset of patients with OSCC (n = 119) from the external HNSCC cohort. The PBLs analyzed were neutrophils, monocytes, and lymphocytes individually, the neutrophil-to-lymphocyte ratio (NLR), and a combined index using all PBLs called Systemic Inflammation Response Index (SIRI). RESULTS All parameters were significant predictors of survival using the previous cutoffs. However, OSCC cutoffs stratified survival outcomes better. Considering neutrophils ≤4.8 × 109 /L as reference, patients with 4.8-9.1 × 109 /L neutrophils had 1.536 times higher risk of death (95% CI, 1.295-1.822), and patients with ≥9.1 × 109 /L had 3.076 times higher risk (95% CI: 2.170-4.360). All PBLs maintained independent prognostic capacity in multivariable analysis. Neutrophils, NLR, and SIRI were significant predictors of survival when validating OSCC cutoffs in the external validation cohort. CONCLUSIONS Pretreatment peripheral blood neutrophils, NLR, and SIRI are the most robust independent predictors of overall survival among all PBLs in OSCC. The authors report externally validated cutoffs that demonstrate the feasibility of including PBLs as host features in the preoperative prognostication of OSCC.
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Affiliation(s)
- Cristina Valero
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Daniella K Zanoni
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marlena R McGill
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ian Ganly
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Luc G T Morris
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Miquel Quer
- Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jatin P Shah
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York.,Department of Oncology, Radiotherapy, and Plastic Surgery, Sechenov University, Bol'shaya Purogovskaya Ulitsa, 19c1, Moscow, Russia
| | - Richard J Wong
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Xavier León
- Department of Otorhinolaryngology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Snehal G Patel
- Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
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