Background:No clear evidence exists regarding the relationship between the systemic immune-inflammation index(SII)and the efficacy of first-line chemotherapy combined with immunotherapy in patients with advanced non-s...Background:No clear evidence exists regarding the relationship between the systemic immune-inflammation index(SII)and the efficacy of first-line chemotherapy combined with immunotherapy in patients with advanced non-small cell lung cancer(NSCLC).This study aimed to establish the relationship between the SII and survival of patients with advanced NSCLC.Methods:This study included 123 patients with advanced NSCLC.The cutoff value of the SII was determined to be 1172 using ROC curve analysis.We evaluated the relationship between the SII and progression-free survival(PFS)and overall survival(OS)using the Cox regression model and Kaplan-Meier(KM)curve analysis.We stratified patients into multiple subgroups based on covariates such as age,sex,and smoking history.Subgroup analysis was used to evaluate the relationship between high SII,disease progression,and mortality risk.Results:Univariate analysis indicated that no significant difference existed between SII and PFS,but univariate analysis showed a significant association between SII and OS(hazard ratio[HR]=1.93,95% confidence interval[CI]=1.14-3.29,p=0.015).The fully adjusted Cox regression analysis also showed a significant correlation between the SII and OS after adjustment for covariables(HR=1.76,95%CI=1.02-3.02,p=0.041).In some subgroups,a high SII positively correlated with the risk of disease progression,and the relationship between a high SII and the risk of mortality was consistent in almost all subgroups.Conclusions:These results indicate that pretreatment SII may be an independent predictivemarker for patients with advanced NSCLC undergoing first-line chemotherapy combined with immunotherapy.However,large-scale prospective studies are required to confirm our results.展开更多
Objective The systemic immune-inflammation index(SII)has recently attracted significant interest as a new biomarker for predicting the prognosis of patients with glioblastoma(GBM).However,the predictive significance o...Objective The systemic immune-inflammation index(SII)has recently attracted significant interest as a new biomarker for predicting the prognosis of patients with glioblastoma(GBM).However,the predictive significance of it is still a subject of debate.This study intended to assess the clinical effectiveness of the SII in GBM and establish a nomogram.Methods Receiver operating characteristic(ROC)curves were utilized to determine the optimal cut-off values of the SII.Kaplan–Meier(KM)survival curves were used to analyze the median overall survival(OS).Cox regression analysis was carried out to evaluate the associations between OS and different clinical factors.Based on the SII and clinical characteristics,a nomogram was constructed,and its value in clinical application was evaluated by means of decision curve analysis.Results The optimal SII cut-off value was 610.13.KM analysis revealed that GBM patients with higher SII values had shorter OS(15.0 vs.34.0 months,P=0.044).Multivariate analysis demonstrated that a high SII was an independent predictor of poor outcome in GBM(HR=1.79,P=0.029).The nomogram incorporating the preoperative SII showed good predictive accuracy for GBM patient prognosis(C-index=0.691).Conclusions The SII is an independent predictive indicator for GBM.Patients with elevated SII levels tend to have a poorer prognosis.A nomogram combining the SII with clinical and molecular pathological features can assist clinicians in assessing the risk of death in GBM patients,providing a basis for individualized treatment decisions.展开更多
BACKGROUND Systemic immune-inflammation index(SII)combined with serum lactoferrin(LF)level can provide a reference for predicting the postoperative survival and prognosis of older patients with colon cancer.AIM To eva...BACKGROUND Systemic immune-inflammation index(SII)combined with serum lactoferrin(LF)level can provide a reference for predicting the postoperative survival and prognosis of older patients with colon cancer.AIM To evaluate the predictive value of SII combined with serum LF for postoperative survival in older patients with colon cancer.METHODS This prospective study included 62 older patients[range,65-85 years;average age(72.46±6.02)years]with colon cancer who underwent radical surgery at our hospital between January 2023 and September 2024.Colon cancer was confirmed on postoperative pathology.All patients underwent peripheral blood,LF,and tumor marker tests and imaging examinations preoperatively.The ability to predict overall survival(OS)and disease-free survival(DFS)by dynamically monitoring the SII[platelet(PLT)count×neutrophil(NEU)count/lymphocyte(LYM)count]and LF levels in combination with postoperative follow-up data was assessed.SII,LF levels,and postoperative data were analyzed using receiver operating characteristic curves,univariate,and multivariate Cox regression analyses to assess OS and DFS.RESULTS All patients were followed up conventionally postoperatively.There were no significant differences in the patients’baseline data.From 3 months preoperatively until after surgery,the values of routine blood indices(NEUs,LYMs,and PLTs)and SII tended to decrease,but the difference was not statistically significant.The LF level gradually decreased,and there were significant differences at 1 week,1 month and 3 months postoperatively(P<0.05).Liver and kidney functions significantly increased 1 week postoperatively and gradually recovered(P<0.05).The C-reactive protein level significantly increased 1 week postoperatively,whereas the prealbumin level significantly decreased then recovered 3 months postoperatively(P<0.05).The levels of carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)significantly increased 6 months postoperatively,suggesting an increased risk of recurrence(P<0.05).Both the OS and DFS showed significant changes over time.Preoperative SII and LF levels had significant predictive values for OS and DFS.In logistics regression analysis,a SII of 585 or greater and LF level less than 185 ng/mL(determined by maximizing the Youden index)correlated with postoperative survival(P<0.05).Further Cox regression analysis showed that the SII and LF,CA19-9,and CEA levels were independent predictors of postoperative OS(P<0.05),whereas the tumor,node,metastasis stage;LF level;and SII were independent predictors of DFS.CONCLUSION This preliminary analysis suggests that the SII and LF levels may predict the survival and prognosis of older patients with colon cancer postoperatively,when assessing the risk of postoperative recurrence and complications.These two categories of indicators have good prognostic evaluation potential in clinical practice and can provide strong support for the development of individualized treatment strategies.展开更多
AIM To investigate the clinical significance of preoperative systemic immune-inflammation index(SII) in patients with colorectal cancer(CRC). METHODS A retrospective analysis of 1383 cases with CRC was performed follo...AIM To investigate the clinical significance of preoperative systemic immune-inflammation index(SII) in patients with colorectal cancer(CRC). METHODS A retrospective analysis of 1383 cases with CRC was performed following radical surgery. SII was calculated with the formula SII =(P × N)/L, where P, N, and L refer to peripheral platelet, neutrophil, and lymphocyte counts, respectively. The clinicopathological features and follow-up data were evaluated to compare SII with other systemic inflammation-based prognostic indices such as the neutrophil-lymphocyte ratio(NLR) and platelet-lymphocyte ratio(PLR) in patients with CRC.RESULTS The optimal cut-off point for SII was defined as 340. The overall survival(OS) and disease-free survival(DFS) were better in patients with low NLR, PLR, and SII(P < 0.05). The SII was an independent predictor of OS and DFS in multivariate analysis. The area under the receiver-operating characteristics(ROC) curve for SII(0.707) was larger than those for NLR(0.602) and PLR(0.566). In contrast to NLR and PLR, SII could effectively discriminate between the TNM subgroups. CONCLUSION SII is a more powerful tool for predicting survival outcome in patients with CRC. It might assist the identification of high-risk patients among patients with the same TNM stage.展开更多
BACKGROUND Hepatocellular carcinoma(HCC)is a major factor for cancer-associated mortality globally.Although the systemic immune-inflammation index(SII)and albumin(ALB)show individual prognostic value for various cance...BACKGROUND Hepatocellular carcinoma(HCC)is a major factor for cancer-associated mortality globally.Although the systemic immune-inflammation index(SII)and albumin(ALB)show individual prognostic value for various cancers,their combined significance(SII/ALB)in HCC patients undergoing curative hepatectomy is still unknown.It is hypothesized that a higher SII/ALB ratio correlates with poorer outcomes with regard to overall survival(OS)and recurrence-free survival(RFS).AIM To investigate the effect of preoperative SII/ALB in predicting the prognosis of HCC patients undergoing hepatectomy.METHODS Patients who received curative surgery for HCC at a single institution between 2014 and 2019 were retrospectively analyzed.Cox proportional hazards models and Kaplan-Meier curves were utilized to estimate OS and RFS.A nomogram was created using prognostic factors determined by the least absolute shrinkage and selection operator method and analyzed using multivariate Cox regression.This nomogram was assessed internally through the calibration plots,receiver operating characteristic(ROC)analysis,decision curve analysis(DCA)and the concordance index(C-index).RESULTS This study enrolled 1653 HCC patients.Multivariate analyses demonstrated that SII/ALB independently predicted OS[hazard ratio(HR)=1.22,95%CI:1.03-1.46,P=0.025]and RFS(HR=1.19,95%CI:1.03-1.38,P=0.022).Age,alpha-fetoprotein,hepatitis B surface antigen,albumin-bilirubin grade,tumor diameter,portal vein tumor thrombus,tumor number,and SII/ALB were incorporated into the nomogram to predict OS.The nomogram had a C-index of 0.73(95%CI:0.71-0.76)and 0.71(95%CI:0.67-0.74)for the training and validation cohorts,respectively.The area under the ROC curve,DCA and calibration curves demonstrated high accuracy and clinical benefits.CONCLUSION The SII/ALB may independently predict outcomes in HCC patients who receive curative surgical treatment.In addition,the nomogram can be used in HCC treatment decision-making.展开更多
