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Sørensen NV, Hasseldam H, Johansen FF, Kristiansen U, Overgaard K, Klingenberg Iversen H, Rasmussen RS. Long-term immune cell profiling in stroke patients with or without infections. Int J Neurosci 2024; 134:197-205. [PMID: 35791087 DOI: 10.1080/00207454.2022.2098733] [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: 11/05/2021] [Accepted: 06/30/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Infections are frequent complications in acute ischemic stroke and may be caused by an altered immune response influencing brain damage. We compared long-term immune responses in stroke patients with or without infections during the recovery period by performing a long-term profiling of clinically relevant inflammatory parameters from stroke onset until day 49. MATERIALS AND METHODS Thirty-four stroke patients were retrospectively included and divided into two groups depending on infection status. Group 1 had no infections (N = 17) and group 2 had post-admission infection (N = 17). The patients were evaluated carefully for infections and evolution of the peripheral inflammatory response. Neutrophils, monocytes, lymphocytes, total leukocytes and C-reactive protein were evaluated in relation to the occurrence and development of infections. In both patient groups, an acute boost in neutrophils and monocytes were observed whereas the opposite was true for lymphocytes. RESULTS In Group 1, neutrophils and monocytes approached normal levels after 20-30 days, but remained elevated in Group 2. We found an increase in neutrophils (p = 0.01) and leukocytes (p < 0.01) as well as C-reactive protein (p < 0.01) among infected patients. Lymphocytes remained depressed in Group 2, while Group 1 slowly approached baseline levels. In both groups, CRP levels initially increased with a slow return to baseline levels. From day 0 to 49 after stroke, uninfected patients generally experienced a decline in leukocytes, neutrophils and monocytes (all p < 0.05), while no similar changes happened among infected patients. CONCLUSIONS Our study provides an overview of general immune cell kinetics after stroke related to infection status. Immune cell numbers were severely disturbed for weeks after the insult, independent of infection status, although infected patients achieved the highest cell counts of neutrophils, leukocytes and for C-reactive protein. The sustained depression of lymphocytes, especially and paradoxically among infected patients, warrants future studies into the mechanisms behind this, with potential for future therapies aimed at restoring normal immunity and thereby improving patient outcome.
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Affiliation(s)
| | - Henrik Hasseldam
- Biotech Research and Innovation Center, University of Copenhagen, Copenhagen, Denmark
| | | | - Uffe Kristiansen
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Karsten Overgaard
- Department of Neurology, University Hospital of Copenhagen, Herlev, Denmark
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Liu W, Wang J, Wang M, Ding X, Wang M, Liu M. Association between immune-inflammatory indexes and lower urinary tract symptoms: an analysis of cross-sectional data from the US National Health and Nutrition Examination Survey (2005-2008). BMJ Open 2024; 14:e080826. [PMID: 38521530 PMCID: PMC10961552 DOI: 10.1136/bmjopen-2023-080826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 03/08/2024] [Indexed: 03/25/2024] Open
Abstract
OBJECTIVE This study aimed to systematically investigate the relationship between immune-inflammatory indexes with lower urinary tract symptoms (LUTSs). DESIGN Cross-sectional study. SETTING National Health and Nutrition Examination Survey (NHANES) (2005-2008). PARTICIPANTS A total of 2709 men with complete information for immune-inflammatory indexes and LUTSs were included from NHANES 2005-2008. OUTCOMES AND ANALYSES Automated haematology analysing devices are used to measure blood cell counts, and LUTSs were presented by standard questionnaires. Non-linear and logistic regression analyses were used to estimate their association after adjustment for confounders. RESULTS Multivariate logistic regression showed that pan-immune-inflammation value (OR (95% CI)=1.60 (1.14 to 2.23)), systemic inflammation response index (SIRI) (OR (95% CI)=1.82 (1.21 to 2.73)), neutrophil/lymphocyte ratio (NLR) (OR (95% CI)=1.81 (1.31 to 2.49)), derived NLR (dNLR) (OR (95% CI)=1.91 (1.35 to 2.70)) and C reactive protein (CRP) (OR (95% CI)=1.71 (1.05 to 2.79)) was positively associated with LUTS. Additionally, composite immune-inflammation markers exhibited a stronger association with LUTS than any single index, with the ORs for high SIRI+high CRP, high NLR+high CRP and high dNLR+high CRP being 2.26, 2.44 and 2.16, respectively (all p<0.05). Furthermore, subgroup analyses revealed that age, smoking status and hypertension have different effects on the relationship between immune-inflammatory markers and LUTS. CONCLUSIONS This study indicated that high levels of immune-inflammatory markers were associated with an increased risk of clinical LUTS. The combination of CRP with SIRI, NLR and dNLR, respectively, showed a stronger positive correlation with clinical LUTS compared with any single index.
