Systemic immune–inflammation index
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PURPOSE: To examine the predictive and prognostic value of preoperative Systemic Immune-inflammation Index (SII) in patients with radio-recurrent prostate cancer (PCa) treated with salvage radical prostatectomy (SRP). MATERIALS AND METHODS: This multicenter retrospective study included 214 patients with radio-recurrent PCa, treated with SRP between 2007 and 2015. SII was measured preoperatively (neutrophils × platelets/lymphocytes) and the cohort was stratified using optimal cut-off. Uni- and multivariable logistic and Cox regression analyses were performed to evaluate the predictive and prognostic value of SII as a preoperative biomarker. RESULTS: A total of 81 patients had high preoperative SII (≥ 730). On multivariable logistic regression modeling, high SII was predictive for lymph node metastases (OR 3.32, 95% CI 1.45-7.90, p = 0.005), and non-organ confined disease (OR 2.55, 95% CI 1.33-4.97, p = 0.005). In preoperative regression analysis, high preoperative SII was an independent prognostic factor for cancer-specific survival (CSS; HR 10.7, 95% CI 1.12-103, p = 0.039) and overall survival (OS; HR 8.57, 95% CI 2.70-27.2, p < 0.001). Similarly, in postoperative multivariable models, SII was associated with worse CSS (HR 22.11, 95% CI 1.23-398.12, p = 0.036) and OS (HR 5.98, 95% CI 1.67-21.44, p = 0.006). Notably, the addition of SII to preoperative reference models improved the C-index for the prognosis of CSS (89.5 vs. 80.5) and OS (85.1 vs 77.1). CONCLUSIONS: In radio-recurrent PCa patients, high SII was associated with adverse pathological features at SRP and survival after SRP. Preoperative SII could help identify patients who might benefit from novel imaging modalities, multimodal therapy or a closer posttreatment surveillance.
- MeSH
- brachyterapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- lokální recidiva nádoru imunologie mortalita patologie chirurgie MeSH
- lymfatické uzliny patologie MeSH
- lymfocyty * MeSH
- míra přežití MeSH
- multivariační analýza MeSH
- nádory prostaty imunologie mortalita patologie chirurgie MeSH
- neutrofily * MeSH
- počet leukocytů MeSH
- počet lymfocytů MeSH
- počet trombocytů MeSH
- předoperační období MeSH
- prognóza MeSH
- proporcionální rizikové modely MeSH
- prostatektomie * MeSH
- radioterapie s modulovanou intenzitou MeSH
- retrospektivní studie MeSH
- senioři MeSH
- staging nádorů MeSH
- trombocyty * MeSH
- záchranná terapie * MeSH
- zánět krev imunologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
Cíl: Naším cílem bylo zjistit, zda sérový delta index neutrofilů a další parametry systémového zánětlivého indexu mohou mít při použití s jinými bio chemickými markery u preeklampsie a HELLP syndromu pomocný účinek v diagnostice a určit roli zánětu v patogenezi těchto onemocnění. Materiál a metody: Do studie bylo zahrnuto 121 těhotných žen, které splnily kritéria pro zařazení a vyloučení. Do sledované skupiny bylo zařazeno 52 těhotných s diagnostikovanou preeklampsií, 19 těhotných s diagnostikovaným HELLP syndromem a do kontrolní skupiny 50 zdravých těhotných žen. Demografické údaje, hematologické a bio chemické parametry a zánětlivé markery (sérový neutrofilní delta index – DNI – a systémové parametry zánětlivého indexu) skupin byly zaznamenány a porovnány mezi skupinami. Výsledky: Z hlediska poměru neutrofilních lymfocytů, poměru lymfocytů trombocytů a DNI byla skupina HELLP odlišná od obou skupin. Kontrolní skupina a skupina s preeklampsií byly podobné. Z hlediska poměru monocytů k lymfocytům byla skupina preeklampsie odlišná od obou skupin. Kontrolní a HELLP skupiny byly podobné. Z hlediska indexu systémového zánětu byly všechny skupiny podobné. Závěr: V naší studii jsme zjistili, že využití DNI v mateřském séru spolu s dalšími bio chemickými parametry může pomoci v diagnostice preeklampsie a HELLP syndromu a zánět může hrát roli v patogenezi těchto onemocnění.