AIM:To investigate systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),and plateletto-lymphocyte ratio(PLR)levels in patients with type 2 diabetes at different stages of diabetic retinopathy(DR...AIM:To investigate systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),and plateletto-lymphocyte ratio(PLR)levels in patients with type 2 diabetes at different stages of diabetic retinopathy(DR).METHODS:This retrospective study included 141 patients with type 2 diabetes mellitus(DM):45 without diabetic retinopathy(NDR),47 with non-proliferative diabetic retinopathy(NPDR),and 49 with proliferative diabetic retinopathy(PDR).Complete blood counts were obtained,and NLR,PLR,and SII were calculated.The study analysed the ability of inflammatory markers to predict DR using receiver operating characteristic(ROC)curves.The relationships between DR stages and SII,PLR,and NLP were assessed using multivariate logistic regression.RESULTS:The average NLR,PLR,and SII were higher in the PDR group than in the NPDR group(P=0.011,0.043,0.009,respectively);higher in the NPDR group than in the NDR group(P<0.001 for all);and higher in the PDR group than in the NDR group(P<0.001 for all).In the ROC curve analysis,the NLR,PLR,and SII were significant predictors of DR(P<0.001 for all).The highest area under the curve(AUC)was for the PLR(0.929 for PLR,0.925 for SII,and 0.821 for NLR).Multivariate regression analysis indicated that NLR,PLR,and SII were statistically significantly positive and independent predictors for the DR stages in patients with DM[odds ratio(OR)=1.122,95%confidence interval(CI):0.200–2.043,P<0.05;OR=0.038,95%CI:0.018–0.058,P<0.05;OR=0.007,95%CI:0.001–0.01,P<0.05,respectively).CONCLUSION:The NLR,PLR,and SII may be used as predictors of DR.展开更多
BACKGROUND Pediatric appendicitis is a common cause of abdominal pain in children and is recognized as a significant surgical emergency.A prompt and accurate diagnosis is essential to prevent complications such as per...BACKGROUND Pediatric appendicitis is a common cause of abdominal pain in children and is recognized as a significant surgical emergency.A prompt and accurate diagnosis is essential to prevent complications such as perforation and peritonitis.AIM To investigate the predictive value of the systemic immune-inflammation index(SII)combined with the pediatric appendicitis score(PAS)for the assessment of disease severity and surgical outcomes in children aged 5 years and older with appendicitis.METHODS Clinical data of 104 children diagnosed with acute appendicitis were analyzed.The participants were categorized into the acute appendicitis group and chronic appendicitis group based on disease presentation and further stratified into the good prognosis group and poor prognosis group based on prognosis.The SII and PAS were measured,and a joint model using the combined SII and PAS was constructed to predict disease severity and surgical outcomes.RESULTS Significant differences were observed in the SII and PAS parameters between the acute appendicitis group and chronic appendicitis group.Correlation analysis showed associations among the SII,PAS,and disease severity,with the combined SII and PAS model demonstrating significant predictive value for assessing disease severity[aera under the curve(AUC)=0.914]and predicting surgical outcomes(AUC=0.857)in children aged 5 years and older with appendicitis.CONCLUSION The study findings support the potential of integrating the SII with the PAS for assessing disease severity and predicting surgical outcomes in pediatric appendicitis,indicating the clinical utility of the combined SII and PAS model in guiding clinical decision-making and optimizing surgical management strategies for pediatric patients with appendicitis.展开更多
Background Systemic immune-inflammation index(SII)has emerged as a potential marker for assessing inflammation and predicting outcomes in patients with acute coronary syndrome(ACS).However,its role in forecasting clin...Background Systemic immune-inflammation index(SII)has emerged as a potential marker for assessing inflammation and predicting outcomes in patients with acute coronary syndrome(ACS).However,its role in forecasting clinical prognosis in ACS patients undergoing primary coronary angiography remains unclear.Methods This retrospective study included 657 ACS patients who underwent primary coronary angiography between January 2016 and January 2023.Patients were divided into low and high SII groups based on the Youden index cut-off value.The primary endpoint was the occurrence of major adverse cardiovascular events(MACEs),including nonfatal myocardial infarction(MI),nonfatal stroke,heart failure,target lesion revascularization(TLR),and cardiovascular death.Kaplan-Meier survival analysis and Cox regression were performed to assess the association between SII and outcomes.Results Patients with high SII had significantly higher rates of MACEs(25.7%vs.10.3%,P<0.001),including nonfatal MI,heart failure,and TLR.After adjusting for conventional risk factors,SII remained an independent predictor of MACEs(HR:2.102,95%CI:1.616-3.011,P=0.002).Kaplan-Meier analysis confirmed poorer event-free survival in the high SII group(P=0.00093).Conclusions Elevated SII was associated with a higher risk of adverse outcomes in ACS patients,suggesting its potential utility as a comprehensive tool for risk stratification and prognosis in ACS patients.[S Chin J Cardiol 2024;25(3):142-148]展开更多
BACKGROUND The prognosis of intrahepatic cholangiocarcinoma(ICC)patients following surgical resection remains poor.It is necessary to investigate effective biomarkers or prognostic models for ICC patients.AIM To inves...BACKGROUND The prognosis of intrahepatic cholangiocarcinoma(ICC)patients following surgical resection remains poor.It is necessary to investigate effective biomarkers or prognostic models for ICC patients.AIM To investigate the prognostic effect of systemic immune-inflammation index(SII)to predict long-term outcomes in ICC patients with undergoing hepatic resection.METHODS Consecutive ICC patients who underwent initial hepatectomy with curative intent from January 2009 to September 2017 were retrospectively reviewed.Receiver-operating characteristic(ROC)curves were used to determine the optimal cut-off values of SII.Kaplan-Meier curves and Cox proportional hazards regression were performed to evaluate the discriminative ability of preoperative SII in predicting overall survival(OS)and recurrence-free survival(RFS).RESULTS A total of 530 patients were included and randomly divided into derivation(n=265)and validation cohort(n=265).The optimal cut-off value for SII was 450.Ata median follow-up of 18 mo(range,1-115.4 mo),317(59.8%)patients died and381(71.9%)patients experienced tumor relapse.Low SII level was associated with better OS and RFS(both P<0.05).Multivariate analyses identified multiple tumors,node invasion and high SII level as independent risk factors for OS,while multiple tumors,node invasion and high SII level were identified as independent risk factors for RFS.Validation cohort confirmed the findings of derivation cohort.CONCLUSION The present study demonstrated the feasibility of preoperative SII as a prognostic indicator for ICC.Patients with increased SII level were associated with worse OS and earlier tumor recurrence.Elevated SII level was an independent risk factor for OS and RFS in patients with ICC after hepatectomy.In the future,the SII could help stratifying patients with ICC,thus guiding therapeutic choices,especially in immunotherapy.展开更多
Background:The role of inflammation in the development of gestational diabetes mellitus(GDM)has recently become a focus of research.The systemic immune-inflammation index(SII)and systemic inflammation response index(S...Background:The role of inflammation in the development of gestational diabetes mellitus(GDM)has recently become a focus of research.The systemic immune-inflammation index(SII)and systemic inflammation response index(SIRI),novel indices,reflect the body’s chronic immune-inflammatory state.This study aimed to investigate the associations between the SII or SIRI and GDM.Methods:A prospective birth cohort study was conducted at Beijing Obstetrics and Gynecology Hospital from February 2018 to December 2020,recruiting participants in their first trimester of pregnancy.Baseline SII and SIRI values were derived from routine clinical blood results,calculated as follows:SII=neutrophil(Neut)count×platelet(PLT)count/lymphocyte(Lymph)count,SIRI=Neut count×monocyte(Mono)count/Lymph count,with participants being grouped by quartiles of their SII or SIRI values.Participants were followed up for GDM with a 75-g,2-h oral glucose tolerance test(OGTT)at 24-28 weeks of gestation using the glucose thresholds of the International Association of Diabetes and Pregnancy Study Groups(IADPSG).Logistic regression was used to analyze the odds ratios(ORs)(95%confidence intervals[CIs])for the the associations between SII,SIRI,and the risk of GDM.Results:Among the 28,124 women included in the study,the average age was 31.8±3.8 years,and 15.76%(4432/28,124)developed GDM.Higher SII and SIRI quartiles were correlated with increased GDM rates,with rates ranging from 12.26%(862/7031)in the lowest quartile to 20.10%(1413/7031)in the highest quartile for the SII(P_(trend)<0.001)and 11.92-19.31%for the SIRI(P_(trend)<0.001).The ORs(95%CIs)of the second,third,and fourth SII quartiles were 1.09(0.98-1.21),1.21(1.09-1.34),and 1.39(1.26-1.54),respectively.The SIRI findings paralleled the SII outcomes.For the second through fourth quartiles,the ORs(95%CIs)were 1.24(1.12-1.38),1.41(1.27-1.57),and 1.64(1.48-1.82),respectively.These associations were maintained in subgroup and sensitivity analyses.Conclusion:The SII and SIRI are potential independent risk factors contributing to the onset of GDM.展开更多