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Affiliation(s)
- Wen Liu
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Jia Wang
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China
| | - Miaomiao Wang
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Xin Ding
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Miao Wang
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Ming Liu
- Department of Urology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
- Graduate School of Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 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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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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Lin W, Wang H, Lin ME. Relationship Between Systemic Inflammatory Response Index and Erectile Dysfunction: A Cross-sectional Study. Urology 2023; 181:69-75. [PMID: 37673404 DOI: 10.1016/j.urology.2023.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/08/2023] [Accepted: 08/17/2023] [Indexed: 09/08/2023]
Abstract
OBJECTIVE To explore the association between systemic inflammation response index (SIRI) and erectile dysfunction (ED) in American men. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) between 2001 and 2004 were used. Multivariate logistic regression and restricted cubic spline were used to evaluate the relationship between SIRI and ED. Interaction analysis was performed for subgroups to verify the results. Meanwhile, 1:1 propensity score matching was performed to adjust for potential confounding factors for data reanalysis to confirm the reliability of the results. RESULTS A total of 3543 US adults aged 20years or older were included in the study, of whom 955 participants were considered to have ED. After adjusting for potential confounding factors, we found that compared with the lowest tertiles, the highest tertiles of SIRI showed a positive association with ED, which odd ratio was 1.70 (95%CI: 1.16-2.50). Dose-response curve analysis showed a positive linear correlation between SIRI and ED prevalence. And in the subgroup analysis, the interaction analysis showed that the results were consistent. Meanwhile, the matching of propensity scores further confirmed the validity of the results. CONCLUSION In conclusion, in this cross-sectional study, we found a positive relationship between SIRI and the prevalence of ED. Further experimental studies are needed to explore the underlying mechanism in the future.
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Affiliation(s)
- Weilong Lin
- The First Affiliated Hospital of Shantou University Medical College, Medical College of Shantou University, Shantou, China
| | - Haoxu Wang
- The First Affiliated Hospital of Shantou University Medical College, Medical College of Shantou University, Shantou, China
| | - Ming-En Lin
- The First Affiliated Hospital of Shantou University Medical College, Medical College of Shantou University, Shantou, China.
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da Silva AJ, dos Santos Lopes AC, Mota APL, Silva ACSE, Dusse LMS, Alpoim PN. Pediatric chronic kidney disease: blood cell count indexes as inflammation markers. J Bras Nefrol 2023; 45:458-469. [PMID: 37948452 PMCID: PMC10726671 DOI: 10.1590/2175-8239-jbn-2022-0190en] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 06/11/2023] [Indexed: 11/12/2023] Open
Abstract
INTRODUCTION Chronic kidney disease (CKD) is defined as a progressive decline of kidney functions. In childhood, the main triggering factors are congenital anomalies of the kidneys and urinary tract (CAKUT) and glomerulopathies. Inflammatory responses present challenges for diagnosis and staging, which justifies studies on biomarkers/indexes. AIM To define blood cell count indexes and verify their association with pediatric CKD etiology and staging. The included indexes were: Neutrophil-Lymphocyte Ratio (NLR), Derived Neutrophil-Lymphocyte Ratio (dNLR), Lymphocyte-Monocyte Ratio (LMR), Systemic Inflammation Response Index (SIRI), Aggregate Index of Systemic Inflammation (AISI), and Systemic Immune-Inflammation Index (SII). METHODS We determined the indexes in 52 pediatric CKD patients and 33 healthy controls by mathematical calculation. CKD patients were separated in five groups based on the etiology and staging: Group IA: glomerulopathies at stage 1 or 2; IB: glomerulopathies at stage 3 or 4; IIA: CAKUT at stage 1 or 2; IIB: CAKUT at stage 3 or 4; and III: stages 3 or 4 of other etiologies. In addition, we combined all patients with CKD in one group (IV). Group V was a healthy control group. RESULTS Lower values of LMR were observed for groups IB and IIB compared to group V (p = 0.047, p = 0.031, respectively). Increased values of SIRI were found for group III versus group V (p = 0.030). There was no difference for other indexes when the groups were compared two by two. CONCLUSION The LMR and SIRI indexes showed promising results in the evaluation of inflammation, as they correlated with CKD etiologies and specially staging in these patients.