Objective: We aimed to determine whether the serum delta neutrophil index and other systemic inflammatory index parameters can have an auxiliary effect in the diagnosis when used with other bio chemical markers in preeclampsia and HELLP syndrome and to determine the role of inflammation in the pathogenesis of these diseases. Materials and methods: 121 pregnant women who met the inclusion and exclusion criteria were included in the study. 52 pregnant women diagnosed with preeclampsia and 19 pregnant women diagnosed with HELLP syndrome were included in the study group, and 50 healthy pregnant women were included in the control group. Demographic data, hematological and bio chemical parameters, and inflammatory markers (serum delta neutrophil index – DNI – and systemic inflammatory index parameters) of the groups were recorded and compared between groups. Results: In terms of neutrophil lymphocyte ratio, platelet lymphocyte ratio, and DNI, the HELLP group was different from both groups. The control and preeclampsia groups were similar. In terms of monocyte-to-lymphocyte ratio, the preeclampsia group was different from both groups. The control and HELLP groups were similar. In terms of the systemic inflammatory index, all groups were similar. Conclusion: In our study, we found that when maternal serum DNI values are used together with other bio chemical parameters, it can help in the diagnosis of preeclampsia and HELLP syndrome, and inflammation may play a role in the pathogenesis of these diseases.
- Klíčová slova
- delta neutrophil index, systemic inflammation index,
- MeSH
- biologické markery * krev MeSH
- dospělí MeSH
- HELLP syndrom diagnóza MeSH
- lidé MeSH
- neutrofily MeSH
- preeklampsie diagnóza MeSH
- statistika jako téma MeSH
- studie případů a kontrol MeSH
- těhotenství MeSH
- zánět krev MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
PURPOSE: We assessed the prognostic value of systemic immune-inflammation index (SII) to refine risk stratification of the heterogeneous spectrum of patients with non-muscle-invasive bladder cancer (NMIBC) METHODS: In this multi-institutional cohort, preoperative blood-based SII was retrospectively assessed in 1117 patients with NMIBC who underwent transurethral resection of bladder (TURB) between 1996 and 2007. The optimal cut-off value of SII was determined as 580 using the best Youden index. Cox regression analyses were performed. The concordance index (C-index) and decision curve analysis (DCA) were used to assess the discrimination of the predictive models. RESULTS: Overall, 309 (28%) patients had high SII. On multivariable analyses, high SII was significantly associated with worse PFS (hazard ratio [HR] 1.84; 95% confidence interval [CI] 1.23-2.77; P = 0.003) and CSS (HR 2.53; 95% CI 1.42-4.48; P = 0.001). Subgroup analyses, according to the European Association of Urology guidelines, demonstrated the main prognostic impact of high SII, with regards to PFS (HR 3.39; 95%CI 1.57-7.31; P = 0.002) and CSS (HR 4.93; 95% CI 1.70-14.3; P = 0.005), in patients with intermediate-risk group; addition of SII to the standard predictive model improved its discrimination ability both on C-index (6% and 12%, respectively) and DCA. In exploratory intergroup analyses of patients with intermediate-risk, the improved discrimination ability was retained the prediction of PFS and CSS. CONCLUSION: Preoperative SII seems to identify NMIBC patients who have a worse disease and prognosis. Such easily available and cheap standard biomarkers may help refine the decision-making process regarding adjuvant treatment in patients with intermediate-risk NMIBC.
- MeSH
- hodnocení rizik MeSH
- invazivní růst nádoru MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory močového měchýře komplikace imunologie patologie MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- senioři MeSH
- zánět etiologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
PURPOSE: To investigate the prognostic role of the preoperative systemic immune-inflammation index (SII) in patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU). MATERIALS AND METHODS: We retrospectively analyzed our multi-institutional database to identify 2492 patients. SII was calculated as platelet count × neutrophil/lymphocyte count and evaluated at a cutoff of 485. Logistic regression analyses were performed to investigate the association of SII with muscle-invasive and non-organ-confined (NOC) disease. Cox regression analyses were performed to investigate the association of SII with recurrence-free, cancer-specific, and overall survival (RFS/CSS/OS). RESULTS: Overall, 986 (41.6%) patients had an SII > 485. On univariable logistic regression analyses, SII > 485 was associated with a higher risk of muscle-invasive (P = 0.004) and NOC (P = 0.03) disease at RNU. On multivariable logistic regression, SII remained independently associated with muscle-invasive disease (P = 0.01). On univariable Cox regression analyses, SII > 485 was associated with shorter RFS (P = 0.002), CSS (P = 0.002) and OS (P = 0.004). On multivariable Cox regression analyses SII remained independently associated with survival outcomes (all P < 0.05). Addition of SII to the multivariable models improved their discrimination of the models for predicting muscle-invasive disease (P = 0.02). However, all area under the curve and C-indexes increased by < 0.02 and it did not improve net benefit on decision curve analysis. CONCLUSIONS: Preoperative altered SII is significantly associated with higher pathologic stages and worse survival outcomes in patients treated with RNU for UTUC. However, the SII appears to have relatively limited incremental additive value in clinical use. Further study of SII in prognosticating UTUC is warranted before routine use in clinical algorithms.
