The prognostic predictive value of systemic immune index and systemic inflammatory response index in nasopharyngeal carcinoma: A systematic review and meta-analysis

Systemic Inflammatory Biomarkers as a Predictive Markers for Ovarian Cancer

Objective

Tumor markers such as CA125 are highly beneficial in predictive ovarian malignancy; however, this advanced test is not always available in remote areas. To address this issue, the author aimed to explore the use of systemic inflammatory biomarkers as complementary modalities for diagnosis of ovarian malignancy.

Methods

This diagnostic study utilized a cross-sectional approach, with outcomes measured by AUC and sensitivity. A total of 132 patients with adnexal tumors were consecutively included and measured a complete blood count. From this, the MLR (Monocyte Lymphocyte Ratio), NLR (Neutrophil Lymphocyte Ratio), PLR (Platelet Lymphocyte Ratio), SII (Systemic Immune Inflammation Index), and SIRI (Systemic Inflammatory Response Index) biomarkers were calculated. After surgery, histopathological examination was performed as the gold standard and the biomarker predictions were then compared to it, followed by statistical analysis.

Results

The AUC values for MLR, NLR, PLR, SII, and SIRI were 0.70, 0.731, 0.696, 0.743, and 0.722, respectively. The p-values were MLR (0.005), NLR (0.001), PLR (0.001), SII (<0.001), and SIRI (<0.001), respectively. In multivariate analysis, only SII was significant (p = 0.015). The Exp(B) and 95% CI were 5.472 (1.383-21.655). The validity test for SII showed satisfactory results: sensitivity 71.64%, specificity 73.84%, PPV 73.84%, NPV 71.64%, accuracy 72.72%, LR+ 2.74%, and LR- 0.38%.

Conclusion

Systemic inflammatory biomarkers, particularly SII may aid in the predictive markers of early ovarian with diagnostic values nearly as good as CA125 (sensitivity 71.64% vs 75.97%). These biomarkers can serve as complementary predictive markes modalities for ovarian malignancy, especially when advanced tumor marker tests like CA125 are not available in remote areas.

Systemic inflammatory response index as a novel biomarker for age-related macular degeneration: a cross-sectional study from NHANES (2005-2008)

Background

Chronic low-grade systemic inflammation plays a significant role in age-related macular degeneration (AMD) pathogenesis. The systemic inflammatory response index (SIRI), a novel inflammatory marker, may predict various diseases. However, data on the relationship between SIRI and AMD are limited. This study examines the relationship between SIRI and AMD and assesses its potential as a predictive biomarker.

Methods

A cross-sectional analysis of the National Health and Nutrition Examination Survey (NHANES) data from 2005 to 2008 was conducted on participants aged ≥40 years with SIRI and AMD status data. Multivariable logistic regression models adjusted for confounders were used to assess the association. Sensitivity and subgroup analyses, along with restricted cubic spline (RCS) curve analysis, were performed.

Results

Among 5,365 participants, 425 (7.9%) had AMD. The median SIRI was higher in AMD patients (1.23 vs. 1.04, p < 0.001). Higher SIRI was independently associated with increased odds (adjusted OR: 1.18, 95% CI:1.07-1.29, p = 0.001). RCS analyses revealed a dose-response relationship (p = 0.002). Subgroup analyses showed a positive association in male participants, individuals with hypertension, individuals with obesity, and non-smokers. Higher SIRI levels were independently associated with increased AMD risk (adjusted OR: 1.27, 95% CI: 1.03-1.56, p = 0.023).

Conclusion

Elevated SIRI is independently associated with increased AMD risk in the U.S. population. SIRI may serve as a biomarker for identifying high-risk individuals, enabling early intervention. The cross-sectional design limits causal inference, and unmeasured confounders may affect the results. SIRI could potentially serve as a non-invasive biomarker for AMD risk, pending further validation through longitudinal studies.

Machine learning-derived prognostic signature for progression-free survival in non-metastatic nasopharyngeal carcinoma

BACKGROUND

Early detection of high-risk nasopharyngeal carcinoma (NPC) recurrence is essential. We created a machine learning-derived prognostic signature (MLDPS) by combining three machine learning (ML) models to predict progression-free survival (PFS) in patients with non-metastatic NPC.

