<p>Pretreatment Systemic Inflammation Response Index in Patients with Breast Cancer Treated with Neoadjuvant Chemotherapy as a Useful Prognostic Indicator</p>

Abstract

Background and Objective: Systemic inflammation response index (SIRI=N×M/L), based on neutrophil (N), monocyte (M), and lymphocyte (L) counts, is used to predict the survival of patients with malignant tumors and can fully evaluate the balance between host immune and inflammatory condition. The present study is aimed to evaluate the potential prognostic significance of SIRI in patients with breast cancer undergoing neoadjuvant chemotherapy. Subjects and Methods: A total of 262 breast cancer patients treated with neoadjuvant chemotherapy were enrolled in this retrospective study. The optimal cutoff value of SIRI by receiver operating characteristic curve stratified patients into low SIRI (<0.85×10 9 /L) group and high SIRI (≥0.85×10 9 /L) group. The associations between breast cancer and clinicopathological variables by SIRI were determined by chi-square test or Fisher's exact test. Kaplan-Meier plots and log-rank test were used to evaluate the clinical outcomes of disease-free survival (DFS) and overall survival (OS). Univariate and multivariate Cox proportional hazards regression models were used to analyze the prognostic value of SIRI. The toxicity of neoadjuvant chemotherapy was evaluated by the National Cancer Institute Common Toxicity Criteria (NCICTC). Results: The results were shown that SIRI had prognostic significance by optimal cutoff value of 0.85×10 9 /L on DFS and OS in univariate and multivariate Cox regression survival analyses. Compared with patients who had high SIRI, patients with low SIRI had longer DFS and OS (41.27 vs 30.45 months, HR: 1.694, 95% CI: 1.128-2.543, P=0.011; 52.86 vs 45.75 months, HR: 1.288, 95% CI: 0.781-3.124, P=0.002, respectively). The patients with low SIRI had better 3-, 5-, and 10-year rates of DFS and OS than those with high SIRI. The common toxicities after neoadjuvant chemotherapy were hematologic and gastrointestinal reaction, and the SIRI had no significance on toxicities of all enrolled patients, excepted diarrhea. In patients without neural invasion, those with low SIRI had better prognosis and lower recurrence rates than those with high SIRI.Conclusion: Pretreatment SIRI with the advantage of repeatable, convenient, and non-invasive is a useful prognostic indicator for breast cancer patients who received neoadjuvant chemotherapy and is a promising biomarker for breast cancer on treatment strategy decisions.

Pretreatment systemic inflammation response index is predictive of pathological complete response in patients with breast cancer receiving neoadjuvant chemotherapy

“…In addition, in postmenopausal women with breast cancer, Hua et al reported that patients with low SIRI had significantly longer OS than those with high SIRI [ 32 ]. Consistently, Chen et al observed that among patients with breast cancer treated with NAC, those with low SIRI had longer DFS and OS, but they did not find a statistical correlation between SIRI and pCR, which contradicts our results [ 11 ]. In patients with breast cancer, different ages, stages and phenotypes also correspond to different immune responses, therefore leading to different SIRIs.…”

“…The systemic inflammation response index (SIRI) is an integrated indicator based on the counts of peripheral venous blood neutrophils, monocytes and lymphocytes that might reflect the status of the local immune response and systemic inflammation [ 10 ]. To date, the relationship between SIRI and pCR has rarely been reported [ 11 ]. SIRI was first reported by Qi et al for its ability to predict the survival of patients with pancreatic cancer [ 10 ].…”

Blood Cell Count Derived Inflammation Indexes in Patients with Idiopathic Pulmonary Fibrosis

“…Nevertheless, our study showed that both platelet and monocytes are not different between IPF patients and healthy controls, and combined indexes do not perform better than NLR. The latters have shown better predictive abilities than NLR, in acute clinical conditions and malignancies [10,14,37,38]; this probably means that in cases of chronic inflammation adaptive phenomena prevent the increment of specific other than neutrophil and lymphocyte cell populations and stabilize their turnover. As a result, combined indexes may not be more effective than NLR in chronic systemic inflammation.…”

Systemic Inflammation Response Index Is a Predictor of Poor Survival in Locally Advanced Nasopharyngeal Carcinoma: A Propensity Score Matching Study

“…Increasing evidence has shown that systemic immune response markers are promising prognostic biomarkers for various cancers. The combined indicators of neutrophils, lymphocytes, monocytes, and platelets, such as NLR ( 18 , 19 ), PLR ( 20 ), SII ( 21 , 22 ) and SIRI ( 23 , 24 ), have been reported to be predictive of cancer prognosis. SIRI is a new systemic inflammatory response biomarker based on neutrophil, monocyte, and lymphocyte counts.…”