Prognostic value of the preoperative systemic immune-inflammation index in patients with non-small cell lung cancer: A systematic review and meta-analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

CHEN Mengqi ¹ , LIU Kemeng ² , ZHAO Huaqin ¹ ,  HE Xia ¹

1. Department of Respiratory and Critical Care Medicine, Second People's Hospital of Deyang City, Deyang, 618000, Sichuan, P. R. China;
2. Department of Thoracic Surgery, Renshou County People's Hospital, Meishan, 620500, Sichuan, P. R. China;

Corresponding author：

HE Xia, Email: 978192194@qq.com

Keywords：

Systemic immune-inflammation index; non-small cell lung cancer; prognosis; systematic review/meta-analysis

DOI：

10.7507/1007-4848.202202011

Video：

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Objective To explore the association between the preoperative systemic immune-inflammation index (SII) and prognosis in non-small cell lung cancer (NSCLC) patients. Methods A comprehensive literature survey was performed on PubMed, Web of Science, EMbase, The Cochrane Library, Wanfang, and CNKI databases to search the related studies from inception to December 2021. The hazard ratio (HR) and 95% confidence interval (CI) were combined to evaluate the correlation of the preoperative SII with overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS) in NSCLC patients. Results A total of 11 studies involving 9 180 patients were eventually included. The combined analysis showed that high SII levels were significantly associated with worse OS (HR=1.61, 95%CI 1.36-1.90, P<0.001), DFS (HR=1.50, 95%CI 1.34-1.68, P<0.001), and RFS (HR=1.17, 95%CI 1.04-1.33, P<0.001). Subgroup analyses also further verified the above results. Conclusion Preoperative SII is a powerful prognostic biomarker for predicting outcome in patients with operable NSCLC and contribute to prognosis evaluation and treatment strategy formulation. However, more well-designed and prospective studies are warranted to verify our findings.

Citation： CHEN Mengqi, LIU Kemeng, ZHAO Huaqin, HE Xia. Prognostic value of the preoperative systemic immune-inflammation index in patients with non-small cell lung cancer: A systematic review and meta-analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2023, 30(3): 440-446. doi: 10.7507/1007-4848.202202011 Copy

