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. 2016 Jul 12;7(28):44185-44193.
doi: 10.18632/oncotarget.9923.

Systemic Immune-Inflammation Index, Thymidine Phosphorylase and Survival of Localized Gastric Cancer Patients After Curative Resection

Free PMC article

Systemic Immune-Inflammation Index, Thymidine Phosphorylase and Survival of Localized Gastric Cancer Patients After Curative Resection

Liu Huang et al. Oncotarget. .
Free PMC article


Systemic immune-inflammation index (SII), based on lymphocyte (L), neutrophil (N), and platelet (P) counts, was recently developed and reflects comprehensively the balance of host inflammatory and immune status. We explored its prognostic value in localized gastric cancer (GC) after R0 resection and the potential associations with Thymidine phosphorylase (TYMP), which was reported to increase the migration and invasion of gastric cancer cells. A total of 455 GC patients who received D2 gastrectomy were enrolled. Blood samples were obtained within 1 week before surgery to measure SII (SII = P × N/L). TYMP expression was measured on tumor sections by immunohistochemical analysis. Preoperative high SII indicated worse prognosis (HR: 1.799; 95% CI: 1.174-2.757; p = 0.007) in multivariate analysis and was associated with higher pathological TNM stage, deeper local invasion of tumor and lymph node metastasis (all p < 0.001). SII predicted poor overall survival in pathological TNM stage I subgroup also (p < 0.001). Furthermore we found that in high SII group, positive rate of TYMP expression increased (53.7% vs 42.7%, p = 0.046) and TYMP positive patients had higher SII score (median 405.9 vs. 351.9, p = 0.026). SII, as a noninvasive and low cost prognostic marker, may be helpful to identify higher-risk patients after R0 resection, even for stage I GC patients.

Keywords: gastric cancer; peripheral blood counts; survival; systemic immune-inflammation index; thymidine phosphorylase.

Conflict of interest statement

The authors declare no conflicts of interest.


Figure 1
Figure 1. Prognostic significance of SII in GC patients undergoing R0 resection
Kaplan-Meier analysis of OS for the SII in all GC patients after curative resection A., in stage I B. and in stage II+III C. respectively.
Figure 2
Figure 2. The prognostic significance of the SII in GC patients with different thymidine phosphorylase (TYMP) expression subgroups
The correlation between the SII and TYMP expression A., *, p = 0.026; Kaplan-Meier analysis of OS for the SII in TYMP negative B. and TYMP positive patients C.; Immunohistochemical staining for TYMP in cancer tissues (original magnification × 100). TYMP = 0, less than 10% of the cancer cells were TYMP-positive D.; TP = 1+, more than 10% but less than 50% of the cancer cells were TYMP-positive E.; TP = 2+, more than 50% of the cancer cells were TYMP-positive F.. TYMP = 0 was considered as TYMP negative while TYMP = 1+ or 2+ was considered as TYMP positive.

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