Predictive Effect of Systemic Immune-Inflammation Index Combined With Prognostic Nutrition Index Score on Efficacy and Prognosis of Neoadjuvant Intraperitoneal and Systemic Paclitaxel Combined With Apatinib Conversion Therapy in Gastric Cancer Patients With Positive Peritoneal Lavage Cytology: A Prospective Study

Abstract

BackgroundGastric cancer with only peritoneal lavage cytology (GC-CY1) is a special type of gastric cancer, which is defined as stage IV. The pre-treatment systemic immune-inflammation index (SII) and prognostic nutritional index (PNI) are representative blood indexes of systemic inflammatory response and nutritional status. However, the clinical significance of combined detection of these two indexes is still unclear. This study aims to evaluate the clinical value of the new score system by combining SII and PNI (SII-PNI score) as a predictor of efficacy and prognosis after neoadjuvant intraperitoneal and systemic (NIPS) paclitaxel combined with Apatinib conversion therapy for GC-CY1 patients.MethodsWe registered a prospective clinical study involving 36 GC-CY1 patients from April 2018 to August 2019 (NCT03718624). All patients underwent re-laparoscopic exploration after treatment. According to free cancer cells (FCCs) status, these patients were divided into FCCs group and non-FCCs group. The SII-PNI score ranged from 0 to 2 as follows: score of 2, high SII (≥512.1) and low PNI (≤52.9); score of 1, either high SII or low PNI; score of 0, no high SII nor low PNI.ResultsAll patients underwent re-laparoscopic exploration after 3 cycles of NIPS paclitaxel and Apatinib conversion therapy. Among them, 28 cases (77.78%) were in non-FCCs group, and 8 cases (22.22%) were in FCCs group. The SII-PNI score of non-FCCs patients was significantly lower than that of FCCs patients (p=0.041). The prognosis of patients with high SII-PNI score was significantly worse than that of patients with low SII-PNI score (p<0.001). Multivariate analysis showed that SII-PNI score was an independent prognostic factor for predicting overall survival and progression-free survival (p=0.001, 0.002).ConclusionPretreatment SII-PNI score is an important predictor for the efficacy of GC-CY1 patients after NIPS paclitaxel combined with Apatinib conversion therapy, which can help to identify high-risk groups and predict prognosis.

Combined systemic immune-inflammatory index (SII) and prognostic nutritional index (PNI) predicts chemotherapy response and prognosis in locally advanced gastric cancer patients receiving neoadjuvant chemotherapy with PD-1 antibody sintilimab and XELOX: a prospective study

“…Peripheral venous blood samples were collected in fasting state within 1 week before initiation of chemotherapy in all patients. The counts of peripheral neutrophils, lymphocytes and platelets were measured and analyzed by an automatic blood analyzer (Beckman Coulter LH750), and the levels of peripheral albumin were measured and analyzed by an automatic blood analyzer (Beckman Coulter AU5800) [ 22 ]. The definitions of PNI and SII were shown as follows: PNI = albumin (g/L) + 5 × total lymphocyte counts (10 9 /L); SII = platelet × neutrophil/lymphocyte counts [ 22 ].…”

Combined systemic inflammatory immunity index and prognostic nutritional index scores as a screening marker for sarcopenia in patients with locally advanced gastric cancer

“…Peripheral venous blood was collected from all patients on an empty stomach within 1 week before surgery. Peripheral blood neutrophil, lymphocyte, and platelet counts in LAGC patients were analyzed by the method in our previous study ( 29 , 30 ). The specific operation process is as follows: using an automatic hematology analyzer (Beckman Coulter LH750) to measure and analyze the counts of neutrophils, platelets and lymphocytes, and the albumin level using an automatic hematology analyzer (Beckman Coulter AU5800) assay analysis.…”

“…The specific operation process is as follows: using an automatic hematology analyzer (Beckman Coulter LH750) to measure and analyze the counts of neutrophils, platelets and lymphocytes, and the albumin level using an automatic hematology analyzer (Beckman Coulter AU5800) assay analysis. The SII was defined as follows: SII = P × N/L, where P, N, and L were the platelet, neutrophil, and lymphocyte counts, respectively ( 29 , 30 , 33 ). Similarly, PNI is calculated by albumin plus 5 times lymphocyte count ( 34 ).…”

“…The increase of inflammatory cytokines in the body promotes the increase of muscle metabolism, which will further induce the imbalance of muscle protein synthesis and catabolism ( 27 , 28 ). The systemic inflammatory immunity index (SII) is a new inflammatory index based on peripheral blood neutrophil, lymphocyte and platelet counts that adequately reflects the balanced relationship between immunity and inflammation ( 29 , 30 ). A recent cross-sectional study that included 4,224 elderly patients found that higher SII levels were associated with an increased prevalence of sarcopenia ( 31 ).…”

Inflammatory Indexes as Prognostic Factors of Survival in Geriatric Patients with Hepatocellular Carcinoma: A Case Control Study of Eight Slovak Centers

“…Case report forms (CRFs) included baseline blood test results, which were also later used to calculate the neutrophil-to-lymphocyte ratio (NLR) [ 15 ], the platelet-to-lymphocyte ratio (PLR) [ 16 ], systemic immune-inflammation index (SII) [ 17 ], the model for end-stage liver disease score (MELD) [ 18 ], and the albumin–bilirubin grade (ALBI) [ 19 ]. If any condition that could have influenced baseline values was present (acute infection, corticosteroid treatment, etc.…”