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Affiliation(s)
- Aislander Junio da Silva
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, MG, Brazil
| | - Ana Cristina dos Santos Lopes
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, MG, Brazil
| | - Ana Paula Lucas Mota
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, MG, Brazil
| | - Ana Cristina Simões e Silva
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Pediatria, Belo Horizonte, MG, Brazil
| | - Luci Maria Sant’Ana Dusse
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, MG, Brazil
| | - Patrícia Nessralla Alpoim
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Análises Clínicas e Toxicológicas, Belo Horizonte, MG, Brazil
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Liang XW, Liu B, Yu HJ, Chen JC, Cao Z, Wang SZ, Wu JC. Prognostic significance of the systemic inflammation response index in gastrointestinal malignancy patients: a pooled analysis of 10,091 participants. Future Oncol 2023; 19:1961-1972. [PMID: 37800335 DOI: 10.2217/fon-2023-0545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
Background: We performed a meta-analysis to investigate the association of the systemic inflammation response index (SIRI) with long-term survival outcomes in patients with gastrointestinal malignancy. Methods: PubMed, Web of Science and Embase were searched for relevant studies evaluating the prognostic significance of the SIRI in gastrointestinal malignancies until May 2023. Results: 30 studies with 10,091 patients were included. The pooled results identified that patients in the high SIRI group had a worse overall survival and disease-free survival, which was observed across various tumor types, tumor stages and primary treatments. Conclusion: An elevated SIRI is negatively associated with worse survival outcomes of gastrointestinal malignancy patients and can be used as a risk stratification index for gastrointestinal malignancies.
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Affiliation(s)
- Xian-Wen Liang
- Department of Hepatobiliary & Pancreatic Surgery, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan Province, 570311, China
| | - Bing Liu
- Department of Gastrointestinal Surgery, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, 570208, China
| | - Hai-Jing Yu
- Department of International Nursing School, Hainan Medical University, Haikou, Hainan Province, 570102, China
| | - Jia-Cheng Chen
- Department of Hepatobiliary & Pancreatic Surgery, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan Province, 570311, China
| | - Zhi Cao
- Department of Hepatobiliary & Pancreatic Surgery, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan Province, 570311, China
| | - Sheng-Zhong Wang
- Department of Gastrointestinal Surgery, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, 570208, China
| | - Jin-Cai Wu
- Department of Hepatobiliary & Pancreatic Surgery, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan Province, 570311, China
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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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Zhou S, Zhao Y, Lu Y, Liang W, Ruan J, Lin L, Lin H, Huang K. Cancer-specific survival in patients with cholangiocarcinoma after radical surgery: a Novel, dynamic nomogram based on clinicopathological features and serum markers. BMC Cancer 2023; 23:533. [PMID: 37308861 DOI: 10.1186/s12885-023-11040-9] [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: 12/20/2022] [Accepted: 06/05/2023] [Indexed: 06/14/2023] Open
Abstract
BACKGROUND This study aims to (1) identify preoperative testing-based characteristics associated with enhanced prognosis and survival for cholangiocarcinoma patients, and (2)create a distinctive nomogram to anticipate each patient's cancer-specific survival (CSS). METHODS Retrospective analysis was performed on 197 CCA patients who underwent radical surgery at Sun Yat-sen Memorial Hospital; they were divided into a 131-person "training cohort" and a 66-person "internal validation cohort." The prognostic nomogram was created following a preliminary Cox proportional hazard regression search for independent factors influencing the patients' CSS. Its applicable domain was examined via an external validation cohort, which included 235 patients from the Sun Yat-sen University Cancer Center. RESULTS The median follow-up period for the 131 patients in the training group was 49.3 months (range, 9.3 to 133.9 months). One-, three-, and five-year CSS rates were 68.7%, 24.5%, and 9.2%, respectively, with the median CSS length being 27.4 months (range: 1.4 to 125.2 months). PLT, CEA, AFP, tumor location, differentiation, lymph node metastasis, chemotherapy, and TNM stage were determined to be independent risk factors for CCA patients by univariate and multivariate Cox proportional hazard regression analysis. We were able to accurately predict postoperative CSS after incorporating all of these characteristics into a nomogram. The AJCC's 8th edition staging method's C-indices were statistically substantially (P < 0.001) lower than the nomogram's C-indices (0.84, 0.77, and 0.74 in the training, internal and external validation cohorts respectively). CONCLUSIONS A realistic and useful model for clinical decision-making and the optimization of therapy is presented as a nomogram that includes serum markers and clinicopathologic features for predicting postoperative survival in cholangiocarcinoma.