METHODS

A cohort of 653 patients with non-metastatic NPC was divided into a training (n = 457) and validation (n = 196) dataset (7:3 ratio). The study included clinicopathological characteristics, hematologic markers, and MRI findings in three machine learning models-random forest (RF), extreme gradient boosting (XGBoost), and least absolute shrinkage and selection operator (LASSO)-to predict progression-free survival (PFS). A Venn diagram identified the overlapping signatures from the three ML algorithms. Cox proportional hazard analysis determined the MLDPS for PFS.

RESULTS

The RF, XGBoost, and LASSO algorithms identified six consensus factors from the 33 signatures. Cox proportional hazards analysis showed that the MLDPS includes age, lymphocyte count, number of positive lymph nodes, and regional lymph node density. Additionally, MLDPS effectively stratified prognosis, with low-risk individuals showing better PFS than high-risk individuals (p < 0.001).

CONCLUSION

MLDPS, based on clinicopathological characteristics, hematologic markers, and MRI findings, is crucial for guiding clinical management and personalizing treatments for patients with non-metastatic NPC.

Prognostic value of pretreatment peripheral blood hemoglobin×lymphocyte/monocyte ratio in patients with nasopharyngeal carcinoma

OBJECTIVES

Peripheral whole blood cell counts have been used as prognostic indicators for various cancers, but their predictive value in nasopharyngeal carcinoma remain unclear. This study aims to evaluate the prognostic significance of the pretreatment hemoglobin×lymphocyte/monocyte ratio (HLMR) in non-recurrent, non-metastatic NPC patients undergoing definitive radiotherapy.

METHODS

Clinical and follow-up data from 805 NPC patients who completed definitive radiotherapy or chemoradiotherapy were retrospectively analyzed. Pretreatment hemoglobin, lymphocyte count, and monocyte count were collected to calculate HLMR. Receiver operating characteristic (ROC) curves were used to determine the optimal cut-off value of HLMR. Patients were then classified into high and low HLMR groups. The association between HLMR and clinicopathological characteristic was assessed using chi-square tests. Independent prognostic factors for overall survival (OS) and progression-free survival (PFS) were identified using Cox proportional hazards models. A nomogram was constructed based on the independent predictors to estimate patient survival rates, and internal validation was performed using a validation cohort.

RESULTS

The ROC curve identified 605.5 as the optimal HLMR cut-off value for predicting 5-year survival. Multivariate Cox regression analysis revealed that T stage (HR=1.886, 95% CI 1.331 to 2.673, P<0.001), N stage (HR=2.021, 95% CI 1.267 to 3.225, P=0.003), Eastern Cooperative Oncology Group (ECOG) score (HR=3.991, 95% CI 1.257 to 12.677, P=0.019), concurrent chemoradiotherapy regimen (HR=0.338, 95% CI 0.156 to 0.731, P=0.006), and HLMR (HR=0.648, 95% CI 0.460 to 0.912, P=0.013) were independent prognostic factors for OS. A nomogram including T stage, N stage, and HLMR in the training cohort was constructed to predict 3-, 5-, and 7-year OS, with a C-index of 0.713. The area under the curves for predicting 3-, 5-, and 7-year OS were 0.744, 0.665, and 0.682, respectively. Calibration curves showed good agreement between predicted and observed survival rates. The above results were further confirmed in the validation cohort.

CONCLUSIONS

Pretreatment HLMR may serve as a promising prognostic biomarker for patients with nasopharyngeal carcinoma.

Prognostic and clinicopathological role of pretreatment systemic inflammation response index (SIRI) in gastric cancer: a systematic review and meta-analysis

BACKGROUND

The systemic inflammatory response index (SIRI) is calculated via the following formula: SIRI = monocyte count × neutrophil count/lymphocyte count. The value of the SIRI in predicting the prognosis of gastric cancer (GC) remains controversial. This study revealed the precise effect of the SIRI in predicting GC prognosis through a meta-analysis.

METHODS

The ability of the SIRI to predict GC prognosis was evaluated by calculating combined hazard ratios (HRs) and 95% confidence intervals (CIs). Furthermore, the combined odds ratios (ORs) and 95% CIs were determined to analyze the associations between the SIRI and the clinicopathological characteristics of patients with GC.