Purpose Cancer is a major social,public health,and economic issue.The Systemic Immune-Inflammation Index(SII)has been linked to the prognosis of various cancer types.This study aims to explore the potential relationsh...Purpose Cancer is a major social,public health,and economic issue.The Systemic Immune-Inflammation Index(SII)has been linked to the prognosis of various cancer types.This study aims to explore the potential relationship between SII and cancer.Methods This study utilized National Health and Nutrition Examination Survey(NHANES)data from 2013 to 2020,encompassing a total of 16,897 participants.We employed multivariate logistic regression models,subgroup analyses,smooth curve fitting,and threshold effect analyses to examine the relationship between SII and cancer.Results The analysis of the multivariate logistic regression models revealed a significant positive correlation between SII and cancer,consistent across most subgroups.Additionally,an"N"-shaped pattern was observed between SII and cancer,with significant inflection points at 1169 and 1950.Notably,when SII was below 1169,the positive correlation between SII and cancer remained statistically significant.Conclusion Our findings indicate an"N"-shaped relationship between SII and cancer,suggesting a potentially high cost-effectiveness ratio in cancer screening that could enhance early cancer detection.However,this discovery necessitates further validation through additional research.展开更多
BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia...BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia,nausea,vomiting,and other discomforts,and often suffer from malnutrition,which in turn negatively affects perioperative safety,prognosis,and the effectiveness of adjuvant therapeutic measures.Consequently,some nutritional indicators such as nutritional risk index(NRI),prognostic nutritional index(PNI),and systemic immune-inflammatorynutritional index(SIINI)can be used as predictors of the prognosis of GC patients.AIM To examine the prognostic significance of PNI,NRI,and SIINI in postoperative patients with GC.METHODS A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018.The area under the receiver operating characteristic(ROC)curve was assessed using ROC curve analysis,and the optimal cutoff values for NRI,PNI,and SIINI were identified using the You-Review-HTMLden index.Survival analysis was performed using the Kaplan-Meier method.In addition,univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.RESULTS This study included a total of 803 patients.ROC curves were used to evaluate the prognostic ability of NRI,PNI,and SIINI.The results revealed that SIINI had superior predictive accuracy.Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group(P<0.05).Univariate analysis identified NRI[hazard ratio(HR)=0.68,95%confidence interval(CI):0.52-0.89,P=0.05],PNI(HR=0.60,95%CI:0.46-0.79,P<0.001),and SIINI(HR=2.10,95%CI:1.64-2.69,P<0.001)as prognostic risk factors for patients with GC.However,multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC(HR=1.65,95%CI:1.26-2.16,P<0.001).CONCLUSION Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC.Compared with NRI and PNI,SIINI may offer greater application for prognostic assessment.展开更多
BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neut...BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammatory index(SII)for GC.METHODS The baseline data of 133 patients with GC and 134 patients with precancerous gastric conditions admitted between January 2022 and December 2023 were retrospectively analyzed.The information on peripheral blood platelet,neutrophil,and lymphocyte counts in each patient was collected,and the NLR,PLR,and SII levels of both groups were calculated.Additionally,multivariate logistic regression analysis was conducted,and the diagnostic implications of NLR,PLR,and SII in differentiating patients with precancerous gastric conditions,compared with those with GC,were analyzed through receiver operating characteristic(ROC)curves.RESULTS The data indicated that NLR,PLR,and SII had abnormally increased levels in the patients with GC.Gender and body mass index were risk factors for the occurrence of GC.ROC data revealed that the areas under the curve of three patients with precancerous gastric conditions,who were differentiated from those with GC,were 0.824,0.787,and 0.842,respectively.CONCLUSION NLR,PLR,and SII are all abnormally expressed in GC and have diagnostic implications,especially when used as joint indicators,in distinguishing patients with precancerous gastric conditions from those with GC.展开更多
Objective:This study aimed to evaluate the prognostic value of the pretreatment systemic immune-inflammation index(SII)in non-metastatic nasopharyngeal carcinoma(NPC).Methods:We retrospectively analyzed the data of 83...Objective:This study aimed to evaluate the prognostic value of the pretreatment systemic immune-inflammation index(SII)in non-metastatic nasopharyngeal carcinoma(NPC).Methods:We retrospectively analyzed the data of 839 patients with non-metastatic NPC recruited from two independent institutions.The training-set cohort and the external validation-set cohort was comprised of 459 and 380 patients from each institution,respectively.The optimal cut-offvalue of SII was determined,and a prognostic risk stratification model was developed based on the training cohort and further assessed in the validation cohort.The propensity score matching(PSM)method was applied to minimize the confounding effects of unbalanced covariables.Results:The optimal cut-offvalue of the SII in the training cohort was 686,which was confirmed using the vali-dation cohort.Multivariate analysis showed that both before and after PSM,SII values>686 were independently associated with worse progression-free survival(PFS)ratio in both cohorts(before PSM,P=0.008 and P=0.008;after PSM,P=0.008 and P=0.007,respectively).Based on the analysis of independent prognostic factors of SII and N stage,we developed a categorical risk stratification model,which achieved significant discrimination among risk indexes associated with PFS and distant metastasis-free survival(DMFS)in the training cohort.There was no significant difference in PFS between RT alone and combined therapies within the low-and intermediate-risk groups(5-year PFS,77.5%vs.75.3%,P=0.275).Patients in the high-risk group who received concurrent chemoradiotherapy experienced superior PFS compared with those who received other therapies(5-year PFS,64.9%vs.40.3%,P=0.003).Conclusion:Pretreatment SII predicts PFS of patients with non-metastatic NPC.Prognostic risk stratification incorporating SII is instructive for selecting individualized treatment.展开更多
Gastric ulcer(GU)represents a clinically significant manifestation of peptic ulcer disease,driven by a complex interplay of microbial,environmental,and immuneinflammatory factors.A recent cross-sectional study by Shen...Gastric ulcer(GU)represents a clinically significant manifestation of peptic ulcer disease,driven by a complex interplay of microbial,environmental,and immuneinflammatory factors.A recent cross-sectional study by Shen et al systematically evaluated six complete blood count-derived inflammatory indices:Neutrophil-tolymphocyte ratio,monocyte-to-lymphocyte ratio,platelet-to-lymphocyte ratio,systemic immune-inflammation index,systemic inflammatory response index(SIRI),and aggregate index of systemic inflammation and demonstrated their positive associations with GU prevalence,identifying SIRI as the strongest predictor.This editorial contextualizes these findings within the broader literature,clarifies that these indices reflect systemic rather than GU-specific inflammation,highlights methodological strengths and major limitations,and proposes a conceptual clinical algorithm for integrating SIRI into GU risk assessment.Future multicenter studies incorporating Helicobacter pylori infection,non-steroidal antiinflammatory drug exposure,and prospective design are essential to validate and translate these findings into clinical practice.展开更多
Atrial fibrillation(Afib)is a common arrhythmia with significant public health implications,affecting millions of individuals worldwide.Catheter ablation(CA)is an established treatment for drug-resistant Afib,yet recu...Atrial fibrillation(Afib)is a common arrhythmia with significant public health implications,affecting millions of individuals worldwide.Catheter ablation(CA)is an established treatment for drug-resistant Afib,yet recurrence remains a major concern,impacting quality of life in a significant portion of patients.Inflammation plays a critical role in the recurrence of Afib after ablation,with systemic inflammatory markers such as C-reactive protein being linked to higher recurrence rates.In this editorial,we discuss the study by Wang et al,published in the latest issue,which investigates the predictive role of the systemic immune inflammation index(SII)in Afib recurrence following radiofrequency CA.Elevated pre-ablation SII levels are identified as an independent predictor of recurrence,significantly enhancing the predictive power of the APPLE score.Integration of SII improved the APPLE score’s predictive performance,as shown by enhanced area under the curve,net reclassification improvement,and integrated discrimination improvement.This combined model highlights the importance of both structural and inflammatory factors in Afib recurrence,offering a more personalized approach to patient management.Additionally,the affordability and accessibility of SII enhance its practicality in clinical workflows.The study by Wang et al underscores the potential of integrating SII with existing scoring systems to refine risk stratification and optimize treatment strategies.Future research should validate these findings across diverse populations,explore limitations such as the potential influence of comorbidities on SII reliability,and investigate additional biomarkers to enhance predictive accuracy.展开更多