- MeSH
- biologické markery * MeSH
- imunita * MeSH
- lidé MeSH
- odds ratio MeSH
- počet leukocytů MeSH
- počet lymfocytů MeSH
- počet trombocytů MeSH
- prognóza MeSH
- recidiva MeSH
- urologické nádory diagnóza etiologie mortalita terapie MeSH
- zánět etiologie metabolismus MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Identifying those of patients with metastatic renal cell carcinoma (mRCC) who are most likely to benefit from cytoreductive nephrectomy (CN) is challenging. We tested the association between preoperative value of Systemic Immune-Inflammation Index (SII) and overall survival (OS) as well as cancer-specific survival (CSS) in mRCC patients treated with CN. METHODS: mRCC patients treated with CN at different institutions were included. After assessing for the optimal pretreatment SII cut‐off value, we found 710 to have the maximum Youden Index value. The overall population was therefore divided into two SII groups using this cut‐off (low, <710 vs. high, ≥710). Univariable and multivariable Cox regression analyses tested the association SII and OS as well as CSS. The discrimination of the model was evaluated with the Harrel's Concordance Index (C-Index). The clinical value of the SII was evaluated with decision curve analysis (DCA). RESULTS: Among 613 mRCC patients, 298 (49%) patients had a SII≥710. Median follow-up was 31 (IQR 16-58) months. On univariable analysis, high preoperative serum SII was significantly associated with worse OS (HR: 1.28, 95% CI: 1.07-1.54, P=0.01) and CSS (HR: 1.29, 95% CI: 1.08-1.55, P=0.01). On multivariable analysis, which adjusted for the effect of established clinicopathologic features, SII≥710 was associated with OS (HR: 1.25, 95% CI: 1.04-1.50, P=0.02) and CSS (HR: 1.26, 95% CI: 1.05-1.52, P=0.01). The addition of SII only slightly improved the discrimination of a base model that included established clinicopathologic features (C-index: 0.637 vs. 0.629). On DCA, the inclusion of SII did not improve the net-benefit of the prognostic model. On multivariable analyses, SII≥710 remained independently associated with the worse OS and CSS in IMDC intermediate risk group (both: HR: 1.31, 95% CI: 1.02-1.67, P=0.03). In the subgroup analyses based on the BMI, among patients with BMI ≥ 25, SII was significantly associated with OS (HR: 1.29, 95% CI: 1.04-1.61, P=0.02) and CSS (HR: 1.31, 95% CI: 1.05-1.63, P=0.02). CONCLUSIONS: We found an independent association of high SII prior to CN with unfavorable clinical outcomes, particularly in patients with intermediate risk mRCC and patients with increased BMI. Despite these results, it does not seem to add any prognostic or clinical benefit beyond that obtained by currently available clinicopathologic characteristics as sole worker.
- MeSH
- cytoredukční chirurgie * MeSH
- karcinom z renálních buněk * imunologie patologie chirurgie MeSH
- lidé MeSH
- nádory ledvin * imunologie patologie chirurgie MeSH
- nefrektomie * metody MeSH
- předoperační péče MeSH
- prognóza MeSH
- zánět imunologie patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Systemic treatment with immune combinations is the gold standard for metastatic renal cell carcinoma (mRCC) worldwide. The systemic immune-inflammation index (SII) is a prognostic marker for several types of malignant neoplasms, including mRCC, in the era of tyrosine kinase inhibitor (TKI) treatment. Data regarding the prognostic value of the SII in patients with mRCC treated with immunotherapy are scarce and controversial. METHODS: We retrospectively collected the data of patients with mRCC from 56 centers in 18 countries. SII (Platelet × Neutrophil/Lymphocyte count) was calculated prior to the first systemic treatment and cut-off was defined by a survival receiver operating characteristic (ROC) analysis. The primary objective of our retrospective study was to assess the outcomes of patients treated with first-line immunotherapy. RESULTS: Data from 1034 mRCC patients was collected and included in this analysis. The SII cut-off value was 1265. After a follow-up of 26.7 months, and the overall survival (OS) and progression-free survival (PFS) were 39.8 and 15.7 months, respectively. According to SII (low vs. high), patients with low-SII had longer OS (55.7 vs. 22.2 months, P < .001), better PFS (20.8 vs. 8.5 months, P < .001), and higher overall response rate (52 vs. 37%, P = .033). CONCLUSION: A high SII is associated with poor oncological outcomes in patients with mRCC. SII could be an easily accessible prognostic indicator for use in clinical practice.