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Affiliation(s)
- Shurui Zhou
- Department of Gastroenterology, Zhongshan School of Medicine, Sun Yat-sen Memorial Hospital, Sun Yat- sen University, The 107th of Yanjiang West Road, Guangzhou, 510120, China
| | - Yue Zhao
- Department of Gastroenterology, Zhongshan School of Medicine, Sun Yat-sen Memorial Hospital, Sun Yat- sen University, The 107th of Yanjiang West Road, Guangzhou, 510120, China
| | - Yanzong Lu
- Department of Ophthalmology, No.903 Hospital of PLA Joint Logistic Support Force, Hangzhou, 310013, China
| | - Weiling Liang
- Department of Gastroenterology, Zhongshan School of Medicine, Sun Yat-sen Memorial Hospital, Sun Yat- sen University, The 107th of Yanjiang West Road, Guangzhou, 510120, China
| | - Jianmin Ruan
- Department of Gastroenterology, Zhongshan School of Medicine, Sun Yat-sen Memorial Hospital, Sun Yat- sen University, The 107th of Yanjiang West Road, Guangzhou, 510120, China
| | - Lijun Lin
- Department of Gastroenterology, Zhongshan School of Medicine, Sun Yat-sen Memorial Hospital, Sun Yat- sen University, The 107th of Yanjiang West Road, Guangzhou, 510120, China
| | - Haoming Lin
- Department of Pancreatobiliary Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, The 107th of Yanjiang West Road, Guangzhou, 510120, China.
| | - Kaihong Huang
- Department of Gastroenterology, Zhongshan School of Medicine, Sun Yat-sen Memorial Hospital, Sun Yat- sen University, The 107th of Yanjiang West Road, Guangzhou, 510120, China.
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Li N, Zhang Y, Qu W, Zhang C, Ding Z, Wang L, Cui B. Analysis of systemic inflammatory and coagulation biomarkers in advanced cervical cancer: Prognostic and predictive significance. Int J Biol Markers 2023:3936155231163599. [PMID: 36927209 DOI: 10.1177/03936155231163599] [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: 03/18/2023]
Abstract
OBJECTIVE Peripheral systemic inflammatory, nutritional, and coagulation biomarkers have prognostic and predictive value in various malignancies. We evaluated the prognostic and predictive roles of systemic inflammatory, nutritional, and coagulation biomarkers in the circulating blood of patients with advanced cervical cancer. METHODS A retrospective study of 795 patients with cervical cancer who received concurrent chemoradiation therapy was performed. Overall survival was evaluated by the Kaplan-Meier estimator. Univariate and multivariate Cox regression models were used to determine prognostic factors associated with overall survival. RESULTS The median follow-up time was 76 months. In the univariate analysis, overall survival showed positive prognostic value in patients with a platelet-to-lymphocyte ratio (PLR) <164.29 (P = 0.010), and a plasma fibrinogen (FIB) level <4 g/L(P = 0.012). In the multivariate analysis, the PLR (P = 0.036), and FIB level (P = 0.047) maintained their significance for overall survival. Therefore, the PLR and FIB levels are independent prognostic factors in patients with advanced cervical cancer. CONCLUSIONS Systemic inflammatory and coagulation biomarkers could help to understand survival differences in the clinical treatment of advanced cervical cancer. The PLR and FIB levels are independent prognostic factors of poor survival in patients with advanced cervical cancer.