Atrial fibrillation(AF)is the most common arrhythmia in humans,affecting more than 40 million people worldwide.Radiofrequency catheter ablation(RFCA)was first introduced as a treatment for AF by Haïssaguerre M in...Atrial fibrillation(AF)is the most common arrhythmia in humans,affecting more than 40 million people worldwide.Radiofrequency catheter ablation(RFCA)was first introduced as a treatment for AF by Haïssaguerre M in the late 1990s.This procedure quickly became the treatment of choice,especially for symptomatic patients with AF refractory to medication.However,up to 45%of patients may experience AF recurrence within 12 months after RFCA.In this setting,AF recurrence is likely multifactorial,including atrial remodeling,local fibrosis or incomplete ablation due to failure in locating the trigger.Additionally,patients with obesity,sleep apnea,hypertension,or diabetes are at an increased risk of AF recurrence after RFCA.Inflammation is increasingly recognized as a potential key factor in AF recurrence and may arise both from the healing response of heart tissue post-ablation or from chronic low-grade inflammation,as observed in many risk factors.Here,we present an original study by Wang et al,which investigated the combination of the systemic immune-inflammation index-a marker developed to assess overall inflammatory status-and the APPLE score,designed to predict AF recurrence following RFCA.The study found that using both indicators together improved the accuracy of AF recurrence prediction.These findings underscore the significant role of inflammation in cardiovascular disease and demonstrated its impact on AF recurrence after RFCA.Further research is warranted to validate the combined use of these two scores in clinical settings for predicting AF recurrence following catheter ablation.展开更多
The recurrence of atrial fibrillation(AF)in patients after successful radiofrequency catheter ablation(RFCA)appears to be an unresolved clinical issue and needs to be clearly elucidated.There are many factors associat...The recurrence of atrial fibrillation(AF)in patients after successful radiofrequency catheter ablation(RFCA)appears to be an unresolved clinical issue and needs to be clearly elucidated.There are many factors associated with AF recurrence,such as duration of AF,male sex,concomitant heart failure,hemodynamic parameters,chronic obstructive pulmonary disease,hypertension,obstructive sleep apnea,hyperthyroidism,smoking and obesity.However,the inflammatory changes are strongly associated with electrical and structural cardiac remodeling,cardiac damage,myocardial fibrotic changes,microvascular dysfunction and altered reparative response.In this context,biomarkers reflecting the different stages of AF pathogenesis deserve thorough investigation.The authors of the retrospective study revealed that one-year recurrence rate of non-valvular AF in the high systemic immune inflammation(SII)index group was significantly increased compared to that of the low SII index group and provided additional predictive value to the APPLE.Furthermore,the authors suggest that this biomarker may help physicians to optimize the selection of AF patients and to develop a personalized treatment approach.In conclusion,the SII index may serve as a valuable indicator of recurrent AF in patients after RFCA and may be a biomarker with plausible predictive value for poor clinical outcomes.展开更多
Background The association of systemic inflammatory response index(SIRI)with prognosis of coronary artery disease(CAD)patients has never been investigated in a large sample with long-term follow-up.This study aimed to...Background The association of systemic inflammatory response index(SIRI)with prognosis of coronary artery disease(CAD)patients has never been investigated in a large sample with long-term follow-up.This study aimed to explore the association of SIRI with all-cause and cause-specific mortality in a nationally representative sample of CAD patients from United States.Methods A total of 3386 participants with CAD from the National Health and Nutrition Examination Survey(NHANES)1999-2018 were included in this study.Cox proportional hazards model,restricted cubic spline(RCS),and receiver operating characteristic curve(ROC)were performed to investigate the association of SIRI with all-cause and cause-specific mortality.Piecewise linear regression and sensitivity analyses were also performed.Results During a median follow-up of 7.7 years,1454 all-cause mortality occurred.After adjusting for confounding factors,higher lnSIRI was significantly associated with higher risk of all-cause(HR=1.16,95%CI:1.09-1.23)and CVD mortality(HR=1.17,95%CI:1.05-1.30)but not cancer mortality(HR=1.17,95%CI:0.99-1.38).The associations of SIRI with all-cause and CVD mortality were detected as J-shaped with threshold values of 1.05935 and 1.122946 for SIRI,respectively.ROC curves showed that lnSIRI had robust predictive effect both in short and long terms.Conclusions SIRI was independently associated with all-cause and CVD mortality,and the dose-response relationship was Jshaped.SIRI might serve as a valid predictor for all-cause and CVD mortality both in the short and long terms.展开更多
Objective:To investigate the effectiveness of the systemic immune-inflammatory(SII)index and other inflammatory parameters in predicting mortality among patients with acute cholecystitis(AC).Methods:279 Patients prese...Objective:To investigate the effectiveness of the systemic immune-inflammatory(SII)index and other inflammatory parameters in predicting mortality among patients with acute cholecystitis(AC).Methods:279 Patients presented to the emergency department with abdominal pain and diagnosis of AC between September 2021 and September 2023 were included in the study.Demographic data,laboratory parameters,clinical follow-ups,and outcomes of the patients were recorded.Results:The mean age of the patients was(55.0±16.3)years and 36.6%were male.63.8%Had gallbladder/choledochal stones and 49.5%underwent surgery.The mortality rate was 6.1%.Advanced age(P=0.170)and prolonged hospitalization(P=0.011)were statistically significant risk factors for mortality.Decreased lymphocyte count(P=0.020)and increased C-reactive protein(CRP)levels(P=0.033)were found to be risk factors for mortality.According to the mortality predictor ROC analysis results,the cut-off for SII index was 3138(AUC=0.817,sensitivity=70.5%,specificity=84.7%),the cut-off for neutrophil count was 15.28×10^(3)/mm^(3)(AUC=0.761,sensitivity=52.9%,specificity=95.0%),the cut-off for leukocyte count was 19.0×10^(3)/mm^(3)(AUC=0.714,sensitivity=52.9%,specificity=98.0%),cut-off for CRP was 74.55(AUC=0.758,sensitivity=70.5%,specificity=79.0%),cut-off for aspartate transaminase(AST)was 33.0 IU/L(AUC=0.658,sensitivity=82.3%,specificity=50.3%).Conclusions:The SII index may be a good predictor of mortality with high sensitivity and specificity.Elevated levels of neutrophils,leukocytes,CRP,and AST are other inflammatory parameters that can be used to predict mortality associated with AC.展开更多
基金supported by grants from the“Joint Project on Regional High-Incidence Diseases Research of Guangxi Natural Science Foundation”under Grant No.2023JJA141341the“Guangxi Medical and Health Key Discipline Construction Project.”。
文摘Background:No clear evidence exists regarding the relationship between the systemic immune-inflammation index(SII)and the efficacy of first-line chemotherapy combined with immunotherapy in patients with advanced non-small cell lung cancer(NSCLC).This study aimed to establish the relationship between the SII and survival of patients with advanced NSCLC.Methods:This study included 123 patients with advanced NSCLC.The cutoff value of the SII was determined to be 1172 using ROC curve analysis.We evaluated the relationship between the SII and progression-free survival(PFS)and overall survival(OS)using the Cox regression model and Kaplan-Meier(KM)curve analysis.We stratified patients into multiple subgroups based on covariates such as age,sex,and smoking history.Subgroup analysis was used to evaluate the relationship between high SII,disease progression,and mortality risk.Results:Univariate analysis indicated that no significant difference existed between SII and PFS,but univariate analysis showed a significant association between SII and OS(hazard ratio[HR]=1.93,95% confidence interval[CI]=1.14-3.29,p=0.015).The fully adjusted Cox regression analysis also showed a significant correlation between the SII and OS after adjustment for covariables(HR=1.76,95%CI=1.02-3.02,p=0.041).In some subgroups,a high SII positively correlated with the risk of disease progression,and the relationship between a high SII and the risk of mortality was consistent in almost all subgroups.Conclusions:These results indicate that pretreatment SII may be an independent predictivemarker for patients with advanced NSCLC undergoing first-line chemotherapy combined with immunotherapy.However,large-scale prospective studies are required to confirm our results.