RESULTS

Seven publications on a total of 1763 cases were included in this study. The SIRI threshold was between 0.58 and 1.35, and the median value was 0.85. Our pooled findings revealed that a higher SIRI was significantly linked with poor overall survival (OS) (HR = 1.87, 95% CI = 1.59-2.20, p < 0.001) and disease-free survival (DFS; HR = 1.88, 95% CI = 1.50-2.36, p < 0.001) in GC patients. However, the SIRI did not exhibit a significant association with sex (OR = 1.98, 95% CI = 0.82-4.75, p = 0.126), surgery type (OR = 0.96, 95% CI = 0.61-1.51, p = 0.847), tumor differentiation (OR = 0.75, 95% CI = 0.54-1.06, p = 0.099), or TNM stage (OR = 1.25, 95% CI = 0.34-4.62, p = 0.743) in patients with GC.

CONCLUSIONS

An elevated SIRI was significantly associated with unfavorable OS and DFS in patients with GC. Thus, the SIRI is a reliable biomarker for predicting GC prognosis in clinical practice.

Prognostic role of systemic inflammation response index (SIRI) in patients with pancreatic cancer: a meta-analysis

Background

The significance of the systemic inflammation response index (SIRI) in predicting the prognosis of patients with pancreatic cancer (PC) has been extensively explored; however, findings remain controversial. As such, this meta-analysis was performed to more precisely determine the utility of the SIRI in predicting PC prognosis.

Methods

A comprehensive literature search of the PubMed, Web of Science, Embase, and Cochrane Library databases for relevant studies, published up to June 25, 2024, was performed. The primary and secondary endpoints were overall survival (OS) and progression-free survival (PFS), respectively. The prognostic utility of the SIRI in predicting PC prognosis was estimated by calculating pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs).

Results

Seven studies comprising 1160 patients were included in the present meta-analysis. Pooled findings revealed that elevated SIRI was as a prominent prognostic marker of OS (HR 2.40 [95% CI 1.88-3.05]; p<0.001) and PFS (HR 1.95 [95% CI 1.19-3.21]; p=0.008) in patients diagnosed with PC. According to subgroup analysis, the SIRI remained an outstanding prognostic marker for OS, irrespective of region, sample size, study center, study design, TNM stage, cancer type, cut-off value, treatment, or survival analysis type (all p<0.05). Moreover, based on subgroup analysis, the SIRI demonstrated significant utility in predicting PFS, irrespective of region and threshold value (p<0.05).

Conclusion

Results of the present meta-analysis revealed that an increased SIRI significantly predicted OS and PFS in patients diagnosed with PC. Considering its cost-effectiveness and availability, the SIRI may be a promising biomarker for predicting prognosis in patients with PC.

Prognostic and clinicopathological value of systemic inflammation response index (SIRI) in patients with breast cancer: a meta-analysis

BACKGROUND

Many studies have explored the value of the systemic inflammation response index (SIRI) in predicting the prognosis of patients with breast cancer (BC); however, their findings remain controversial. Consequently, we performed the present meta-analysis to accurately identify the role of SIRI in predicting BC prognosis.

METHODS

PubMed, Embase, Cochrane Library, and Web of Science databases were comprehensively searched between their inception and February 10, 2024. The significance of SIRI in predicting overall survival (OS) and disease-free survival (DFS) in BC patients was analyzed by calculating pooled hazard ratios (HRs) and corresponding 95% confidence intervals (CIs).

RESULTS

Eight articles involving 2,997 patients with BC were enrolled in the present study. According to our combined analysis, a higher SIRI was markedly associated with dismal OS (HR = 2.43, 95%CI = 1.42-4.15, p < 0.001) but not poor DFS (HR = 2.59, 95%CI = 0.81-8.24, p = 0.107) in patients with BC. Moreover, based on the pooled results, a high SIRI was significantly related to T3-T4 stage (OR = 1.73, 95%CI = 1.40-2.14, p < 0.001), N1-N3 stage (OR = 1.61, 95%CI = 1.37-1.91, p < 0.001), TNM stage III (OR = 1.63, 95%CI = 1.34-1.98, p < 0.001), and poor differentiation (OR = 1.25, 95%CI = 1.02-1.52, p = 0.028).