1.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2.	Bade BC, Dela Cruz CS. Lung cancer 2020: Epidemiology, etiology, and prevention. Clin Chest Med, 2020, 41(1): 1-24.
3.	Vansteenkiste J, Crinò L, Dooms C, et al. 2nd ESMO Consensus Conference on Lung Cancer: Early-stage non-small-cell lung cancer consensus on diagnosis, treatment and follow-up. Ann Oncol, 2014, 25(8): 1462-1474.
4.	Gao Y, Zhang H, Li Y, et al. Preoperative increased systemic immune-inflammation index predicts poor prognosis in patients with operable non-small cell lung cancer. Clin Chim Acta, 2018, 484: 272-277.
5.	Galdiero MR, Marone G, Mantovani A. Cancer inflammation and cytokines. Cold Spring Harb Perspect Biol, 2018, 10(8): a02866.
6.	Łochowski M, Chałubińska-Fendler J, Zawadzka I, et al. The prognostic significance of preoperative platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios in patients operated for non-small cell lung cancer. Cancer Manag Res, 2021, 13: 7795-7802.
7.	Yan H, Cai L, Chen S, et al. Preoperative lymphocyte-to-monocyte ratio versus platelet-to-lymphocyte ratio as a prognostic predictor for non-small cell lung cancer patients. J Med Biochem, 2020, 39(2): 160-164.
8.	Yang R, Chang Q, Meng X, et al. Prognostic value of systemic immune-inflammation index in cancer: A meta-analysis. J Cancer, 2018, 9(18): 3295-3302.
9.	Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
10.	李静宜. 癌症复合炎性因子水平与非小细胞肺癌预后的相关分析. 山东大学, 2018.
11.	Guo W, Cai S, Zhang F, et al. Systemic immune-inflammation index (SII) is useful to predict survival outcomes in patients with surgically resected non-small cell lung cancer. Thorac Cancer, 2019, 10(4): 761-768.
12.	Wang J, Hui Z, Men Y, et al. Systemic inflammation-immune status predicts survival in stage Ⅲ-N2 non-small cell lung cancer. Ann Thorac Surg, 2019, 108(6): 1701-1709.
13.	张辉, 施仲义, 胡一迪, 等. 术前系统免疫炎症指数和反应蛋白/血清白蛋白比值与非小细胞肺癌预后的相关性. 中国卫生检验杂志, 2019, 29(5): 573-576.
14.	Shoji F, Kozuma Y, Toyokawa G, et al. Complete blood cell count-derived inflammatory biomarkers in early-stage non-small-cell lung cancer. Ann Thorac Cardiovasc Surg, 2020, 26(5): 248-255.
15.	Yan X, Li G. Preoperative systemic immune-inflammation index predicts prognosis and guides clinical treatment in patients with non-small cell lung cancer. Biosci Rep, 2020, 40(3): BSR20200352.
16.	Fu F, Deng C, Wen Z, et al. Systemic immune-inflammation index is a stage-dependent prognostic factor in patients with operable non-small cell lung cancer. Transl Lung Cancer Res, 2021, 10(7): 3144-3154.
17.	Shen YJ, Qian LQ, Ding ZP, et al. Prognostic value of inflammatory biomarkers in patients with stage Ⅰ lung adenocarcinoma treated with surgical dissection. Front Oncol, 2021, 11: 711206.
18.	孙晓庆, 宗明园, 傅露. 系统免疫炎症指数对非小细胞肺癌患者预后的预测作用. 华南国防医学杂志, 2021, 35(12): 866-870.
19.	Watanabe K, Noma D, Masuda H, et al. Preoperative inflammation-based scores predict early recurrence after lung cancer resection. J Thorac Dis, 2021, 13(5): 2812-2823.
20.	Elinav E, Nowarski R, Thaiss CA, et al. Inflammation-induced cancer: Crosstalk between tumours, immune cells and microorganisms. Nat Rev Cancer, 2013, 13(11): 759-771.
21.	Jomrich G, Gruber ES, Winkler D, et al. Systemic immune-inflammation index (SII) predicts poor survival in pancreatic cancer patients undergoing resection. J Gastrointest Surg, 2020, 24(3): 610-618.
22.	Park J, Wysocki RW, Amoozgar Z, et al. Cancer cells induce metastasis-supporting neutrophil extracellular DNA traps. Sci Transl Med, 2016, 8(361): 361ra138.
23.	De Larco JE, Wuertz BR, Furcht LT. The potential role of neutrophils in promoting the metastatic phenotype of tumors releasing interleukin-8. Clin Cancer Res, 2004, 10(15): 4895-4900.
24.	Houghton AM, Rzymkiewicz DM, Ji H, et al. Neutrophil elastase-mediated degradation of IRS-1 accelerates lung tumor growth. Nat Med, 2010, 16(2): 219-223.
25.	Franco AT, Corken A, Ware J. Platelets at the interface of thrombosis, inflammation, and cancer. Blood, 2015, 126(5): 582-588.
26.	Li N. Platelets in cancer metastasis: To help the "villain" to do evil. Int J Cancer, 2016, 138(9): 2078-2087.
27.	Kataru RP, Ly CL, Shin J, et al. Tumor lymphatic function regulates tumor inflammatory and immunosuppressive microenvironments. Cancer Immunol Res, 2019, 7(8): 1345-1358.
28.	Qiu Y, Zhang Z, Chen Y. Prognostic value of pretreatment systemic immune-inflammation index in gastric cancer: A meta-analysis. Front Oncol, 2021, 11: 537140.
29.	Biswas T, Kang KH, Gawdi R, et al. Using the systemic immune-inflammation index (SII) as a mid-treatment marker for survival among patients with stage-Ⅲ locally advanced non-small cell lung cancer (NSCLC). Int J Environ Res Public Health, 2020, 17(21): 7995.
30.	Yang H, Wang K, Li B, et al. The prognostic role of blood inflammatory biomarkers and EGFR mutation status in stage ⅢA/N2 non-small cell lung cancer patients treated with trimodality therapy. Front Oncol, 2021, 11: 707041.
31.	Xiaowei M, Wei Z, Qiang W, et al. Assessment of systemic immune-inflammation index in predicting postoperative pulmonary complications in patients undergoing lung cancer resection. Surgery, 2022, 172(1): 365-370.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. Bade BC, Dela Cruz CS. Lung cancer 2020: Epidemiology, etiology, and prevention. Clin Chest Med, 2020, 41(1): 1-24.
