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

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). 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. 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). 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.

Yan X ，Li G 《-》

Systemic immune-inflammation index, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio can predict clinical outcomes in patients with metastatic non-small-cell lung cancer treated with nivolumab.

Explore markers to predict the clinical outcomes of checkpoint inhibitors have high unmet needs. The following study investigates whether hematologic parameter such as systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) is associated with nivolumab efficacy in advanced non-small-cell lung cancer (NSCLC). Advanced/metastatic NSCLC patients treated with nivolumab monotherapy for second-line or further-line treatment at Jilin Cancer Hospital between March 2016 and July 2018 were enrolled in this retrospective study. The optimal cutoff values of SII, NLR, and PLR for predicting efficacy and prognosis were determined according to receiver operating characteristic (ROC) curve and the areas under the ROC curve. Progression-free survival (PFS) and overall survival (OS) were calculated and compared using Kaplan-Meier method and log-rank test. Prognostic values of each variable were evaluated with univariate and multivariate Cox proportional hazard regression (PHR) analyses. A total of 44 patients with advanced NSCLC were included; the median age was 60 (range: 43-74). The optimal cutoff value of SII/NLR/PLR predicted PFS and OS was 603.5, 3.07, and 144. Low SII, NLR, and PLR were associated with longer PFS (HR for SII = 0.34, 95%CI 0.15-0.76, P = 0.006; HR for NLR = 0.46, 95%CI 0.22-0.99, P = 0.048; HR for PLR = 0.39, 95%CI 0.17-0.94, P = 0.025) and OS (HR for SII = 0.16, 95%CI 0.05-0.51, P = 0.005; HR for NLR = 0.20, 95%CI 0.06-0.62, P = 0.002; HR for PLR = 0.20, 95%CI 0.06-0.73, P = 0.008). NLR ≤ 3.07, PLR ≤ 144, SII ≤ 603.5 were independently associated with longer PFS and OS. The SII, NLR, and PLR are promising prognostic predictor for patients with metastatic NSCLC patients.

Liu J ，Li S ，Zhang S ，Liu Y ，Ma L ，Zhu J ，Xin Y ，Wang Y ，Yang C ，Cheng Y ... -  《-》

Systemic immune-inflammation index predicting chemoradiation resistance and poor outcome in patients with stage III non-small cell lung cancer.

Tong YS ，Tan J ，Zhou XL ，Song YQ ，Song YJ ... -  《Journal of Translational Medicine》

Preoperative increased systemic immune-inflammation index predicts poor prognosis in patients with operable non-small cell lung cancer.

A novel systemic immune-inflammation index (SII) has been recently reported to be associated with clinical outcome in several tumors. However, the prognostic value of SII has not been reported in operable non-small cell lung carcinoma (NSCLC). We aimed to investigate its clinical and prognostic value in patients with operable NSCLC underwent curative surgery. Four hundred ten NSCLC patients staged I-IIIA were included in this retrospective study. The SII was calculated by the formula: neutrophil× platelet/lymphocyte. Receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value for SII. Kaplan-Meier method and Cox proportional regression were used to analyze the prognostic value of SII. Patients were stratified into high low SII (≤395.4) and SII (>395.4) groups. High SII was significantly associated with advanced T stage and positive lymph node metastasis. Kaplan-Meier survival analysis showed that SII, PLR, NLR and LMR were all associated with OS. Multivariate analysis identified that SII was an independent predictor of OS. Furthermore, SII remained prognostic significance for NSCLC patients stratified by TNM subgroups. Preoperative SII was a powerful prognostic biomarker for predicting outcome in patients with operable NSCLC. Preoperative SII may assist clinicians treatment strategy making and individual treatment choice.

Gao Y ，Zhang H ，Li Y ，Wang D ，Ma Y ，Chen Q ... -  《-》

The combination of plasma fibrinogen and neutrophil lymphocyte ratio (F-NLR) is a predictive factor in patients with resectable non small cell lung cancer.

The prognostic value of inflammation indexes in non small cell lung cancer (NSCLC) was not established. Therefore, we assessed the clinical applicability of the F-NLR score, which is based on fibrinogen (F) and the neutrophil-lymphocyte ratio (NLR), and the glasgow prognostic score (GPS) to predict the prognoses of NSCLC patients. We retrospectively identified 515 patients with stage I/II/IIIA who underwent surgery at our institution, and evaluated their preoperative serum levels of CRP, albumin, fibrinogen, neutrophil count, and the lymphocyte count. The cut-off values of the fibrinogen level and NLR were determined with receiver operating characteristic (ROC) curve. GPS was classified into three groups as previously described. The disease free survival (DFS) and overall survival (OS) were calculated by the Kaplan-Meier method. Categorical variables were compared using the χ2 test. Survival curves were estimated using the Kaplan-Meier method, and the Cox proportional hazard model was used to assess the prognostic factors. The F-NLR was significantly associated with sex (p = 0.000), smoking history (p = 0.014), lesion type (p = 0.000), histologic type (p = 0.000), T stage (p = 0.000), venous invasion (p = 0.000), lymphatic invasion (p = 0.000), and TNM stage (p = 0.000). The 5-year DFS rates in F-NLR groups 0, 1, and 2 were 46.7%, 36.4%, 30.1%, respectively (p = 0.000), and the 5-year overall survival (OS) rates in the above three groups were 52.0%, 39.8%, 32.1%, respectively (p = 0.000). Multivariate analysis showed that venous invasion (p = 0.036), lymph node metastasis (p = 0.000), and F-NLR (p = 0.034) were independent prognostic factors for DFS. Age (p = 0.015), venous invasion (p = 0.024), lymph node metastasis (p = 0.000), and F-NLR (p = 0.019) were independent prognostic factors for OS. Thus, F-NLR was the independent prognostic factor for both the DFS and OS. And patients with a high-risk preoperative F-NLR group may benefit from adjuvant therapy by subgroup analysis. Our results demonstrated that F-NLR, a novel inflammation-based grading system, as well as the GPS, appeared to have value as a promising clinical predictor of the prognosis for the resectable non small cell lung cancer patients.

Wang H ，Zhao J ，Zhang M ，Han L ，Wang M ，Xingde L ... -  《-》