Retrospective Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Nov 27, 2023; 15(11): 2445-2455
Published online Nov 27, 2023. doi: 10.4240/wjgs.v15.i11.2445
Correlation between preoperative systemic immune inflammation index, nutritional risk index, and prognosis of radical resection of liver cancer
Jing Li, Hai-Yan Shi, Min Zhou
Jing Li, Department of Infectious Diseases, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Hai-Yan Shi, Department of Radiology, Liuzhou Hospital of Traditional Chinese Medicine, Liuzhou 545001, Guangxi Zhuang Autonomous Region, China
Min Zhou, Department of Integrated Chinese and Western Medicine, Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Institute of Cancer Research, Nanjing 210009, Jiangsu Province, China
Co-first authors: Jing Li and Hai-Yan Shi.
Author contributions: Li J and Shi HY designed and conducted the research and wrote the manuscript; Zhou M provided clinical advice and supervised the report; All authors were involved in the critical review of the results and have contributed to, read, and approved the final manuscript. Li J and Shi HY contributed equally to this work as co-first authors. The reasons for designating Li J and Shi HY as co-first authors are threefold. First, the research was performed as a collaborative effort, and the designation of co-first authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant paper. This also ensures effective communication and management of post-submission matters, ultimately enhancing the paper's quality and reliability. Second, the overall research team encompassed authors with a variety of expertise and skills from different fields; thus, the designation of co-first authors best reflects this diversity. This also promotes the most comprehensive and in-depth examination of the research topic, ultimately enriching readers' understanding by offering various expert perspectives. Third, Li J and Shi HY contributed efforts of equal substance throughout the research process. The choice of these researchers as co-first authors acknowledges and respects their equal contribution, while recognizing the spirit of teamwork and collaboration on this study. To conclude, we believe that designating Li J and Shi HY as co-first authors is appropriate for our manuscript and accurately reflects our team's collaborative spirit, equal contributions, and diversity.
Supported by the Soft Science Research Project of Liuzhou Association for Science and Technology, No. 20200120; and Self-funded scientific research project of Guangxi Zhuang Autonomous Region Health Commission, No. Z20200258.
Institutional review board statement: This study was reviewed and approved by Liuzhou Hospital of Traditional Chinese Medicine.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: The authors declare no conflict of interest.
Data sharing statement: Clinical data used in this study can be obtained from the corresponding author.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Min Zhou, MD, Attending Doctor, Technician, Department of Integrated Chinese and Western Medicine, Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Institute of Cancer Research, No. 42 Baiziting, Xuanwu District, Nanjing 210009, Jiangsu Province, China. cathyzhou0511@njmu.edu.cn
Received: August 30, 2023
Peer-review started: August 30, 2023
First decision: September 13, 2023
Revised: September 22, 2023
Accepted: October 17, 2023
Article in press: October 17, 2023
Published online: November 27, 2023
Processing time: 89 Days and 1.6 Hours
Abstract
BACKGROUND

Radical surgery is the most commonly used treatment for hepatocellular carcinoma (HCC). However, the surgical effect remains not ideal, and prognostic evaluation is insufficient. Furthermore, clinical intervention is rife with uncertainty and not conducive to prolonging patient survival.

AIM

To explore correlations between the systemic immune inflammatory index (SII) and geriatric nutritional risk index (GNRI) and HCC operation prognosis.

METHODS

This retrospective study included and collected follow up data from 100 HCC. Kaplan–Meier survival curves were used to analyze the correlation between SII and GNRI scores and survival. SII and GNRI were calculated as follows: SII = neutrophil count × platelet count/lymphocyte count; GNRI = [1.489 × albumin (g/L) + 41.7 × actual weight/ideal weight]. We analyzed the predictive efficacy of the SII and GNRI in HCC patients using receiver operating characteristic (ROC) curves, and the relationships between the SII, GNRI, and survival rate using Kaplan–Meier survival curves. Cox regression analysis was utilized to analyze independent risk factors influencing prognosis.

RESULTS

After 1 year of follow-up, 24 patients died and 76 survived. The area under the curve (AUC), sensitivity, specificity, and the optimal cutoff value of SII were 0.728 (95% confidence interval: 0.600-0.856), 79.2%, 63.2%, and 309.14, respectively. According to ROC curve analysis results for predicting postoperative death in HCC patients, the AUC of SII and GNRI combination was higher than that of SII or GNRI alone, and SII was higher than that of GNRI (P < 0.05). The proportion of advanced differentiated tumors, tumor maximum diameter (5–10 cm, > 10 cm), lymph node metastasis, and TNM stage III-IV in patients with SII > 309.14 was higher than that in patients with SII ≤ 309.14 (P < 0.05). The proportion of patients aged > 70 years was higher in patients with GNRI ≤ 98 than that in patients with GNRI > 98 (P < 0.05). The 1-year survival rate of the SII > 309.14 group (compared with the SII ≤ 309.14 group) and GNRI ≤ 98 group (compared with the GNRI > 98 group) was lower (P < 0.05).

CONCLUSION

The prognosis after radical resection of HCC is related to the SII and GNRI and poor in high SII or low GNRI patients.

Keywords: Systemic immune inflammation index; Nutritional risk index; Radical resection; Liver cancer; Prognosis; Correlation

Core Tip: Hepatocellular carcinoma (HCC) has a high incidence and mortality. We evaluated the systemic immune inflammatory index (SII), geriatric nutritional risk index (GNRI), and clinicopathological features of 100 patients undergoing radical HCC resection in this research. We analyzed the correlation between SII, GNRI, and clinicopathological characteristics and addressed the problem of weak prognostic assessment by studying the changes in survival rates of patients undergoing HCC treatment under different levels of SII and GNRI.