CONCLUSION

According to our results, a high SIRI significantly predicted poor OS in patients with BC. Furthermore, elevated SIRI was also remarkably related to increased tumor size and later BC tumor stage. The SIRI can serve as a novel prognostic biomarker for patients with BC.

Association between the systemic inflammation response index and kidney stones in US adults: a cross-sectional study based on NHANES 2007-2018

This study examined the relationship between the systemic inflammation response index (SIRI) and kidney stone occurrence in adults in the United States. It also evaluated its potential as a predictor of kidney stones. A total of 24,833 adult participants were included in the study using cross-sectional data from the 2007-2018 National Health and Nutrition Examination Survey (NHANES) database. A history of kidney stones was ascertained through the administration of a questionnaire, and SIRI values (calculated based on neutrophil, monocyte, and lymphocyte counts) were determined for each participant. Logistic regression models were employed to examine the relationship between SIRI and kidney stones while accounting for potential confounding variables such as gender, age, race, lifestyle, and history of chronic disease. Subgroup analyses were also conducted. A significant positive correlation was observed between SIRI and kidney stones. In the unadjusted model, elevated SIRI was significantly and positively associated with an increased risk of kidney stones (OR = 1.17). Analysis of SIRI quartiles demonstrated a gradual increase in the risk ratio of kidney stones with increasing SIRI levels, indicating a clear dose-response relationship. In particular, in the model adjusted for multiple confounding variables, the risk of developing kidney stones in the highest SIRI quartile was increased by 20% compared to the lowest SIRI quartile (OR = 1.20, P = 0.007). There is a significant positive correlation between SIRI and kidney stones. SIRI may predict kidney stone risk and highlight the systemic inflammatory state's substantial contribution to kidney stones' pathogenesis.

Investigation of Nutritional Factors and Malnutrition Risk Prediction Model in Hospitalized Patients with Systemic Lupus Erythematosus in China

Introduction

Nutritional status is a critical indicator of overall health and immune function, significantly influencing treatment outcomes. Despite its importance, the nutritional status of patients with systemic lupus erythematosus (SLE) often receives insufficient attention. This study aims to evaluate the nutritional status of patients with SLE, identify factors associated with malnutrition, and develop a risk prediction model for malnutrition in this population.

Methods

We collected clinical data from a convenience sample of SLE patients at a general hospital in Ningxia Province, China, between January and December 2022. Univariate and multivariate logistic regression analyses were performed to determine the independent risk factors for malnutrition. A risk prediction model was constructed and evaluated using the receiver operating characteristic (ROC) curve.

Results

This study included 420 patients with SLE (mean age: 41.43 years, 91.7% women), of whom 46.2% were malnourished based on their serum albumin levels. Multivariate logistic regression analysis identified monthly income (OR=0.192, P<0.05), sleep quality (OR=2.559, P<0.05), kidney involvement (OR=4.269, P<0.05), disease activity (OR=2.743, P<0.05), leukocyte count (OR=1.576, P<0.05), lymphocyte count (OR=0.393, P<0.05), hemoglobin (OR=0.972, P<0.05), complement C3 (OR=0.802, P<0.05), and complement C4 (OR=0.493, P<0.05) as independent risk factors for malnutrition. The prediction model showed good predictive value with an area under the ROC curve of 0.895 (95% CI: 0.823-0.840), sensitivity of 0.907, and specificity of 0.827. The Hosmer-Lemeshow test indicated a good model fit (χ²=10.779, P=0.215).

Discussion

Malnutrition is a significant concern among SLE patients, influenced by a range of socioeconomic and clinical factors. Our risk prediction model, with its high sensitivity and specificity, provides a robust tool for early identification of malnutrition in this population. Implementing this model in clinical practice can guide healthcare providers in prioritizing at-risk patients, enabling proactive nutritional interventions that could potentially improve clinical outcomes, enhance quality of life, and reduce healthcare costs associated with SLE.

Prognostic role of systemic inflammation response index in patients with non-small cell lung cancer: a meta-analysis

OBJECTIVES

The significance of the systemic inflammation response index (SIRI) for predicting prognostic outcomes in patients with non-small cell lung cancer (NSCLC) has been analysed in previous studies, but no consistent conclusions have been obtained. Consequently, the present meta-analysis was performed to identify the significance of SIRI in predicting the prognosis of NSCLC.

