| Yan Ke,Wei Wanyi,Yang Jie,et al.Predictive value of systemic immune-inflammation index combined with clinical staging for prognosis of esophageal cancer patients[J].Chinese Journal of Radiological Medicine and Protection,2022,42(1):25-31 |
| Predictive value of systemic immune-inflammation index combined with clinical staging for prognosis of esophageal cancer patients |
| Received:August 23, 2021 |
| DOI：10.3760/cma.j.cn112271-20210823-00340 |
| KeyWords:Esophageal neoplasms Radiotherapy Systemic immune-inflammation index(SII) Clinical staging Prognosis |
| FundProject: |
| Author Name | Affiliation | E-mail | | Yan Ke | Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Wei Wanyi | Department of Neurology, Hebei General Hospital, Shijiazhuang 050051, China | | | Yang Jie | Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Shen Wenbin | Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Wang Xiaobin | Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Du Xingyu | Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Zhao Hanjun | Department of Respiratory, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | | | Zhu Shuchai | Department of Radiation Oncology, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China | sczhu1965@163.com |
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| Abstract:: |
| Objective To investigate the relationship between systemic immune-inflammation index (SII) and the prognosis of esophageal cancer patients treated with radical radiotherapy and to predict the prognosis of the patients using the SII combined with clinical staging.Methods A retrospective analysis was conducted for 248 patients with esophageal cancer who were admitted to the Department of Radiotherapy in the Fourth Hospital of Hebei Medical University between 2014 and 2016. These patients included 146 males and 102 females, with a median age of 67 years. Among them, 134 patients received concurrent chemotherapy and 114 patients received radiotherapy alone. The SII before radiotherapy was defined as platelet count×neutrophil count/lymphocyte count. The patients were divided into a low-SII group and a high-SII group according to the optimal cutoff value of pretreatment SII determined by the receiver operating characteristics (ROC) curve. Survival analysis was calculated using the Kaplan-Meier method, and the Cox proportional hazards model was used for multivariate analysis. For these patients, the prognosis effects and the predictive value for survival of different SII levels combined with TNM staging were compared.Results According to the ROC curves, the optimal cutoff value of SII before radiotherapy was 740.80. Based on this number, the patients were divided into a low-SII group (< 740.80, 150 cases) and a high-SII group (≥ 740.80, 98 cases). The objective response rate of the low-SII group was significantly higher than that of the high-SII group (86.0% vs 75.5%, χ2=4.39, P=0.036). The 1-, 3-, and 5-year overall survival (OS) rates of the low-SII group were 78.6%, 45.6%, and 32.3%, respectively. These rates were significantly higher than the corresponding rates of the high-SII group, which were 71.0%, 28.3%, and 16.4% (χ2=11.22, P=0.001), respectively. Moreover, the 1-, 3- and 5-year progression-free survival (PFS) rates of the low-SII group were 67.0%, 36.9%, and 32.0%, respectively. Again, these rates were significantly higher than those of the high-SII group, which were 45.5%, 17.5%, and 12.5% (χ2=15.38, P < 0.001), respectively. Multivariate analysis showed that TNM staging, treatment method, and SII were independent prognostic factors for OS and PFS (HR=1.39-1.60, P < 0.05). Patients with low SII and early clinical staging had a better prognosis than other subgroups (χ2=13.68, 13.43, P=0.001). The area under curve (AUC) of SII combined with TNM staging (0.70) was higher than that of SII (0.63) and TNM staging (0.62) (Z=2.48, 2.57, P < 0.05).Conclusions Pretreatment SII has a high predictive value for the prognosis of esophageal cancer after radiotherapy, and higher SII indicates a worse prognosis. Thus, combining SII with TNM staging can improve the prediction accuracy of the prognosis of esophageal cancer patients. |
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