基金funded by National Natural Science Foundation of China,grant number 82203007.
文摘Objective The systemic immune-inflammation index(SII)has recently attracted significant interest as a new biomarker for predicting the prognosis of patients with glioblastoma(GBM).However,the predictive significance of it is still a subject of debate.This study intended to assess the clinical effectiveness of the SII in GBM and establish a nomogram.Methods Receiver operating characteristic(ROC)curves were utilized to determine the optimal cut-off values of the SII.Kaplan–Meier(KM)survival curves were used to analyze the median overall survival(OS).Cox regression analysis was carried out to evaluate the associations between OS and different clinical factors.Based on the SII and clinical characteristics,a nomogram was constructed,and its value in clinical application was evaluated by means of decision curve analysis.Results The optimal SII cut-off value was 610.13.KM analysis revealed that GBM patients with higher SII values had shorter OS(15.0 vs.34.0 months,P=0.044).Multivariate analysis demonstrated that a high SII was an independent predictor of poor outcome in GBM(HR=1.79,P=0.029).The nomogram incorporating the preoperative SII showed good predictive accuracy for GBM patient prognosis(C-index=0.691).Conclusions The SII is an independent predictive indicator for GBM.Patients with elevated SII levels tend to have a poorer prognosis.A nomogram combining the SII with clinical and molecular pathological features can assist clinicians in assessing the risk of death in GBM patients,providing a basis for individualized treatment decisions.
基金Supported by Rugao Science and Technology Research and Development Program(Agriculture and Social Development)Project,No.SRGS(24)061.
文摘BACKGROUND Systemic immune-inflammation index(SII)combined with serum lactoferrin(LF)level can provide a reference for predicting the postoperative survival and prognosis of older patients with colon cancer.AIM To evaluate the predictive value of SII combined with serum LF for postoperative survival in older patients with colon cancer.METHODS This prospective study included 62 older patients[range,65-85 years;average age(72.46±6.02)years]with colon cancer who underwent radical surgery at our hospital between January 2023 and September 2024.Colon cancer was confirmed on postoperative pathology.All patients underwent peripheral blood,LF,and tumor marker tests and imaging examinations preoperatively.The ability to predict overall survival(OS)and disease-free survival(DFS)by dynamically monitoring the SII[platelet(PLT)count×neutrophil(NEU)count/lymphocyte(LYM)count]and LF levels in combination with postoperative follow-up data was assessed.SII,LF levels,and postoperative data were analyzed using receiver operating characteristic curves,univariate,and multivariate Cox regression analyses to assess OS and DFS.RESULTS All patients were followed up conventionally postoperatively.There were no significant differences in the patients’baseline data.From 3 months preoperatively until after surgery,the values of routine blood indices(NEUs,LYMs,and PLTs)and SII tended to decrease,but the difference was not statistically significant.The LF level gradually decreased,and there were significant differences at 1 week,1 month and 3 months postoperatively(P<0.05).Liver and kidney functions significantly increased 1 week postoperatively and gradually recovered(P<0.05).The C-reactive protein level significantly increased 1 week postoperatively,whereas the prealbumin level significantly decreased then recovered 3 months postoperatively(P<0.05).The levels of carcinoembryonic antigen(CEA)and carbohydrate antigen 19-9(CA19-9)significantly increased 6 months postoperatively,suggesting an increased risk of recurrence(P<0.05).Both the OS and DFS showed significant changes over time.Preoperative SII and LF levels had significant predictive values for OS and DFS.In logistics regression analysis,a SII of 585 or greater and LF level less than 185 ng/mL(determined by maximizing the Youden index)correlated with postoperative survival(P<0.05).Further Cox regression analysis showed that the SII and LF,CA19-9,and CEA levels were independent predictors of postoperative OS(P<0.05),whereas the tumor,node,metastasis stage;LF level;and SII were independent predictors of DFS.CONCLUSION This preliminary analysis suggests that the SII and LF levels may predict the survival and prognosis of older patients with colon cancer postoperatively,when assessing the risk of postoperative recurrence and complications.These two categories of indicators have good prognostic evaluation potential in clinical practice and can provide strong support for the development of individualized treatment strategies.
基金Supported by National Nature Science Foundation of China,No.81672343 and No.81372341Guangdong Province Natural Science Fund of China,No.2014A030310111Guangdong Science and Technology Plan Project of China,No.2013B021800131and No.201604020003
文摘AIM To investigate the clinical significance of preoperative systemic immune-inflammation index(SII) in patients with colorectal cancer(CRC). METHODS A retrospective analysis of 1383 cases with CRC was performed following radical surgery. SII was calculated with the formula SII =(P × N)/L, where P, N, and L refer to peripheral platelet, neutrophil, and lymphocyte counts, respectively. The clinicopathological features and follow-up data were evaluated to compare SII with other systemic inflammation-based prognostic indices such as the neutrophil-lymphocyte ratio(NLR) and platelet-lymphocyte ratio(PLR) in patients with CRC.RESULTS The optimal cut-off point for SII was defined as 340. The overall survival(OS) and disease-free survival(DFS) were better in patients with low NLR, PLR, and SII(P < 0.05). The SII was an independent predictor of OS and DFS in multivariate analysis. The area under the receiver-operating characteristics(ROC) curve for SII(0.707) was larger than those for NLR(0.602) and PLR(0.566). In contrast to NLR and PLR, SII could effectively discriminate between the TNM subgroups. CONCLUSION SII is a more powerful tool for predicting survival outcome in patients with CRC. It might assist the identification of high-risk patients among patients with the same TNM stage.
基金Supported by The National Natural Science Foundation of China,No.81770566 and No.82000599The NHC Key Laboratory of Echinococcosis Prevention and Control,No.2021WZK1004The Health Commission of the Tibet Autonomous Region,No.311220432.