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Affiliation(s)
- Ningfeng Li
- Department of Gynecology, 117907Weifang People's Hospital, Weifang, China
| | - Yan Zhang
- Department of Gynecology, 117907Weifang People's Hospital, Weifang, China
| | - Wenjie Qu
- Department of Obstetrics and Gynecology, 91623Qilu Hospital of Shandong University, Jinan, China
| | - Chao Zhang
- Department of Emergency, 235960The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhaoxia Ding
- Department of Gynecology, 235960The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Linlin Wang
- Department of Radiation Oncology, Shandong Academy of Medical Science, 71107Shandong Cancer Hospital Affiliated to Shandong University, Jinan, China
| | - Baoxia Cui
- Department of Obstetrics and Gynecology, 91623Qilu Hospital of Shandong University, Jinan, China
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12
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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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The Combination of Inflammatory Biomarkers as Prognostic Indicator in Salivary Gland Malignancy. Cancers (Basel) 2022; 14:cancers14235934. [PMID: 36497416 PMCID: PMC9740974 DOI: 10.3390/cancers14235934] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/23/2022] [Accepted: 11/29/2022] [Indexed: 12/02/2022] Open
Abstract
Background: The aim of this study was to investigate how the systemic inflammation response index (SIRI), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), taken individually and combined, are associated with overall survival (OS) in patients surgically treated for malignant salivary gland tumors (MSGTs). Methods: A retrospective analysis of 74 cases following surgery at our department between January 2011 and June 2018 was performed. The Receiver Operating Characteristic (ROC) curve was used to calculate the optimal cutoff values for SII, SIRI, PLR, and NLR. Survival curves of different groups at 1−3−5 years were estimated using the Kaplan−Meier method. Results: The optimal thresholds with the highest sensitivity and specificity were 3.95 for NLR, 187.6 for PLR, 917.585 for SII, and 2.045 for SIRI. The ROC curves revealed that the best combination with AUC = 0.884 was SII + SIRI. The estimated 5-year OS probability in patients with SII+ SIRI scores of 0, 1, and 2 was 96%, 87.5% and 12.5%, respectively (p < 0.001). Conclusion: SII+ SIRI can independently predict the OS of patients after MSGT surgery. The prognostic score system based on SII+ SIRI may be good clinical practice as a reference for clinical decision-making.
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14
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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: 12] [Impact Index Per Article: 6.0] [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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Wang S, Feng Y, Xie Y, Zhao X, Ma J, Liu X, Hu C, Hou T. High fibrinogen-albumin ratio index (FARI) predicts poor survival in head and neck squamous cell carcinoma patients treated with surgical resection. Eur Arch Otorhinolaryngol 2022; 279:4541-4548. [DOI: 10.1007/s00405-022-07391-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 04/04/2022] [Indexed: 12/24/2022]
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16
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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: 27] [Impact Index Per Article: 13.5] [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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Luo Z, Jiao B, Huang T, Zhao H, Zhang G. What is the Role of the Preoperative Blood-Based Inflammation Biomarkers in the Prognosis of Upper Tract Urothelial Carcinoma With Radical Nephroureterectomy? A Single-Centre Retrospective Study. Technol Cancer Res Treat 2022; 21:15330338221095667. [PMID: 35585719 PMCID: PMC9127859 DOI: 10.1177/15330338221095667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective: To assess the prognostic value of preoperative blood-based inflammation biomarkers, including the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR), on the survival outcomes of patients with upper tract urothelial carcinoma (UTUC) following radical nephroureterectomy (RNU). Methods: We retrospectively studied the data of 172 patients who were diagnosed with UTUC after RNU during 2008 to 2018. We determined the cut-off value by using X-tile software. The area under the curve (AUC) and concordance index (C-index) were utilized to compare the predictive accuracy between subgroups. We also performed decision curve analysis (DCA) to evaluate the clinical net benefit of prognostic models. The Kaplan-Meier method and Cox proportional hazards regression models were performed to evaluate the association between these inflammation biomarkers and survival outcomes. Results: The median follow-up period was 45.5 (range: 1-143; interquartile range, IQR: 27-77) months. Kaplan-Meier analyses showed that a high NLR or PLR significantly reduced overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS) and metastasis-free survival (MFS), and a low LMR markedly decreased RFS and MFS. The multivariate Cox proportional hazards model revealed that the NLR plus PLR was an independent predictor of worse survival (all P < .05). Additionally, the AUC and C-index of the new prognostic models were the largest for the 1- to 5-year OS, CSS, RFS, and MFS were the largest. Conclusion: Our study confirms that the combination of preoperative NLR and PLR could be an independent risk factor for UTUC patients who have undergone RNU. The addition of NLR and PLR may improve the accuracy of current prognostic models and help guide clinical strategies in the treatment of UTUC.
