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Comparative Study
. 2017 Sep 14;23(34):6261-6272.
doi: 10.3748/wjg.v23.i34.6261.

Systemic immune-inflammation index for predicting prognosis of colorectal cancer

Jian-Hui Chen  1 , Er-Tao Zhai  1 , Yu-Jie Yuan  1 , Kai-Ming Wu  1 , Jian-Bo Xu  1 , Jian-Jun Peng  1 , Chuang-Qi Chen  1 , Yu-Long He  1 , Shi-Rong Cai  1
Affiliations
Comparative Study

Systemic immune-inflammation index for predicting prognosis of colorectal cancer

Jian-Hui Chen et al. World J Gastroenterol. .

Abstract

Aim: To investigate the clinical significance of preoperative systemic immune-inflammation index (SII) in patients with colorectal cancer (CRC).

Methods: A retrospective analysis of 1383 cases with CRC was performed following radical surgery. SII was calculated with the formula SII = (P × N)/L, where P, N, and L refer to peripheral platelet, neutrophil, and lymphocyte counts, respectively. The clinicopathological features and follow-up data were evaluated to compare SII with other systemic inflammation-based prognostic indices such as the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in patients with CRC.

Results: The optimal cut-off point for SII was defined as 340. The overall survival (OS) and disease-free survival (DFS) were better in patients with low NLR, PLR, and SII (P < 0.05). The SII was an independent predictor of OS and DFS in multivariate analysis. The area under the receiver-operating characteristics (ROC) curve for SII (0.707) was larger than those for NLR (0.602) and PLR (0.566). In contrast to NLR and PLR, SII could effectively discriminate between the TNM subgroups.

Conclusion: SII is a more powerful tool for predicting survival outcome in patients with CRC. It might assist the identification of high-risk patients among patients with the same TNM stage.

Keywords: Colorectal cancer; Neutrophil-lymphocyte ratio; Platelet-lymphocyte ratio; Prognosis; Systemic immune-inflammation index.

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Conflict of interest statement

Conflict-of-interest statement: The authors have no conflict of interest related to the manuscript.

Figures

Figure 1
Figure 1
Kaplan-Meier curves of overall survival and disease-free survival of colorectal cancer patients based on neutrophil-lymphocyte ratio (A and D), platelet-lymphocyte ratio (B and E), and systemic immune-inflammation index (C and F).
Figure 2
Figure 2
Receiver operating curve analysis of overall survival (A) and disease-free survival (B). NLR: Neutrophil-lymphocyte ratio; PLR: Platelet-lymphocyte ratio; SII: Systemic immune-inflammation index.
Figure 3
Figure 3
Kaplan-Meier curves of overall survival and disease-free survival of colorectal cancer patients based on different levels of systemic immune-inflammation index. A-D: OS for cases with stages I, II, III, and IV CRC, respectively; E and F: DFS for cases with stages I, II, III, and IV CRC, respectively. OS: Overall survival; DFS: Disease-free survival; CRC: Colorectal cancer.
Figure 4
Figure 4
Kaplan-Meier curves of overall survival and disease-free survival of colorectal cancer patients based on different levels of neutrophil-lymphocyte ratio. A-D: OS for cases with stages I, II, III, and IV CRC, respectively; E and F: DFS for cases with stages I, II, III, and IV CRC, respectively. OS: Overall survival; DFS: Disease-free survival; CRC: Colorectal cancer; NLR: Neutrophil-lymphocyte ratio.
Figure 5
Figure 5
Kaplan-Meier curves of overall survival and disease-free survival of colorectal cancer patients based on different levels of platelet-lymphocyte ratio. A-D: OS for cases with stages I, II, III, and IV CRC, respectively; E-F: DFS for cases with stages I, II, III, and IV CRC, respectively. OS: Overall survival; DFS: Disease-free survival; CRC: Colorectal cancer; PLR: Platelet-lymphocyte ratio.
See this image and copyright information in PMC

References

    1. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65:87–108. - PubMed
    1. Edwards BK, Ward E, Kohler BA, Eheman C, Zauber AG, Anderson RN, Jemal A, Schymura MJ, Lansdorp-Vogelaar I, Seeff LC, et al. Annual report to the nation on the status of cancer, 1975-2006, featuring colorectal cancer trends and impact of interventions (risk factors, screening, and treatment) to reduce future rates. Cancer. 2010;116:544–573. - PMC - PubMed
    1. Arnold M, Sierra MS, Laversanne M, Soerjomataram I, Jemal A, Bray F. Global patterns and trends in colorectal cancer incidence and mortality. Gut. 2017;66:683–691. - PubMed
    1. Brenner H, Kloor M, Pox CP. Colorectal cancer. Lancet. 2014;383:1490–1502. - PubMed
    1. Fan XJ, Wan XB, Fu XH, Wu PH, Chen DK, Wang PN, Jiang L, Wang DH, Chen ZT, Huang Y, et al. Phosphorylated p38, a negative prognostic biomarker, complements TNM staging prognostication in colorectal cancer. Tumour Biol. 2014;35:10487–10495. - PubMed

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