- MeSH
- analýza přežití MeSH
- karcinom z renálních buněk * patologie MeSH
- lidé MeSH
- nádory ledvin * patologie MeSH
- prognóza MeSH
- retrospektivní studie MeSH
- zánět patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: This study investigates the associations of body mass index (BMI) and waist circumference (WC) with markers of systemic inflammation in midlife by race and gender. DESIGN: Data were obtained from the Survey of Midlife in the United States, a cross-sectional, observational study of Americans 35 years old or older (White men: N = 410; White women: N = 490; Black men: N = 58; Black women: N = 117). Inflammation was measured by concentrations of fibrinogen and C-reactive protein (CRP) in fasting plasma and concentrations of E-selectin and interleukin-6 (IL-6) in fasting serum. Anthropometric data were used to obtain BMI and WC. Socio-demographic and health-related factors were assessed with a survey. Multivariate models by race and gender were estimated to test the roles of BMI and WC for each inflammation marker. RESULTS: Compared to White men, Black women have higher BMI and higher levels of all four inflammation markers; White women have lower BMI, lower WC, and lower E-selectin and fibrinogen but higher CRP; and Black men have higher fibrinogen. After adjusting for socio-demographic and health-related covariates as well as perceived discrimination, WC is associated with all four markers of inflammation among White men and women; with three markers (fibrinogen, CRP, and IL-6) of inflammation among Black women; and with CRP (and marginally with fibrinogen and E-selectin) among Black men. BMI is associated with higher CRP and fibrinogen among Black men (marginally so for White men) but not for women of either race. CONCLUSIONS: WC shows more consistent associations with inflammation markers than BMI, although the relationships vary by inflammation marker and population group. Our findings suggest that WC is a risk factor for systemic inflammation among White and Black men and women, and BMI is an additional risk factor for Black men.
- MeSH
- běloši statistika a číselné údaje MeSH
- biologické markery MeSH
- C-reaktivní protein biosyntéza MeSH
- černoši nebo Afroameričané statistika a číselné údaje MeSH
- dospělí MeSH
- E-selektin biosyntéza MeSH
- fibrinogen biosyntéza MeSH
- index tělesné hmotnosti * MeSH
- interleukin-6 biosyntéza MeSH
- lidé středního věku MeSH
- lidé MeSH
- mediátory zánětu MeSH
- obvod pasu * MeSH
- průřezové studie MeSH
- rizikové faktory MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- sexuální faktory MeSH
- socioekonomické faktory MeSH
- tělesné váhy a míry MeSH
- zánět etnologie patofyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
- Geografické názvy
- Spojené státy americké MeSH
PURPOSE: To evaluate the predictive and prognostic value of the Systemic Immune-inflammation Index (SII) in a large cohort of patients treated with radical prostatectomy (RP) for clinically non-metastatic prostate cancer (PCa). METHODS: We retrospectively analyzed our multicenter database comprising 6,039 consecutive patients. The optimal preoperative SII cut-off value was assessed with the Youden index calculated on a time-dependent receiver operating characteristic (ROC) curve. Logistic regression and Cox regression analyses were used to investigate the association of SII with pathologic features and biochemical recurrence (BCR), respectively. The discriminatory ability of the models was evaluated by calculating the concordance-indices (C-Index). The clinical benefit of the implementation of SII in clinical decision making was assessed using decision curve analysis (DCA). RESULTS: Patients with high preoperative SII (≥ 620) were more likely to have adverse clinicopathologic features. On multivariable logistic regression analysis, high preoperative SII was independently associated with extracapsular extension (odds ratio [OR] 1.16, P = 0.041), non-organ confined disease (OR 1.18, P = 0.022), and upgrading at RP (OR 1.23, P < 0.001). We built two Cox regression models including preoperative and postoperative variables. In the preoperative multivariable model, high preoperative SII was associated with BCR (hazard ratio [HR] 1.34, 95% CI 1.15-1.55, P < 0.001). In the postoperative multivariable model, SII was not associated with BCR (P = 0.078). The addition of SII to established models did not improve their discriminatory ability nor did it increase the clinical net benefit on DCA. CONCLUSION: In men treated with RP for clinically nonmetastatic PCa, high preoperative SII was statistically associated with an increased risk of adverse pathologic features at RP as well as BCR. However, it did not improve the predictive accuracy and clinical value beyond that obtained by current predictive and prognostic models. SII together with a panel of complementary biomarkers is praised to help guide decision-making in clinically nonmetastatic PCa.
- MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory prostaty patologie chirurgie MeSH
- prognóza MeSH
- prostatektomie metody MeSH
- retrospektivní studie MeSH
- senioři MeSH
- výsledek terapie MeSH
- zánět patologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
Cíl: V této studii jsme se zaměřili na zjištění role parametrů periferní krve a indexu systémového zánětu (SII – systemic inflammatory index) v diagnostice hyperemesis gravidarum (HG) a zda mají prediktivní hodnotu při určování délky hospitalizace a rizika rehospitalizaci v případech HG. Materiál a metoda: V retrospektivní studii byly těhotné ženy hospitalizované pro HG (n = 112) a těhotné ženy zcela zdravé (n = 112) přiřazeny ke gestačnímu věku. Byly hodnoceny parametry zánětu periferní krve celé studované skupiny. Byla zaznamenávána délka hospitalizace a počet rehospitalizací pro případy HG. Výsledky: Do studie bylo zařazeno celkem 224 pacientů, 112 (50 %) v kontrolní skupině a 112 (50 %) ve skupině HG. Byla prokázána pozitivní korelace mezi zvýšenou ketonurií a délkou hospitalizace, parametry periferní krve a SII. Stupeň ketonurie byl shledán jako statisticky nevýznamný pro stanovení rizika rehospitalizace (p = 0,927). Do nemocnice byl přijato zpět 28,57 % (n = 32) případů HG. Při zohlednění délky hospitalizace bylo zjištěno, že SII je statisticky významný u hospitalizací trvajících déle než 2 dny (p = 0,001), ale nikoli u rehospitalizací (p = 0,3). Závěr: SII je významný v diagnostice a určování hospitalizace HG. Je dostačující pro stanovení délky hospitalizace, nikoli však rizika rehospitalizace, která je ukazatelem závažnosti onemocnění.
Objective: In this study, we aimed to investigate the role of peripheral blood parameters and the systemic inflammatory index (SII) in the diagnosis of hyperemesis gravidarum (HG) and whether they have a predictive value in determining the length of hospital stay and the risk of rehospitalization in HG cases. Materials and methods: In the retrospective study, pregnant women who were hospitalized due to HG (n = 112) and pregnant women who were completely healthy (n = 112) were matched for gestational age. Peripheral blood inflammation parameters of the entire study group were evaluated. The length of hospital stay and rehospitalization rate for HG cases were recorded. A total of 224 patients, 112 (50%) in the control group and 112 (50%) in the HG group were included in the study. There was a positive correlation between increased ketonuria and length of hospitalization, peripheric blood parameters, and SII. The degree of ketonuria was found to be statistically insignificant in determining the risk of rehospitalization (p = 0.927). About 28.57% (n = 32) of all HG cases were readmitted to the hospital. When the length of hospital stay was considered, SII was found to be statistically significant in hospitalizations lasting more than 2 days (p = 0.001), but not in rehospitalizations (p = 0.3). Conclusion: SII is significant in diagnosing and determining hospitalization of HG. It is sufficient to determine the length of hospital stay but not rehospitalization risk, which is an indicator of disease severity.
... Etiology 48 -- 3.6 Circulating Markers for Systemic Inflammation Characterization 49 -- 3.7 Conclusion ... ... Inflammation 205 -- Chun-Shiang Chung, Ryan Swan, Mario Perl, Doreen E. ... ... Inflammation 391 -- Nitin Seam and Anthony F. ... ... Inflammation: the Molecular Basis of Inflammation associated with Infection and Shock 397 -- 17.6 Endotoxin ... ... Inflammation 405 References 408 -- Index 417 ...
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- MeSH
- sepse * patofyziologie terapie MeSH
- syndrom systémové zánětlivé reakce * patofyziologie terapie MeSH
- Konspekt
- Patologie. Klinická medicína
- NLK Obory
- anesteziologie a intenzivní lékařství
- biochemie
- NLK Publikační typ
- kolektivní monografie