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Affiliation(s)
- Zhenkai Luo
- 569810Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.,National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Binbin Jiao
- 569810Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.,Department of Urology, 36635China-Japan Friendship Hospital, Beijing, China
| | - Tao Huang
- Department of Urology, 36635China-Japan Friendship Hospital, Beijing, China.,Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
| | - Hang Zhao
- Department of Urology, 36635China-Japan Friendship Hospital, Beijing, China.,Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
| | - Guan Zhang
- 569810Graduate School of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.,Department of Urology, 36635China-Japan Friendship Hospital, Beijing, China.,Peking University China-Japan Friendship School of Clinical Medicine, Beijing, China
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18
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Systemic inflammation response index predicts all-cause mortality in patients with antineutrophil cytoplasmic antibody-associated vasculitis. Int Urol Nephrol 2021; 53:1631-1638. [PMID: 33428165 DOI: 10.1007/s11255-020-02777-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/26/2020] [Indexed: 12/23/2022]
Abstract
OBJECTIVES A systemic inflammation response index (SIRI) has been recently introduced as a tool for the assessment of the prognosis of several critical medical conditions. In this study, we investigated whether SIRI at diagnosis could estimate the cross-sectional disease activity and predict poor prognosis during follow-up in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). METHODS We reviewed the medical records of 224 immunosuppressive drug-naïve AAV patients and obtained clinical and laboratory data both at diagnosis and during follow-up. SIRI was calculated using the following equation: SIRI = peripheral blood neutrophil count × monocyte count/lymphocyte count. RESULTS The median age of AAV patients at diagnosis was 59.0 years and 33% were male. In the univariable linear regression analysis, SIRI value at diagnosis was not significantly correlated with the cross-sectional Birmingham vasculitis activity score (BVAS) (r = 0.125, P = 0.062). When the SIRI cut-off value at diagnosis was set at 2847.9 mm-3 using the receiver operator characteristic curve, the sensitivity was 56.0% and the specificity was 68.3% for all-cause mortality [area 0.618, 95% confidence interval (CI) 0.502, 0.734]. AAV patients with SIRI ≥ 2847.9 mm-3 had a significantly higher risk for all-cause mortality than those with SIRI < 2847.9 mm-3 [relative risk (RR) 2.747, 95% CI 1.181, 6.392]. During follow-up, AAV patients with SIRI ≥ 2847.9 mm-3 exhibited a significantly lower patients' survival rate than those with SIRI < 2847.9 mm-3 (P = 0.003). CONCLUSIONS SIRI at diagnosis could predict all-cause mortality during follow-up but it could not estimate the cross-sectional BVAS in AAV patients.
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Gao X, Pan Y, Zhou L, Li Y, Lin B, Zheng Y. The Fib-PNI-MLR Score, an Integrative Model of Coagulation Cascades, Nutrition Status, and Systemic Inflammatory Response, Predicts Urological Outcomes After Surgery in Patients With Non-Metastatic Renal Cell Carcinoma. Front Oncol 2021; 10:555152. [PMID: 33489870 PMCID: PMC7819501 DOI: 10.3389/fonc.2020.555152] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 11/23/2020] [Indexed: 01/20/2023] Open
Abstract
Cancer-associated inflammation, activation of coagulation cascades, and malnutrition are closely related to the prognosis of patients with malignancy, including renal cell carcinoma (RCC). This study aimed to investigate the prognostic value of a combination of preoperative plasma fibrinogen, prognostic nutritional index, and monocyte-to-lymphocyte ratio (Fib-PNI-MLR) in patients with non-metastatic RCC undergoing nephrectomy. We retrospectively collected medical data from 829 of the 1,019 cases of RCC. The optimal cutoff values of fibrinogen (≥3.54 vs. <3.54, mg/dl), PNI (<47.03 vs. ≥47.03), and MLR (≥0.29 vs. <0.29) were defined using receiver operating characteristic (ROC) analysis and the Fib-PNI-MLR score (range, 0–3) was determined as the sum of points (0 or 1) assigned to each indicator. As a result, Fib-PNI-MLR was an independent risk factor for overall survival (OS), cancer-specific survival (CSS), and metastatic-free survival (MFS) (all P < 0.05). The concordance-index and area under the curve (AUC) were larger for the Fib-PNI-MLR score than that for other clinical parameters. Subgroup analysis (Fuhrman grade G1+G2 and Fuhrman grade G3+G4; pathologic T1, T2, and T3–4 stage) revealed the significant association of a higher Fib-PNI-MLR score with poor urological outcomes (all P < 0.05). Data indicated that patients with higher Fib-PNI-MLR might benefit from partial nephrectomy. The Fib-PNI-MLR score might serve as a promising prognostic factor in patients with non-metastatic RCC.
