BACKGROUND The prognostic value of the Systemic Inflammation Response Index(SIRI)in advanced pancreatic cancer is recognized,but its correlation with patients´nutritional status and outcomes remains unexplored.AI...BACKGROUND The prognostic value of the Systemic Inflammation Response Index(SIRI)in advanced pancreatic cancer is recognized,but its correlation with patients´nutritional status and outcomes remains unexplored.AIM To study the prognostic significance of SIRI and weight loss in metastatic pancreatic cancer.METHODS The PANTHEIA-Spanish Society of Medical Oncology(SEOM)study is a multicentric(16 Spanish hospitals),observational,longitudinal,non-interventional initiative,promoted by the SEOM Real World-Evidence work group.This pilot study sought to analyze the association between weight loss and inflammatory status as defined by SIRI.The cohort stems from a proof-of-concept pilot study conducted at one of the coordinating centers.Patients with pathologically confirmed metastatic pancreatic adenocarcinoma,treated from January 2020 to January 2023,were included.The index was calculated using the product of neutrophil and monocyte counts,divided by lymphocyte counts,obtained within 15 days before initiation chemotherapy.This study evaluated associations between overall survival(OS),SIRI and weight loss.RESULTS A total of 50 patients were included.66%of these patients were male and the median age was 66 years.Metastasis sites:36%liver,12%peritoneal carcinomatosis,10%lung,and 42%multiple locations.Regarding the first line palliative chemotherapy treatments:50%received gemcitabine plus nab-paclitaxel;28%,modified fluorouracil,leucovorin,irinotecan and oxaliplatin,and 16%were administered gemcitabine.42%had a weight loss>5%in the three months(mo)preceding diagnosis.21 patients with a SIRI≥2.3×10^(3)/L exhibited a trend towards a lower median OS compared to those with a SIRI<2.3×10^(3)/L(4 vs 18 mo;P<0.000).Among 21 patients with>5%weight loss before diagnosis,the median OS was 6 mo,in contrast to 19 mo for those who did not experience such weight loss(P=0.003).Patients with a weight loss>5%showed higher SIRI levels.This difference was statistically significant(P<0.000).For patients with a SIRI<2.3×10^(3)/L,those who did not lose>5%of their weight had an OS of 20 mo,compared to 11 mo for those who did(P<0.001).No association was found between carbohydrate antigen 19-9 levels≥1000 U/mL and weight loss.CONCLUSION A higher SIRI was correlated with decreased survival rates in patients with metastatic pancreatic cancer and associated with weight loss.An elevated SIRI is suggested as a predictor of survival,emphasizing the need for prospective validation in the upcoming PANTHEIA-SEOM study.展开更多
Objective The aim of the study was to investigate and compare the prognostic value of advanced inflammatory index,platelet/lymphocyte ratio(PLR),and Ki-67 expression in stageⅢ–Ⅳinoperable non-small cell lung cancer...Objective The aim of the study was to investigate and compare the prognostic value of advanced inflammatory index,platelet/lymphocyte ratio(PLR),and Ki-67 expression in stageⅢ–Ⅳinoperable non-small cell lung cancer(NSCLC)before treatment.Methods The clinical data of 98 inoperable patients with stageⅢ–ⅣNSCLC in our hospital(Fifth Department of Oncology,Hebei General Hospital,Shijiazhuang,China)before treatment were retrospectively analyzed,and advanced lung cancer inflammation index(ALI)was calculated using body mass index(BMI)×serum albumin(ALB)÷neutrophil/lymphocyte ratio(NLR).he optimal cutoff values of ALI and PLR for predicting prognosis is determined.Chi-square test was used to analyze the relationship between patients and clinical characteristics.Kaplan-Meier method was used to calculate the total survival of patients,and log-rank test was used for comparison.Independent prognostic factors were assessed by univariate and multivariate analyses.Spearman correlation was used to analyze the relationship among ALI,PLR,and Ki-67.Results In our study of the 98 cases,the survival time of the patients with ALI<18 was significantly lower than that of patients with ALI>18(P<0.001),with a median survival time of 10 months and 25 months,respectively.The survival time of patients with a PLR<185 was significantly higher than