文摘BACKGROUND Hepatocellular carcinoma(HCC)is a major factor for cancer-associated mortality globally.Although the systemic immune-inflammation index(SII)and albumin(ALB)show individual prognostic value for various cancers,their combined significance(SII/ALB)in HCC patients undergoing curative hepatectomy is still unknown.It is hypothesized that a higher SII/ALB ratio correlates with poorer outcomes with regard to overall survival(OS)and recurrence-free survival(RFS).AIM To investigate the effect of preoperative SII/ALB in predicting the prognosis of HCC patients undergoing hepatectomy.METHODS Patients who received curative surgery for HCC at a single institution between 2014 and 2019 were retrospectively analyzed.Cox proportional hazards models and Kaplan-Meier curves were utilized to estimate OS and RFS.A nomogram was created using prognostic factors determined by the least absolute shrinkage and selection operator method and analyzed using multivariate Cox regression.This nomogram was assessed internally through the calibration plots,receiver operating characteristic(ROC)analysis,decision curve analysis(DCA)and the concordance index(C-index).RESULTS This study enrolled 1653 HCC patients.Multivariate analyses demonstrated that SII/ALB independently predicted OS[hazard ratio(HR)=1.22,95%CI:1.03-1.46,P=0.025]and RFS(HR=1.19,95%CI:1.03-1.38,P=0.022).Age,alpha-fetoprotein,hepatitis B surface antigen,albumin-bilirubin grade,tumor diameter,portal vein tumor thrombus,tumor number,and SII/ALB were incorporated into the nomogram to predict OS.The nomogram had a C-index of 0.73(95%CI:0.71-0.76)and 0.71(95%CI:0.67-0.74)for the training and validation cohorts,respectively.The area under the ROC curve,DCA and calibration curves demonstrated high accuracy and clinical benefits.CONCLUSION The SII/ALB may independently predict outcomes in HCC patients who receive curative surgical treatment.In addition,the nomogram can be used in HCC treatment decision-making.
基金Affiliated Jinling Hospital,Medical School of Nanjing University(No.22JCYYYB29).
文摘AIM:To investigate systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR),and plateletto-lymphocyte ratio(PLR)levels in patients with type 2 diabetes at different stages of diabetic retinopathy(DR).METHODS:This retrospective study included 141 patients with type 2 diabetes mellitus(DM):45 without diabetic retinopathy(NDR),47 with non-proliferative diabetic retinopathy(NPDR),and 49 with proliferative diabetic retinopathy(PDR).Complete blood counts were obtained,and NLR,PLR,and SII were calculated.The study analysed the ability of inflammatory markers to predict DR using receiver operating characteristic(ROC)curves.The relationships between DR stages and SII,PLR,and NLP were assessed using multivariate logistic regression.RESULTS:The average NLR,PLR,and SII were higher in the PDR group than in the NPDR group(P=0.011,0.043,0.009,respectively);higher in the NPDR group than in the NDR group(P<0.001 for all);and higher in the PDR group than in the NDR group(P<0.001 for all).In the ROC curve analysis,the NLR,PLR,and SII were significant predictors of DR(P<0.001 for all).The highest area under the curve(AUC)was for the PLR(0.929 for PLR,0.925 for SII,and 0.821 for NLR).Multivariate regression analysis indicated that NLR,PLR,and SII were statistically significantly positive and independent predictors for the DR stages in patients with DM[odds ratio(OR)=1.122,95%confidence interval(CI):0.200–2.043,P<0.05;OR=0.038,95%CI:0.018–0.058,P<0.05;OR=0.007,95%CI:0.001–0.01,P<0.05,respectively).CONCLUSION:The NLR,PLR,and SII may be used as predictors of DR.
文摘BACKGROUND Pediatric appendicitis is a common cause of abdominal pain in children and is recognized as a significant surgical emergency.A prompt and accurate diagnosis is essential to prevent complications such as perforation and peritonitis.AIM To investigate the predictive value of the systemic immune-inflammation index(SII)combined with the pediatric appendicitis score(PAS)for the assessment of disease severity and surgical outcomes in children aged 5 years and older with appendicitis.METHODS Clinical data of 104 children diagnosed with acute appendicitis were analyzed.The participants were categorized into the acute appendicitis group and chronic appendicitis group based on disease presentation and further stratified into the good prognosis group and poor prognosis group based on prognosis.The SII and PAS were measured,and a joint model using the combined SII and PAS was constructed to predict disease severity and surgical outcomes.RESULTS Significant differences were observed in the SII and PAS parameters between the acute appendicitis group and chronic appendicitis group.Correlation analysis showed associations among the SII,PAS,and disease severity,with the combined SII and PAS model demonstrating significant predictive value for assessing disease severity[aera under the curve(AUC)=0.914]and predicting surgical outcomes(AUC=0.857)in children aged 5 years and older with appendicitis.CONCLUSION The study findings support the potential of integrating the SII with the PAS for assessing disease severity and predicting surgical outcomes in pediatric appendicitis,indicating the clinical utility of the combined SII and PAS model in guiding clinical decision-making and optimizing surgical management strategies for pediatric patients with appendicitis.
文摘Background Systemic immune-inflammation index(SII)has emerged as a potential marker for assessing inflammation and predicting outcomes in patients with acute coronary syndrome(ACS).However,its role in forecasting clinical prognosis in ACS patients undergoing primary coronary angiography remains unclear.Methods This retrospective study included 657 ACS patients who underwent primary coronary angiography between January 2016 and January 2023.Patients were divided into low and high SII groups based on the Youden index cut-off value.The primary endpoint was the occurrence of major adverse cardiovascular events(MACEs),including nonfatal myocardial infarction(MI),nonfatal stroke,heart failure,target lesion revascularization(TLR),and cardiovascular death.Kaplan-Meier survival analysis and Cox regression were performed to assess the association between SII and outcomes.Results Patients with high SII had significantly higher rates of MACEs(25.7%vs.10.3%,P<0.001),including nonfatal MI,heart failure,and TLR.After adjusting for conventional risk factors,SII remained an independent predictor of MACEs(HR:2.102,95%CI:1.616-3.011,P=0.002).Kaplan-Meier analysis confirmed poorer event-free survival in the high SII group(P=0.00093).Conclusions Elevated SII was associated with a higher risk of adverse outcomes in ACS patients,suggesting its potential utility as a comprehensive tool for risk stratification and prognosis in ACS patients.[S Chin J Cardiol 2024;25(3):142-148]
基金Supported by the National Natural Science Foundation of China,No.81972747,No.81872004,No.81800564,No.81770615,No.81700555 and No.81672882the Science and Technology Support Program of Sichuan Province,No.2019YFQ0001,No.2018SZ0115 and No.2017SZ0003+1 种基金the Science and Technology Program of Tibet Autonomous Region,No.XZ201801-GB-02the 1.3.5 Project for Disciplines of Excellence,West China Hospital,Sichuan University,No.ZYJC18008.
文摘BACKGROUND The prognosis of intrahepatic cholangiocarcinoma(ICC)patients following surgical resection remains poor.It is necessary to investigate effective biomarkers or prognostic models for ICC patients.AIM To investigate the prognostic effect of systemic immune-inflammation index(SII)to predict long-term outcomes in ICC patients with undergoing hepatic resection.METHODS Consecutive ICC patients who underwent initial hepatectomy with curative intent from January 2009 to September 2017 were retrospectively reviewed.Receiver-operating characteristic(ROC)curves were used to determine the optimal cut-off values of SII.Kaplan-Meier curves and Cox proportional hazards regression were performed to evaluate the discriminative ability of preoperative SII in predicting overall survival(OS)and recurrence-free survival(RFS).RESULTS A total of 530 patients were included and randomly divided into derivation(n=265)and validation cohort(n=265).The optimal cut-off value for SII was 450.Ata median follow-up of 18 mo(range,1-115.4 mo),317(59.8%)patients died and381(71.9%)patients experienced tumor relapse.Low SII level was associated with better OS and RFS(both P<0.05).Multivariate analyses identified multiple tumors,node invasion and high SII level as independent risk factors for OS,while multiple tumors,node invasion and high SII level were identified as independent risk factors for RFS.Validation cohort confirmed the findings of derivation cohort.CONCLUSION The present study demonstrated the feasibility of preoperative SII as a prognostic indicator for ICC.Patients with increased SII level were associated with worse OS and earlier tumor recurrence.Elevated SII level was an independent risk factor for OS and RFS in patients with ICC after hepatectomy.In the future,the SII could help stratifying patients with ICC,thus guiding therapeutic choices,especially in immunotherapy.
基金supported by the Capital’s Funds for Health Improvement and Research(No.2024-2G-2118)the National Key Research and Development Program of China(No.2016YFC1000100)+2 种基金the Leading Talents in the Construction Project of High Level Public Health Technical Talents in Beijing(No.20221003)the“Green Seedling”Youth Program by the Beijing Hospitals Authority(No.QML20231402)the Young Elite Scientist Sponsorship Program by the Beijing Association for Science and Technology(No.BYESS2022200).
