Retrospective Cohort Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 14, 2017; 23(34): 6261-6272
Published online Sep 14, 2017. doi: 10.3748/wjg.v23.i34.6261
Systemic immune-inflammation index for predicting prognosis of colorectal cancer
Jian-Hui Chen, Er-Tao Zhai, Yu-Jie Yuan, Kai-Ming Wu, Jian-Bo Xu, Jian-Jun Peng, Chuang-Qi Chen, Yu-Long He, Shi-Rong Cai
Jian-Hui Chen, Er-Tao Zhai, Yu-Jie Yuan, Kai-Ming Wu, Jian-Bo Xu, Jian-Jun Peng, Chuang-Qi Chen, Yu-Long He, Shi-Rong Cai, Gastrointestinal Surgery Center, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
Jian-Hui Chen, Er-Tao Zhai, Yu-Jie Yuan, Kai-Ming Wu, Jian-Bo Xu, Jian-Jun Peng, Chuang-Qi Chen, Yu-Long He, Shi-Rong Cai, Gastric Cancer Center, Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China
Author contributions: Chen JH and Zhai ET contributed equally to this study, and both conceptualized and designed the study, analyzed and interpreted the data, drafted the manuscript, and critically revised the manuscript for important intellectual content; Yuan YJ, Wu KM, Xu JB, Peng JJ and He YL participated in data acquisition and statistical analysis; Chen CQ and Cai SR supervised the whole study and monitored the standard surgical operations; all the authors took part in the surgical treatment of colorectal cancer.
Supported by National Nature Science Foundation of China, No. 81672343 and No. 81372341; Guangdong Province Natural Science Fund of China, No. 2014A030310111; and Guangdong Science and Technology Plan Project of China, No. 2013B021800131and No. 201604020003.
Institutional review board statement: The present study was approved by the ethics committee of the First Affiliated Hospital of Sun Yat-sen University.
Informed consent statement: The requirement for informed consent was waived owing to the retrospective nature of this study.
Conflict-of-interest statement: The authors have no conflict of interest related to the manuscript.
Data sharing statement: The original anonymous dataset is available on request from the corresponding author at chenchqi@mail.sysu.edu.cn.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Chuang-Qi Chen, MD, Gastrointestinal Surgery Center, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, Guangdong Province, China. chenchqi@mail.sysu.edu.cn
Telephone: +86-87-755766-6211 Fax: +86-87-755766-6211
Received: March 25, 2017
Peer-review started: March 29, 2017
First decision: March 16, 2017
Revised: June 3, 2017
Accepted: July 4, 2017
Article in press: July 4, 2017
Published online: September 14, 2017
Processing time: 175 Days and 12 Hours
Abstract
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.

Keywords: Colorectal cancer; Systemic immune-inflammation index; Neutrophil-lymphocyte ratio; Platelet-lymphocyte ratio; Prognosis

Core tip: A preoperative systemic immune-inflammation index based on peripheral lymphocyte, neutrophil, and platelet counts was established, and better prognostic predictive abilities for overall survival and recurrence were found when compared with neutrophil-lymphocyte ratio and platelet-lymphocyte ratio in patients with colorectal cancer. This index might assist the identification of high-risk patients among patients with the same TNM stage in clinical practice.