that of patients with a PLR>185(median survival time was 27 months vs.10 months,P<0.001).The higher the Ki-67 expression,the shorter the survival time(P<0.005).The combined ALI and PLR detection results indicated that the survival time of patients with high ALI and low PLR was significantly longer than that of patients with low ALI and high PLR(P<0.001).Univariate analysis showed that smoking history,degree of differentiation,KPS score,Ki-67 expression,ALI value,and PLR affected the prognosis of patients.Multivariate analysis showed that KPS score,ALI value,and Ki-67 expression were independent prognostic factors.Conclusion ALI,PLR,and Ki-67 expression are important predictors of stage III-IV inoperable NSCLC.In terms of the prognostic value,ALI seems to have the best ability to predict patient survival.In addition,the combined detection of ALI and PLR levels before treatment seems to be more helpful in improving our prediction of patient prognosis.Moreover,it is expected to play a role in future clinical applications.展开更多
目的探讨系统性免疫炎症指数(SII)对晚期非小细胞肺癌患者预后的预测价值。方法自2019年1月至2022年6月,回顾性收集新疆医科大学附属肿瘤医院收治的晚期非小细胞肺癌患者143例,对患者随访1年,观察患者是否发生肿瘤特异性死亡,将患者分...目的探讨系统性免疫炎症指数(SII)对晚期非小细胞肺癌患者预后的预测价值。方法自2019年1月至2022年6月,回顾性收集新疆医科大学附属肿瘤医院收治的晚期非小细胞肺癌患者143例,对患者随访1年,观察患者是否发生肿瘤特异性死亡,将患者分为死亡组(n=67)和对照组(n=76),比较两组患者系统性免疫炎症指数和其他临床特征差异,分析晚期非小细胞肺癌死亡的危险因素,同时分析系统性免疫炎症指数对肿瘤特异性死亡的预测价值。结果与对照组比较,死亡组原发肿瘤最大径增大(5.66±2.53 cm vs.4.79±1.91 cm,P=0.020);SII水平显著增高(522.44±242.98 vs.277.84±100.67,P<0.001);TNM分期为Ⅳ期的患者比例增高(76.12%vs.55.26%,P=0.011);合并胸腔积液的患者比例增高(92.54%vs.68.42%,P<0.001)。SII和原发肿瘤最大径对晚期非小细胞肺癌患者肿瘤特异性死亡均有一定预测价值,曲线下面积分别为0.849(95%可信区间:0.790~0.909,P<0.001)和0.598(95%可信区间:0.503~0.693,P=0.044)。原发肿瘤最大径、胸腔积液和SII是晚期非小细胞肺癌患者肿瘤特异性死亡的独立影响因素(P<0.05)。结论晚期非小细胞肺癌患者系统性炎症指数增高与肿瘤特异性死亡有关,可以作为预后的预测指标。展开更多
文摘BACKGROUND The prognostic value of the Systemic Inflammation Response Index(SIRI)in advanced pancreatic cancer is recognized,but its correlation with patients´nutritional status and outcomes remains unexplored.AIM To study the prognostic significance of SIRI and weight loss in metastatic pancreatic cancer.METHODS The PANTHEIA-Spanish Society of Medical Oncology(SEOM)study is a multicentric(16 Spanish hospitals),observational,longitudinal,non-interventional initiative,promoted by the SEOM Real World-Evidence work group.This pilot study sought to analyze the association between weight loss and inflammatory status as defined by SIRI.The cohort stems from a proof-of-concept pilot study conducted at one of the coordinating centers.Patients with pathologically confirmed metastatic pancreatic adenocarcinoma,treated from January 2020 to January 2023,were included.The index was calculated using the product of neutrophil and monocyte counts,divided by lymphocyte counts,obtained within 15 days before initiation chemotherapy.This study evaluated associations between overall survival(OS),SIRI and weight loss.RESULTS A total of 50 patients were included.66%of these patients were male and the median age was 66 years.Metastasis sites:36%liver,12%peritoneal carcinomatosis,10%lung,and 42%multiple locations.Regarding the first line palliative chemotherapy treatments:50%received gemcitabine plus nab-paclitaxel;28%,modified fluorouracil,leucovorin,irinotecan and oxaliplatin,and 16%were administered gemcitabine.42%had a weight loss>5%in the three months(mo)preceding diagnosis.21 patients with a SIRI≥2.3×10^(3)/L exhibited a trend towards a lower median OS compared to those with a SIRI<2.3×10^(3)/L(4 vs 18 mo;P<0.000).Among 21 patients with>5%weight loss before diagnosis,the median OS was 6 mo,in contrast to 19 mo for those who did not experience such weight loss(P=0.003).Patients with a weight loss>5%showed higher SIRI levels.This difference was statistically significant(P<0.000).For patients with a SIRI<2.3×10^(3)/L,those who did not lose>5%of their weight had an OS of 20 mo,compared to 11 mo for those who did(P<0.001).No association was found between carbohydrate antigen 19-9 levels≥1000 U/mL and weight loss.CONCLUSION A higher SIRI was correlated with decreased survival rates in patients with metastatic pancreatic cancer and associated with weight loss.An elevated SIRI is suggested as a predictor of survival,emphasizing the need for prospective validation in the upcoming PANTHEIA-SEOM study.