文摘Background:The role of inflammation in the development of gestational diabetes mellitus(GDM)has recently become a focus of research.The systemic immune-inflammation index(SII)and systemic inflammation response index(SIRI),novel indices,reflect the body’s chronic immune-inflammatory state.This study aimed to investigate the associations between the SII or SIRI and GDM.Methods:A prospective birth cohort study was conducted at Beijing Obstetrics and Gynecology Hospital from February 2018 to December 2020,recruiting participants in their first trimester of pregnancy.Baseline SII and SIRI values were derived from routine clinical blood results,calculated as follows:SII=neutrophil(Neut)count×platelet(PLT)count/lymphocyte(Lymph)count,SIRI=Neut count×monocyte(Mono)count/Lymph count,with participants being grouped by quartiles of their SII or SIRI values.Participants were followed up for GDM with a 75-g,2-h oral glucose tolerance test(OGTT)at 24-28 weeks of gestation using the glucose thresholds of the International Association of Diabetes and Pregnancy Study Groups(IADPSG).Logistic regression was used to analyze the odds ratios(ORs)(95%confidence intervals[CIs])for the the associations between SII,SIRI,and the risk of GDM.Results:Among the 28,124 women included in the study,the average age was 31.8±3.8 years,and 15.76%(4432/28,124)developed GDM.Higher SII and SIRI quartiles were correlated with increased GDM rates,with rates ranging from 12.26%(862/7031)in the lowest quartile to 20.10%(1413/7031)in the highest quartile for the SII(P_(trend)<0.001)and 11.92-19.31%for the SIRI(P_(trend)<0.001).The ORs(95%CIs)of the second,third,and fourth SII quartiles were 1.09(0.98-1.21),1.21(1.09-1.34),and 1.39(1.26-1.54),respectively.The SIRI findings paralleled the SII outcomes.For the second through fourth quartiles,the ORs(95%CIs)were 1.24(1.12-1.38),1.41(1.27-1.57),and 1.64(1.48-1.82),respectively.These associations were maintained in subgroup and sensitivity analyses.Conclusion:The SII and SIRI are potential independent risk factors contributing to the onset of GDM.
文摘Purpose Cancer is a major social,public health,and economic issue.The Systemic Immune-Inflammation Index(SII)has been linked to the prognosis of various cancer types.This study aims to explore the potential relationship between SII and cancer.Methods This study utilized National Health and Nutrition Examination Survey(NHANES)data from 2013 to 2020,encompassing a total of 16,897 participants.We employed multivariate logistic regression models,subgroup analyses,smooth curve fitting,and threshold effect analyses to examine the relationship between SII and cancer.Results The analysis of the multivariate logistic regression models revealed a significant positive correlation between SII and cancer,consistent across most subgroups.Additionally,an"N"-shaped pattern was observed between SII and cancer,with significant inflection points at 1169 and 1950.Notably,when SII was below 1169,the positive correlation between SII and cancer remained statistically significant.Conclusion Our findings indicate an"N"-shaped relationship between SII and cancer,suggesting a potentially high cost-effectiveness ratio in cancer screening that could enhance early cancer detection.However,this discovery necessitates further validation through additional research.
基金Supported by the Scientific Research Project of Hospital Pharmacy of Guangxi Pharmaceutical Association in 2022,No.GXYXH1-202202.
文摘BACKGROUND Gastric cancer(GC)is the fifth most common cancer and the third leading cause of cancer-related deaths in China.Many patients with GC frequently experience symptoms related to the disease,including anorexia,nausea,vomiting,and other discomforts,and often suffer from malnutrition,which in turn negatively affects perioperative safety,prognosis,and the effectiveness of adjuvant therapeutic measures.Consequently,some nutritional indicators such as nutritional risk index(NRI),prognostic nutritional index(PNI),and systemic immune-inflammatorynutritional index(SIINI)can be used as predictors of the prognosis of GC patients.AIM To examine the prognostic significance of PNI,NRI,and SIINI in postoperative patients with GC.METHODS A retrospective analysis was conducted on the clinical data of patients with GC who underwent surgical treatment at the Guangxi Medical University Cancer Hospital between January 2010 and December 2018.The area under the receiver operating characteristic(ROC)curve was assessed using ROC curve analysis,and the optimal cutoff values for NRI,PNI,and SIINI were identified using the You-Review-HTMLden index.Survival analysis was performed using the Kaplan-Meier method.In addition,univariate and multivariate analyses were conducted using the Cox proportional hazards regression model.RESULTS This study included a total of 803 patients.ROC curves were used to evaluate the prognostic ability of NRI,PNI,and SIINI.The results revealed that SIINI had superior predictive accuracy.Survival analysis indicated that patients with GC in the low SIINI group had a significantly better survival rate than those in the high SIINI group(P<0.05).Univariate analysis identified NRI[hazard ratio(HR)=0.68,95%confidence interval(CI):0.52-0.89,P=0.05],PNI(HR=0.60,95%CI:0.46-0.79,P<0.001),and SIINI(HR=2.10,95%CI:1.64-2.69,P<0.001)as prognostic risk factors for patients with GC.However,multifactorial analysis indicated that SIINI was an independent risk factor for the prognosis of patients with GC(HR=1.65,95%CI:1.26-2.16,P<0.001).CONCLUSION Analysis of clinical retrospective data revealed that SIINI is a valuable indicator for predicting the prognosis of patients with GC.Compared with NRI and PNI,SIINI may offer greater application for prognostic assessment.
文摘BACKGROUND The diagnosis of gastric carcinoma(GC)is essential for improving clinical outcomes.However,the biomarkers currently used for GC screening are not ideal.AIM To explore the diagnostic implications of the neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),and systemic immune-inflammatory index(SII)for GC.METHODS The baseline data of 133 patients with GC and 134 patients with precancerous gastric conditions admitted between January 2022 and December 2023 were retrospectively analyzed.The information on peripheral blood platelet,neutrophil,and lymphocyte counts in each patient was collected,and the NLR,PLR,and SII levels of both groups were calculated.Additionally,multivariate logistic regression analysis was conducted,and the diagnostic implications of NLR,PLR,and SII in differentiating patients with precancerous gastric conditions,compared with those with GC,were analyzed through receiver operating characteristic(ROC)curves.RESULTS The data indicated that NLR,PLR,and SII had abnormally increased levels in the patients with GC.Gender and body mass index were risk factors for the occurrence of GC.ROC data revealed that the areas under the curve of three patients with precancerous gastric conditions,who were differentiated from those with GC,were 0.824,0.787,and 0.842,respectively.CONCLUSION NLR,PLR,and SII are all abnormally expressed in GC and have diagnostic implications,especially when used as joint indicators,in distinguishing patients with precancerous gastric conditions from those with GC.
文摘Objective:This study aimed to evaluate the prognostic value of the pretreatment systemic immune-inflammation index(SII)in non-metastatic nasopharyngeal carcinoma(NPC).Methods:We retrospectively analyzed the data of 839 patients with non-metastatic NPC recruited from two independent institutions.The training-set cohort and the external validation-set cohort was comprised of 459 and 380 patients from each institution,respectively.The optimal cut-offvalue of SII was determined,and a prognostic risk stratification model was developed based on the training cohort and further assessed in the validation cohort.The propensity score matching(PSM)method was applied to minimize the confounding effects of unbalanced covariables.Results:The optimal cut-offvalue of the SII in the training cohort was 686,which was confirmed using the vali-dation cohort.Multivariate analysis showed that both before and after PSM,SII values>686 were independently associated with worse progression-free survival(PFS)ratio in both cohorts(before PSM,P=0.008 and P=0.008;after PSM,P=0.008 and P=0.007,respectively).Based on the analysis of independent prognostic factors of SII and N stage,we developed a categorical risk stratification model,which achieved significant discrimination among risk indexes associated with PFS and distant metastasis-free survival(DMFS)in the training cohort.There was no significant difference in PFS between RT alone and combined therapies within the low-and intermediate-risk groups(5-year PFS,77.5%vs.75.3%,P=0.275).Patients in the high-risk group who received concurrent chemoradiotherapy experienced superior PFS compared with those who received other therapies(5-year PFS,64.9%vs.40.3%,P=0.003).Conclusion:Pretreatment SII predicts PFS of patients with non-metastatic NPC.Prognostic risk stratification incorporating SII is instructive for selecting individualized treatment.
