Preoperative systemic immune-inflammation index predicts prognosis and guides clinical treatment in patients with non-small cell lung cancer

Biosci Rep. 2020 Mar 27;40(3):BSR20200352. doi: 10.1042/BSR20200352.

Abstract

Objectives: The purpose of the present study was to evaluate the prognostic value of a systemic immune-inflammation index (SII) and the relationship between SII and the effectiveness of postoperative treatment in patients with non-small cell lung cancer (NSCLC).

Methods: A total of 538 patients diagnosed with NSCLC who had undergone curative surgery were retrospectively enrolled in the study. Clinicopathologic and laboratory variables were collected. SII was defined as neutrophil × platelet/lymphocyte counts. Both univariate and multivariate analyses were performed to analyze the prognostic value of these factors.

Results: The preoperative SII level was associated with sex, smoking history, histological type, lesion type, resection type, pathological stage, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), lymphocyte/monocyte ratio (LMR), fibrinogen and bone metastasis (P<0.05). The univariate and multivariate analyses revealed that SII was an independent prognostic factor for disease-free survival (DFS, P=0.033) and overall survival (OS, P=0.020). Furthermore, the prognostic value of SII was also verified regardless of the histological type and pathological stage. The subgroup analysis demonstrated that patients with a high SII may benefit from adjuvant therapy (P=0.024 for DFS and P=0.012 for OS).

Conclusion: An increased preoperative SII may independently predict the poor DFS and OS in patients with resectable NSCLC. SII may help select NSCLC patients who might benefit from adjuvant chemotherapy.

Keywords: adjuvant chemotherapy; non-small cell lung cancer; prognosis; systemic immune-inflammation index.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / blood
  • Blood Platelets / pathology
  • Carcinoma, Non-Small-Cell Lung / immunology*
  • Carcinoma, Non-Small-Cell Lung / pathology
  • China
  • Disease-Free Survival
  • Female
  • Humans
  • Immunity / immunology*
  • Inflammation / immunology*
  • Inflammation / pathology
  • Kaplan-Meier Estimate
  • Lung Neoplasms / pathology
  • Lymphocytes / pathology
  • Male
  • Middle Aged
  • Neutrophils / pathology
  • Platelet Count
  • Prognosis
  • Progression-Free Survival
  • Retrospective Studies

Substances

  • Biomarkers, Tumor