基金Supported by a grant from the Key Research Project of Medical Science in Hebei Province(No.20180006)。
文摘Objective The aim of the study was to investigate and compare the prognostic value of advanced inflammatory index,platelet/lymphocyte ratio(PLR),and Ki-67 expression in stageⅢ–Ⅳinoperable non-small cell lung cancer(NSCLC)before treatment.Methods The clinical data of 98 inoperable patients with stageⅢ–ⅣNSCLC in our hospital(Fifth Department of Oncology,Hebei General Hospital,Shijiazhuang,China)before treatment were retrospectively analyzed,and advanced lung cancer inflammation index(ALI)was calculated using body mass index(BMI)×serum albumin(ALB)÷neutrophil/lymphocyte ratio(NLR).he optimal cutoff values of ALI and PLR for predicting prognosis is determined.Chi-square test was used to analyze the relationship between patients and clinical characteristics.Kaplan-Meier method was used to calculate the total survival of patients,and log-rank test was used for comparison.Independent prognostic factors were assessed by univariate and multivariate analyses.Spearman correlation was used to analyze the relationship among ALI,PLR,and Ki-67.Results In our study of the 98 cases,the survival time of the patients with ALI<18 was significantly lower than that of patients with ALI>18(P<0.001),with a median survival time of 10 months and 25 months,respectively.The survival time of patients with a PLR<185 was significantly higher than that of patients with a PLR>185(median survival time was 27 months vs.10 months,P<0.001).The higher the Ki-67 expression,the shorter the survival time(P<0.005).The combined ALI and PLR detection results indicated that the survival time of patients with high ALI and low PLR was significantly longer than that of patients with low ALI and high PLR(P<0.001).Univariate analysis showed that smoking history,degree of differentiation,KPS score,Ki-67 expression,ALI value,and PLR affected the prognosis of patients.Multivariate analysis showed that KPS score,ALI value,and Ki-67 expression were independent prognostic factors.Conclusion ALI,PLR,and Ki-67 expression are important predictors of stage III-IV inoperable NSCLC.In terms of the prognostic value,ALI seems to have the best ability to predict patient survival.In addition,the combined detection of ALI and PLR levels before treatment seems to be more helpful in improving our prediction of patient prognosis.Moreover,it is expected to play a role in future clinical applications.
文摘目的探讨系统性免疫炎症指数(SII)对晚期非小细胞肺癌患者预后的预测价值。方法自2019年1月至2022年6月,回顾性收集新疆医科大学附属肿瘤医院收治的晚期非小细胞肺癌患者143例,对患者随访1年,观察患者是否发生肿瘤特异性死亡,将患者分为死亡组(n=67)和对照组(n=76),比较两组患者系统性免疫炎症指数和其他临床特征差异,分析晚期非小细胞肺癌死亡的危险因素,同时分析系统性免疫炎症指数对肿瘤特异性死亡的预测价值。结果与对照组比较,死亡组原发肿瘤最大径增大(5.66±2.53 cm vs.4.79±1.91 cm,P=0.020);SII水平显著增高(522.44±242.98 vs.277.84±100.67,P<0.001);TNM分期为Ⅳ期的患者比例增高(76.12%vs.55.26%,P=0.011);合并胸腔积液的患者比例增高(92.54%vs.68.42%,P<0.001)。SII和原发肿瘤最大径对晚期非小细胞肺癌患者肿瘤特异性死亡均有一定预测价值,曲线下面积分别为0.849(95%可信区间:0.790~0.909,P<0.001)和0.598(95%可信区间:0.503~0.693,P=0.044)。原发肿瘤最大径、胸腔积液和SII是晚期非小细胞肺癌患者肿瘤特异性死亡的独立影响因素(P<0.05)。结论晚期非小细胞肺癌患者系统性炎症指数增高与肿瘤特异性死亡有关,可以作为预后的预测指标。