3. Vansteenkiste J, Crinò L, Dooms C, et al. 2nd ESMO Consensus Conference on Lung Cancer: Early-stage non-small-cell lung cancer consensus on diagnosis, treatment and follow-up. Ann Oncol, 2014, 25(8): 1462-1474.
4. Gao Y, Zhang H, Li Y, et al. Preoperative increased systemic immune-inflammation index predicts poor prognosis in patients with operable non-small cell lung cancer. Clin Chim Acta, 2018, 484: 272-277.
5. Galdiero MR, Marone G, Mantovani A. Cancer inflammation and cytokines. Cold Spring Harb Perspect Biol, 2018, 10(8): a02866.
6. Łochowski M, Chałubińska-Fendler J, Zawadzka I, et al. The prognostic significance of preoperative platelet-to-lymphocyte and neutrophil-to-lymphocyte ratios in patients operated for non-small cell lung cancer. Cancer Manag Res, 2021, 13: 7795-7802.
7. Yan H, Cai L, Chen S, et al. Preoperative lymphocyte-to-monocyte ratio versus platelet-to-lymphocyte ratio as a prognostic predictor for non-small cell lung cancer patients. J Med Biochem, 2020, 39(2): 160-164.
8. Yang R, Chang Q, Meng X, et al. Prognostic value of systemic immune-inflammation index in cancer: A meta-analysis. J Cancer, 2018, 9(18): 3295-3302.
9. Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol, 2010, 25(9): 603-605.
10. 李静宜. 癌症复合炎性因子水平与非小细胞肺癌预后的相关分析. 山东大学, 2018.
11. Guo W, Cai S, Zhang F, et al. Systemic immune-inflammation index (SII) is useful to predict survival outcomes in patients with surgically resected non-small cell lung cancer. Thorac Cancer, 2019, 10(4): 761-768.
12. Wang J, Hui Z, Men Y, et al. Systemic inflammation-immune status predicts survival in stage Ⅲ-N2 non-small cell lung cancer. Ann Thorac Surg, 2019, 108(6): 1701-1709.
13. 张辉, 施仲义, 胡一迪, 等. 术前系统免疫炎症指数和反应蛋白/血清白蛋白比值与非小细胞肺癌预后的相关性. 中国卫生检验杂志, 2019, 29(5): 573-576.
14. Shoji F, Kozuma Y, Toyokawa G, et al. Complete blood cell count-derived inflammatory biomarkers in early-stage non-small-cell lung cancer. Ann Thorac Cardiovasc Surg, 2020, 26(5): 248-255.
15. Yan X, Li G. Preoperative systemic immune-inflammation index predicts prognosis and guides clinical treatment in patients with non-small cell lung cancer. Biosci Rep, 2020, 40(3): BSR20200352.
16. Fu F, Deng C, Wen Z, et al. Systemic immune-inflammation index is a stage-dependent prognostic factor in patients with operable non-small cell lung cancer. Transl Lung Cancer Res, 2021, 10(7): 3144-3154.
17. Shen YJ, Qian LQ, Ding ZP, et al. Prognostic value of inflammatory biomarkers in patients with stage Ⅰ lung adenocarcinoma treated with surgical dissection. Front Oncol, 2021, 11: 711206.
18. 孙晓庆, 宗明园, 傅露. 系统免疫炎症指数对非小细胞肺癌患者预后的预测作用. 华南国防医学杂志, 2021, 35(12): 866-870.
19. Watanabe K, Noma D, Masuda H, et al. Preoperative inflammation-based scores predict early recurrence after lung cancer resection. J Thorac Dis, 2021, 13(5): 2812-2823.
20. Elinav E, Nowarski R, Thaiss CA, et al. Inflammation-induced cancer: Crosstalk between tumours, immune cells and microorganisms. Nat Rev Cancer, 2013, 13(11): 759-771.
21. Jomrich G, Gruber ES, Winkler D, et al. Systemic immune-inflammation index (SII) predicts poor survival in pancreatic cancer patients undergoing resection. J Gastrointest Surg, 2020, 24(3): 610-618.
22. Park J, Wysocki RW, Amoozgar Z, et al. Cancer cells induce metastasis-supporting neutrophil extracellular DNA traps. Sci Transl Med, 2016, 8(361): 361ra138.
23. De Larco JE, Wuertz BR, Furcht LT. The potential role of neutrophils in promoting the metastatic phenotype of tumors releasing interleukin-8. Clin Cancer Res, 2004, 10(15): 4895-4900.
24. Houghton AM, Rzymkiewicz DM, Ji H, et al. Neutrophil elastase-mediated degradation of IRS-1 accelerates lung tumor growth. Nat Med, 2010, 16(2): 219-223.
25. Franco AT, Corken A, Ware J. Platelets at the interface of thrombosis, inflammation, and cancer. Blood, 2015, 126(5): 582-588.
26. Li N. Platelets in cancer metastasis: To help the "villain" to do evil. Int J Cancer, 2016, 138(9): 2078-2087.
27. Kataru RP, Ly CL, Shin J, et al. Tumor lymphatic function regulates tumor inflammatory and immunosuppressive microenvironments. Cancer Immunol Res, 2019, 7(8): 1345-1358.
28. Qiu Y, Zhang Z, Chen Y. Prognostic value of pretreatment systemic immune-inflammation index in gastric cancer: A meta-analysis. Front Oncol, 2021, 11: 537140.
29. Biswas T, Kang KH, Gawdi R, et al. Using the systemic immune-inflammation index (SII) as a mid-treatment marker for survival among patients with stage-Ⅲ locally advanced non-small cell lung cancer (NSCLC). Int J Environ Res Public Health, 2020, 17(21): 7995.
30. Yang H, Wang K, Li B, et al. The prognostic role of blood inflammatory biomarkers and EGFR mutation status in stage ⅢA/N2 non-small cell lung cancer patients treated with trimodality therapy. Front Oncol, 2021, 11: 707041.
31. Xiaowei M, Wei Z, Qiang W, et al. Assessment of systemic immune-inflammation index in predicting postoperative pulmonary complications in patients undergoing lung cancer resection. Surgery, 2022, 172(1): 365-370.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Prognostic value of the preoperative systemic immune-inflammation index in patients with non-small cell lung cancer: A systematic review and meta-analysis

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