基金Supported by the National Natural Science Foundation of China,No.82170406 and No.81970238.
文摘Gastric ulcer(GU)represents a clinically significant manifestation of peptic ulcer disease,driven by a complex interplay of microbial,environmental,and immuneinflammatory factors.A recent cross-sectional study by Shen et al systematically evaluated six complete blood count-derived inflammatory indices:Neutrophil-tolymphocyte ratio,monocyte-to-lymphocyte ratio,platelet-to-lymphocyte ratio,systemic immune-inflammation index,systemic inflammatory response index(SIRI),and aggregate index of systemic inflammation and demonstrated their positive associations with GU prevalence,identifying SIRI as the strongest predictor.This editorial contextualizes these findings within the broader literature,clarifies that these indices reflect systemic rather than GU-specific inflammation,highlights methodological strengths and major limitations,and proposes a conceptual clinical algorithm for integrating SIRI into GU risk assessment.Future multicenter studies incorporating Helicobacter pylori infection,non-steroidal antiinflammatory drug exposure,and prospective design are essential to validate and translate these findings into clinical practice.
文摘Atrial fibrillation(Afib)is a common arrhythmia with significant public health implications,affecting millions of individuals worldwide.Catheter ablation(CA)is an established treatment for drug-resistant Afib,yet recurrence remains a major concern,impacting quality of life in a significant portion of patients.Inflammation plays a critical role in the recurrence of Afib after ablation,with systemic inflammatory markers such as C-reactive protein being linked to higher recurrence rates.In this editorial,we discuss the study by Wang et al,published in the latest issue,which investigates the predictive role of the systemic immune inflammation index(SII)in Afib recurrence following radiofrequency CA.Elevated pre-ablation SII levels are identified as an independent predictor of recurrence,significantly enhancing the predictive power of the APPLE score.Integration of SII improved the APPLE score’s predictive performance,as shown by enhanced area under the curve,net reclassification improvement,and integrated discrimination improvement.This combined model highlights the importance of both structural and inflammatory factors in Afib recurrence,offering a more personalized approach to patient management.Additionally,the affordability and accessibility of SII enhance its practicality in clinical workflows.The study by Wang et al underscores the potential of integrating SII with existing scoring systems to refine risk stratification and optimize treatment strategies.Future research should validate these findings across diverse populations,explore limitations such as the potential influence of comorbidities on SII reliability,and investigate additional biomarkers to enhance predictive accuracy.
文摘Atrial fibrillation(AF)is the most common arrhythmia in humans,affecting more than 40 million people worldwide.Radiofrequency catheter ablation(RFCA)was first introduced as a treatment for AF by Haïssaguerre M in the late 1990s.This procedure quickly became the treatment of choice,especially for symptomatic patients with AF refractory to medication.However,up to 45%of patients may experience AF recurrence within 12 months after RFCA.In this setting,AF recurrence is likely multifactorial,including atrial remodeling,local fibrosis or incomplete ablation due to failure in locating the trigger.Additionally,patients with obesity,sleep apnea,hypertension,or diabetes are at an increased risk of AF recurrence after RFCA.Inflammation is increasingly recognized as a potential key factor in AF recurrence and may arise both from the healing response of heart tissue post-ablation or from chronic low-grade inflammation,as observed in many risk factors.Here,we present an original study by Wang et al,which investigated the combination of the systemic immune-inflammation index-a marker developed to assess overall inflammatory status-and the APPLE score,designed to predict AF recurrence following RFCA.The study found that using both indicators together improved the accuracy of AF recurrence prediction.These findings underscore the significant role of inflammation in cardiovascular disease and demonstrated its impact on AF recurrence after RFCA.Further research is warranted to validate the combined use of these two scores in clinical settings for predicting AF recurrence following catheter ablation.
文摘The recurrence of atrial fibrillation(AF)in patients after successful radiofrequency catheter ablation(RFCA)appears to be an unresolved clinical issue and needs to be clearly elucidated.There are many factors associated with AF recurrence,such as duration of AF,male sex,concomitant heart failure,hemodynamic parameters,chronic obstructive pulmonary disease,hypertension,obstructive sleep apnea,hyperthyroidism,smoking and obesity.However,the inflammatory changes are strongly associated with electrical and structural cardiac remodeling,cardiac damage,myocardial fibrotic changes,microvascular dysfunction and altered reparative response.In this context,biomarkers reflecting the different stages of AF pathogenesis deserve thorough investigation.The authors of the retrospective study revealed that one-year recurrence rate of non-valvular AF in the high systemic immune inflammation(SII)index group was significantly increased compared to that of the low SII index group and provided additional predictive value to the APPLE.Furthermore,the authors suggest that this biomarker may help physicians to optimize the selection of AF patients and to develop a personalized treatment approach.In conclusion,the SII index may serve as a valuable indicator of recurrent AF in patients after RFCA and may be a biomarker with plausible predictive value for poor clinical outcomes.
基金National Key Research and Development Program of China(2022YFC2503500 and 2022YFC2503504)。
文摘Background The association of systemic inflammatory response index(SIRI)with prognosis of coronary artery disease(CAD)patients has never been investigated in a large sample with long-term follow-up.This study aimed to explore the association of SIRI with all-cause and cause-specific mortality in a nationally representative sample of CAD patients from United States.Methods A total of 3386 participants with CAD from the National Health and Nutrition Examination Survey(NHANES)1999-2018 were included in this study.Cox proportional hazards model,restricted cubic spline(RCS),and receiver operating characteristic curve(ROC)were performed to investigate the association of SIRI with all-cause and cause-specific mortality.Piecewise linear regression and sensitivity analyses were also performed.Results During a median follow-up of 7.7 years,1454 all-cause mortality occurred.After adjusting for confounding factors,higher lnSIRI was significantly associated with higher risk of all-cause(HR=1.16,95%CI:1.09-1.23)and CVD mortality(HR=1.17,95%CI:1.05-1.30)but not cancer mortality(HR=1.17,95%CI:0.99-1.38).The associations of SIRI with all-cause and CVD mortality were detected as J-shaped with threshold values of 1.05935 and 1.122946 for SIRI,respectively.ROC curves showed that lnSIRI had robust predictive effect both in short and long terms.Conclusions SIRI was independently associated with all-cause and CVD mortality,and the dose-response relationship was Jshaped.SIRI might serve as a valid predictor for all-cause and CVD mortality both in the short and long terms.
文摘Objective:To investigate the effectiveness of the systemic immune-inflammatory(SII)index and other inflammatory parameters in predicting mortality among patients with acute cholecystitis(AC).Methods:279 Patients presented to the emergency department with abdominal pain and diagnosis of AC between September 2021 and September 2023 were included in the study.Demographic data,laboratory parameters,clinical follow-ups,and outcomes of the patients were recorded.Results:The mean age of the patients was(55.0±16.3)years and 36.6%were male.63.8%Had gallbladder/choledochal stones and 49.5%underwent surgery.The mortality rate was 6.1%.Advanced age(P=0.170)and prolonged hospitalization(P=0.011)were statistically significant risk factors for mortality.Decreased lymphocyte count(P=0.020)and increased C-reactive protein(CRP)levels(P=0.033)were found to be risk factors for mortality.According to the mortality predictor ROC analysis results,the cut-off for SII index was 3138(AUC=0.817,sensitivity=70.5%,specificity=84.7%),the cut-off for neutrophil count was 15.28×10^(3)/mm^(3)(AUC=0.761,sensitivity=52.9%,specificity=95.0%),the cut-off for leukocyte count was 19.0×10^(3)/mm^(3)(AUC=0.714,sensitivity=52.9%,specificity=98.0%),cut-off for CRP was 74.55(AUC=0.758,sensitivity=70.5%,specificity=79.0%),cut-off for aspartate transaminase(AST)was 33.0 IU/L(AUC=0.658,sensitivity=82.3%,specificity=50.3%).Conclusions:The SII index may be a good predictor of mortality with high sensitivity and specificity.Elevated levels of neutrophils,leukocytes,CRP,and AST are other inflammatory parameters that can be used to predict mortality associated with AC.