DESIGN

This study followed the PRISMA guidelines.

DATA SOURCES

PubMed, Web of Science and Embase databases were searched between their inception and 26 November 2023.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES

Studies investigating the relationship between SIRI and survival outcomes of patients with NSCLC were included.

DATA EXTRACTION AND SYNTHESIS

The value of SIRI in predicting prognosis in NSCLC cases was predicted using combined hazard ratios (HRs) and 95% CIs.

RESULTS

Nine articles with 3728 cases were enrolled in this study. Based on our combined data, a higher SIRI value was markedly linked with poor overall survival (OS) (HR=2.08, 95% CI 1.68 to 2.58, p<0.001) and inferior progression-free survival (PFS) (HR=1.74, 95% CI 1.47 to 2.07, p<0.001) of NSCLC. According to the subgroup analysis, country, history and cut-off value did not affect the significance of SIRI in predicting OS and PFS in NSCLC (p<0.05).

CONCLUSIONS

A higher SIRI value was significantly associated with both OS and PFS in patients with NSCLC. Moreover, SIRI had a stable prognostic efficiency for NSCLC in various subgroups.

Prognostic value of systemic immune-inflammation index and systemic inflammation response index for oral cancers: A systematic review and meta-analysis

BACKGROUND

The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) are commonly used prognostic indicators for a variety of cancers. However, their utility in oral cancers is unknown. We systematically examined evidence on the ability of SII and SIRI to predict overall survival (OS) and disease-free survival (DFS) after oral cancers.

MATERIAL AND METHODS

Embase, PubMed, Web of Science, and Scopus were searched for oral cancer studies reporting OS or DFS based on SII or SIRI. Articles published up to 25th May 2024 were included.

RESULTS

17 studies were eligible (14 on SII and 3 on SIRI). Pretreatment high SII scores were found to be significantly linked with poor OS (HR: 1.62 95% 1.26, 2.08 I2=88%) and DFS (HR: 1.62 95% 1.25, 2.27 I2=86%) after oral cancer. Similarly, high SIRI was associated with worse OS in oral cancer patients (HR: 1.60 95% 1.31, 1.94 I2=0%). All results were unchanged on sensitivity analysis. Subgroup analysis based on location, cancer type, sample size, treatment, cut-off, methods of determining cut-off, analysis method, and study quality showed mixed results.

CONCLUSIONS

Acknowledging the limitations of current evidence, it seems that both SII and SIRI can predict the prognosis of oral cancers. High SII and SIRI are both associated with worse OS while high SII also predicts worse DFS.

The Systemic Inflammatory Response Index as a Novel Diagnostic Indicator for Bell's Palsy

Aims/Background The systemic inflammatory response index (SIRI), an emerging hematological marker of inflammation, has shown promise as a promising biomarker for a variety of inflammatory conditions. This study aims to explore the diagnostic role of SIRI in Bell's palsy (BP). Methods For this retrospective study, 73 people diagnosed with BP between January 2021 and December 2023 were recruited, along with 73 healthy controls who were age- and sex-matched. The SIRI and other blood inflammatory markers, including the systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), were determined for all participants, by enumerating their peripheral blood cell counts. Facial nerve function was assessed upon admission and after one month of treatment using the House-Brackmann Facial Nerve Grading System (H-B). According to this system, patients with an H-B grade of 1-2 are considered recovered, while those with an H-B grade of 3-6 are regarded as not recovered. Results The SIRI (0.94 vs 0.48, p < 0.001), SII (480.3 vs 329.12, p < 0.001), NLR (2.42 vs 1.41, p < 0.001), and PLR (141.05 vs 117.28, p = 0.001) showed a significant increase in the BP group compared to the control group. The receiver operating characteristic (ROC) curve analysis revealed that the area under the curve (AUC) for SIRI was higher than those for SII, NLR, and PLR, respectively. Upon one-month follow-up, significant differences in the values of SIRI, SII, and NLR were observed between the favorable prognosis group and the poor prognosis group (SIRI: 1.07 vs 0.87, p = 0.011; SII: 647.85 vs 422.11, p = 0.005; NLR: 3.31 vs 2.11, p = 0.013). The AUC of ROC curve for SIRI was found to be lower than that of SII but higher than that of NLR. Conclusion The SIRI has the potential to be an important BP diagnostic and prognostic marker.

