Systemic immune-inflammation index (SII): A More Promising Inflammation-Based Prognostic Marker for Patients with synchronic colorectal peritoneal carcinomatosis

Abstract

Objective: Synchronic colorectal peritoneal carcinomatosis (SCRPC) was recognized as a predictor of poor prognosis. The aim of this study was to investigate the role of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) on the survival outcome, which might help determine the treatment management of SCRPC patients. Methods: A total of 103 SCRPC patients following cytoreduction surgery (CRS) and systematic chemotherapy (CT) between 1997 and 2013 in the First Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. The comparison of the clinicopathological variables and systematic inflammatory biomarkers, including NLR, PLR and SII, was performed by Chi-test and Cox regression analysis. According to the results of multivariate analysis, a prognostic nomogram was generated, and its prediction ability was measured by the concordance index (C-index). The survival curves were generated using the Kaplan-Meier method and survival comparison between groups was conducted via the log-rank test. Results: Univariate analysis revealed that elevated NLR, PLR and SII were significantly correlate with worse survival outcome. Only low SII value was recognized as an independent favorable prognostic factor for overall survival (HR=1.772, 95% CI=1.015-3.095, P=0.044), except for NLR and PLR. The nomogram could perform well in the prediction of overall survival in SCRPC patients (c-index 0.782). Moreover, SII had strong prognostic discriminatory ability to predict survival outcome for the patients receiving completeness of cytoreduction score (CCR) 0/1 or CCR2/3, rather than NLR and PLR. Conclusions: SII was a better inflammation factor to predict the outcomes of SCRPC patients receiving CRS and systematic CT. Low SII value was the most favorable factor benefiting from different level of CRS and it was useful for determining the appropriate treatment strategy for SCRPC patients.

Predictive Value of the Systemic Immune-Inflammation Index for Intravenous Immunoglobulin Resistance and Cardiovascular Complications in Kawasaki Disease

“…Notably, as a novel systemic inflammatory index merging the information of lymphocyte, neutrophil, and platelet counts, the parameter of systemic immune-inflammation index [SII, platelet count × (neutrophil count/lymphocyte count)] has been recently proposed as a powerful prognostic indicator of poor outcome in patients with cancers (18)(19)(20) and coronary artery diseases (21). Prior findings suggested a higher SII was better to reflect the balance of host inflammatory and immune status than NLR and PLR (19,22,23); nonetheless, the potential effects of SII have not been elaborated in patients with KD.…”

Evaluation of the hematologic indices in patients with thyrotoxicosis with distinct etiologies: a case-control study

“…The relation between thyroid disorders and abnormalities in haematological parameters by affecting bone marrow is a well-known issue (8). In this context, MPV is one of the determinants of the platelet function which is situated in the routine CBC analysis and was shown to be affected in distinct disease conditions including acute pancreatitis, inflammatory bowel diseases, cardiac disorders, peritonitis, autoimmune disorders and tumoral diseases (10)(11)(12)(13)15,16). The diagnostic role of MPV in thyroid diseases is a novel topic of research with conflicting results.…”

“…Enlarging literature data suggests that hyperthyroidism is related with increased risks for leucopenia, neutropenia, thrombocytopaenia, and WBC differentials including altered platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) (1,9). Mean platelet volume (MPV), NLR, and PLR are simple and quick to compute hematologic markers that have been demonstrated to suggest inflammatory response and disease activity in several disease conditions comprising ulcerative colitis, acute pancreatitis, acute appendicitis, gestational diabetes mellitus, cirrhosis, coronary artery disease, neoplastic disorders (10)(11)(12)(13)(14). Moreover, there are several reports depicting the importance of NLR, PLR and MPV in differentiating the central causes of thyrotoxicosis (7)(8)(9).…”

An Association between Inflammation and Cerebral Venous Thrombosis: A Retrospective Study

“…The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/high-density lipoprotein (HDL) ratio (MHR) and systemic immune-in ammation index (SII = platelets * neutrophils/lymphocytes) were widely studied as in ammation indicators in recent years, considering their objectivity, low cost, effectiveness, and repeatability. So far, NLR, PLR, and SII were found to be prognostic factors for diseases such as different neurologic disorders, malignancies, and deep venous thrombosis (DVT) [9][10][11][12][13][14][15][16][17]. Besides, decreased HDL levels and increased monocyte counts were also found to be relevant to in ammation, thus MHR was potently suggested to be a novel in ammatory biomarker [18,19].…”