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Affiliation(s)
- Xiaomin Gao
- Department of Hematology, The Third Clinical Institute Affiliated to Wenzhou Medical University, People's Hospital of Wenzhou, Wenzhou, China.,Department of Urology, Changhai Hospital, Second Military Medical University, Shanghai, China.,Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yue Pan
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lina Zhou
- Department of Nephrology, The Third Clinical Institute Affiliated to Wenzhou Medical University, People's Hospital of Wenzhou, Wenzhou, China
| | - Yeping Li
- Department of Urology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Binwei Lin
- Department of Urology, Rui'an People's Hospital, The Third Affiliated Hospital of the Wenzhou Medical University, Wenzhou, China
| | - Yangqin Zheng
- Department of Hematology, The Third Clinical Institute Affiliated to Wenzhou Medical University, People's Hospital of Wenzhou, Wenzhou, China
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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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Shao Y, Li W, Wang D, Wu B. Prognostic value of preoperative lymphocyte-related systemic inflammatory biomarkers in upper tract urothelial carcinoma patients treated with radical nephroureterectomy: a systematic review and meta-analysis. World J Surg Oncol 2020; 18:273. [PMID: 33097052 PMCID: PMC7585317 DOI: 10.1186/s12957-020-02048-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/14/2020] [Indexed: 12/17/2022] Open
Abstract
Background Growing evidence shows that the preoperative lymphocyte-related systemic inflammatory biomarkers are associated with the prognosis of patients with upper tract urothelial carcinoma (UTUC). These markers include neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR). However, these findings are inconsistent, and the prognostic significance of these biomarkers is unclear. Moreover, the currently available prognostic indicators do not precisely predict the outcome of UTUC patients. This motivated us to investigate the prognostic values of NLR, PLR, and MLR in UTUC patients treated with radical nephroureterectomy (RNU). Methods We prospectively registered this in PROSPERO (CRD42020186531). We performed a comprehensive literature search of the PubMed, Web of Science, EMBASE, and Cochrane Library databases to identify the eligible studies evaluating the prognostic values of preoperative NLR, PLR, and MLR. Hazard ratios with 95% confidence intervals of overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), recurrence-free survival (RFS), metastasis-free survival (MFS), and progression-free survival (PFS) were extracted from the multivariate analyses and analyzed with fixed or random effects models when applicable. Heterogeneity among the studies was evaluated using Cochran’s Q test and I2 statistic. Sensitivity and subgroup analyses were conducted to explore the origin of heterogeneity. The Newcastle-Ottawa Scale (NOS) was applied to assess the quality of each enrolled study. Publication bias was determined using funnel plots together with Egger’s tests. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the quality of the evidence. Results Overall, we included 10,339 UTUC patients from twenty-five retrospective studies. The results indicated that elevated preoperative NLR, PLR, and MLR were significantly associated with worse OS, CSS, DFS/RFS/MFS, and PFS in the UTUC patients undergoing RNU. Furthermore, the results of sensitivity and subgroup analyses demonstrated the rationality and reliability of the results. Conclusions The present meta-analysis demonstrated a significant association between elevated preoperative NLR, PLR, and MLR and poor prognosis in patients with surgically treated UTUC. Hence, lymphocyte-related systemic inflammatory biomarkers, in conjunction with clinicopathological factors, molecular markers, and other prognostic indicators, could be helpful to determine the primary treatment strategies and to design individualized follow-up plans for UTUC patients. Supplementary Information The online version contains supplementary material available at 10.1186/s12957-020-02048-7.
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Affiliation(s)
- Yuan Shao
- Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Wenxia Li
- 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
| | - Bo Wu
- Department of Urology, First Hospital of Shanxi Medical University, Taiyuan, 030001, Shanxi, People's Republic of 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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