The potential predictive value and relationship of blood-based inflammatory markers with the clinical symptoms of Han Chinese patients with first-episode adolescent-onset schizophrenia

Background

Inflammation is associated with the pathophysiology of schizophrenia. The blood markers for systemic inflammation include neutrophil-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), lymphocyte-monocyte ratio (LMR), system inflammation response index (SIRI), and platelet-lymphocyte ratio (PLR). However, these inflammation markers and their relationships with clinical phenotypes among Han Chinese patients with first-episode adolescent-onset schizophrenia (AOS) is unclear. This investigation aimed to elucidate the impact of inflammation on Han Chinese AOS patients as well as the association of blood-based inflammation markers with clinical symptoms.

Methods

Altogether, 203 Han Chinese individuals participated in this study, 102 first-episode AOS patients and 101 healthy controls. The assessment of inflammatory indices was based on complete blood cell count. Furthermore, schizophrenia-related clinical symptoms were evaluated using the five-factor model of the Positive and Negative Syndrome Scale (PANSS).

Results

In Han Chinese first-episode AOS patients, levels of SIRI, PLR, SII, and NLR were significantly increased (p < 0.001), while LMR decreased (p < 0.001) compared to healthy controls. Furthermore, multivariate logistic regression showed that LMR, NLR, SII, and SIRI (all p < 0.05) were independently associated with AOS. Moreover, Receiver operating characteristics assessment indicated that NLR, SIRI, LMR, and SII could effectively distinguish AOS patients from healthy controls. Their areas under the curves were 0.734, 0.701, 0.715, and 0.730 (all p < 0.001). In addition, Correlation analysis revealed that LMR was negatively correlated with the PANSS total, negative, and cognitive factor scores (all p < 0.05); NLR was positively correlated with the cognitive factor score (p < 0.01); SII was negatively correlated with the positive factor score and positively with the negative and cognitive factor scores (all p < 0.05); SIRI was positively correlated with the PANSS total and cognitive factor scores (all p < 0.01).

Conclusions

This research established the involvement of peripheral blood inflammatory markers (LMR, NLR, SII, and SIRI) with the clinical manifestations and pathophysiology of schizophrenia, and these can serve as screening tools or potential indices of the inflammatory state and AOS symptoms severity.

Serum inflammatory markers as prognostic marker for nasopharyngeal carcinoma with liver metastasis: a multi-center retrospective study

BACKGROUND

This retrospective study investigated the prognostic value of serum inflammatory markers in nasopharyngeal carcinoma (NPC) patients, focusing on their association with overall survival (OS) and liver metastasis-free survival (LMFS).

METHODS

The study included 314 NPC patients treated between 2010 and 2020. Clinical characteristics, treatment methods, and serum inflammatory markers were assessed. Patients were categorized into two groups of with and without liver metastasis. Univariate and multivariate Cox regression and Kaplan-Meier survival analyses were performed to investigate the prognostic value of serum inflammatory markers in NPC patients with and without liver metastasis.

RESULTS

In the whole cohort, univariate Cox regression analysis singled out tumor necrosis factor-α (TNF-α) (HR = 1.57, 95% CI 1.44-4.90, p = 0.004) and neutrophil-to-lymphocyte ratio (NLR) (HR = 2.13, 95% CI 1.33-3.99, p = 0.009), which were significantly associated with poorer OS. In patients with liver metastasis, TNF-α and NLR could not independently predict OS. However, high TNF-α levels were independently associated with worse OS in patients without liver metastasis (HR (95% CI) = 2.75 (1.67-8.68), p < 0.001). High NLR levels could independently predict poor OS in both groups with (HR (95% CI) = 1.94 (1.77-6.38), p = 0.010) and without liver metastasis (HR (95% CI) = 1.58 (1.19-7.54), p = 0.009). Ultimately, TNF-α and NLR could not significantly predict LMFS.

CONCLUSION

This study highlights the prognostic significance of TNF-α and NLR in NPC patients, especially in those with liver metastasis. These inflammatory markers could serve as valuable indicators for assessing the prognosis of NPC patients. Further research is warranted to validate their clinical utility and explore potential therapeutic implications.

