Pan-immune-inflammation Value and Prognosis in Patients With Esophageal Cancer

Abstract

The pan-immune-inflammation value was associated with clinical outcomes and tumor-infiltrating lymphocytes in 866 esophageal cancers. Systemic immune competence may influence patient prognosis through local immune response. Objective: To examine the relationship between the pan-immune-inflammation value (PIV), tumor immunity, and clinical outcomes in 866 patients with esophageal cancer. Background: The PIV, calculated from all immune-inflammatory cells in the peripheral blood count, is a recently proposed marker for clinical outcomes in some types of cancers. Nonetheless, the prognostic significance of PIV in esophageal cancer remains unclear. Methods: In the derivation cohort (n = 433), we set the optimal cutoff value using a time-dependent receiver operating characteristic (ROC) curve. In the validation cohort (n = 433), the relationships between the PIV, tumor-infiltrating lymphocytes (TILs), CD8 expression by immunohistochemical staining, and patient prognosis were examined. Results: The area under the ROC curve for the PIV at 5 years was 0.631 in the derivation cohort. The validation cohort, divided into PIV-low cases (n = 223) and PIV-high cases (n = 210), showed significantly worse overall survival (log-rank P = 0.0065; hazard ratio [HR]: 1.48; 95% confidence interval [CI]: 1.12-1.98; P < 0.001; multivariate HR: 1.41; 95% CI: 1.05-1.90; P = 0.023). The prognostic effect of the PIV was not significantly modified by any clinical characteristics (P for interaction > 0.05). The PIV-high cases were significantly associated with a low TIL status (P < 0.001) and low CD8-positive cell counts (P = 0.011). Conclusions: The PIV was associated with clinical outcomes in esophageal cancer, supporting its role as a prognostic biomarker. Considering the relationship between the PIV and TILs, systemic immune competence may influence patient prognosis through a local immune response.

The Association between the Pan-Immune-Inflammation Value and Cancer Prognosis: A Systematic Review and Meta-Analysis

“…Fifteen studies encompassing 4942 patients were included in the meta-analyses [ 32 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ]. The available studies were conducted on several tumors, including CRC, melanoma, breast cancer, and non-small cell lung cancer ( Table 1 ).…”

“…One study evaluated both patients treated with immunotherapy (nivolumab and pembrolizumab alone) and targeted therapy with BRAF inhibitors/MEK inhibitors, and separate data for these treatment types were included in the subgroup analyses [ 32 ]. Ten studies included Caucasian patients [ 32 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 48 ], while five studies were conducted in the Far East [ 44 , 45 , 46 , 47 , 49 ]. Most studies had a low risk of bias according to the NOS ( Table 2 ).…”

“…Fourteen studies with available DFS/PFS data were included in the analyses [ 32 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 48 , 49 ]. All but two studies reported significantly lower DFS/PFS with higher PIV levels, while the DFS/PFS difference did not reach statistical significance in the studies by Guven et al and Susok et al [ 39 , 42 ].…”

Pretreatment Pan-Immune-Inflammation Value Efficiently Predicts Survival Outcomes in Glioblastoma Multiforme Patients Receiving Radiotherapy and Temozolomide

“…As a different approach, limited research has shown that blood-borne platelets, monocytes, neutrophils, and lymphocytes, which are ubiquitous in the highly inflamed GBM microenvironment, have high prognostic usefulness either alone or in distinct unique blends [31]. Constructing sound grounds for our current research, despite the facts conclusively confirming its prognostic competence in various extracranial malignancies [19][20][21][22][23][24][25][26][27][28], the unique PIV has never been examined for its prognostic potential in GBM patients. In this respect, the present research represents the first effort to investigate the prognostic strength of novel PIV in newly diagnosed GBM patients who underwent the standard Stupp regimen.…”

“…The pan-immuneinflammatory value (PIV) is a newly created immune inflammation measure that is a unique combination of monocyte, platelet, neutrophil, and lymphocyte counts [19]. In previous reports, PIV showed a strong association with OS in patients with advanced colorectal cancer, advanced breast cancer, esophageal cancer, small-cell and non-small cell lung cancers, and Merkel cell carcinoma who underwent surgery and/or systemic therapy [19][20][21][22][23][24][25][26][27][28]. Gliomas, particularly GBM, have a severe inflammatory and immunosuppressive milieu that permits them to evade the antitumor immune response, evidencing that the novel PIV might be employed as a likely predictor of outcomes in such patients [9].…”