U-shaped relationship found between fibrinogen-to-albumin ratio and systemic inflammation response index in osteoporotic fracture patients

The relationship between the Systemic Inflammatory Response Index (SIRI) and the Fibrinogen-to-albumin ratio (FAR) has not been extensively investigated. The objective of this study was to determine the independent relationship between FAR and SIRI in people with osteoporotic fractures (OPF). A cross-sectional study was conducted using retrospective data from 3431 hospitalized OPF patients. The exposure variable in this study was the baseline FAR, while the outcome variable was the SIRI. Covariates, including age, gender, BMI, and other clinical and laboratory factors, were adjusted. Cross-correlation analysis and linear regression models were applied. The generalized additive model (GAM) investigated non-linear relationships. Adjusted analysis revealed an independent negative association between FAR and SIRI in OPF patients (β = - 0.114, p = 0.00064, 95% CI - 0.180, - 0.049). A substantial U-shaped association between FAR and SIRI was shown using GAM analysis (p < 0.001). FAR and SIRI indicated a negative association for FAR below 6.344% and a positive correlation for FAR over 6.344%. The results of our study revealed a U-shaped relationship between SIRI and FAR. The lowest conceivable FAR for a bone-loose inflammatory disease might be 6.344%, suggesting that this has particular significance for the medical diagnosis and therapy of persons with OPF. Consequently, the term "inflammatory trough" is proposed. These results offer fresh perspectives on controlling inflammation in individuals with OPF and preventing inflammatory osteoporosis.

Prognostic and clinicopathological significance of systemic inflammation response index in patients with hepatocellular carcinoma: a systematic review and meta-analysis

Background

It is unclear whether the systemic inflammation response index (SIRI) can predict the prognosis of patients with hepatocellular carcinoma (HCC). Consequently, the present study focused on systematically identifying the relationship between SIRI and the prognosis of patients with HCC through a meta-analysis.

Methods

Systematic and comprehensive studies were retrieved from PubMed, Web of Science, Embase, and the Cochrane Library from their inception to August 10, 2023. The role of SIRI in predicting overall survival (OS) and progression-free survival (PFS) in HCC was determined using pooled hazard ratios (HRs) and 95% confidence intervals (CIs). Odds ratios (ORs) and 95% CIs were pooled to analyze the correlations between SIRI and the clinicopathological features of HCC.

Results

Ten articles involving 2,439 patients were included. An elevated SIRI was significantly associated with dismal OS (HR=1.75, 95% CI=1.52-2.01, p<0.001) and inferior PFS (HR=1.66, 95% CI=1.34-2.05, p<0.001) in patients with HCC. Additionally, according to the combined results, the increased SIRI was significantly related to multiple tumor numbers (OR=1.42, 95% CI=1.09-1.85, p=0.009) and maximum tumor diameter >5 cm (OR=3.06, 95% CI=1.76-5.30, p<0.001). However, the SIRI did not show any significant relationship with sex, alpha-fetoprotein content, Child-Pugh class, or hepatitis B virus infection.

Conclusion

According to our results, elevated SIRI significantly predicted OS and PFS in patients with HCC. Moreover, the SIRI was significantly associated with tumor aggressiveness.

Systematic review registration

https://inplasy.com/inplasy-2023-9-0003/, identifier INPLASY202390003.

The associations of two novel inflammation indexes, systemic immune-inflammation index (SII) and system inflammation response index (SIRI), with periodontitis: evidence from NHANES 2009-2014

OBJECTIVES

The research's goal is to look for any potential relationships between the systemic immune-inflammation index (SII) and the system inflammation response index (SIRI), along with inflammation indicators and the likelihood of periodontitis.

METHODS

Ten thousand two hundred eighty-two individuals in sum were determined to be eligible for this cross-sectional study from the National Health and Nutrition Examination Survey (NHANES) between 2009 and 2014. Multiple logistic regression, generalized additive model, smooth curve fitting, subgroup analysis, and interaction tests were done for analyzing the association between periodontitis and SII, SIRI, and other inflammatory indicators.

RESULTS

The analysis, adjusted for population weighting, revealed that individuals with moderate/severe periodontitis had SII levels of 545.46 (95% CI (529.10, 561.82), P = 0.0044) and SIRI levels of 1.33 (95% CI (1.29, 1.37), P < 0.0001). In a fully adjusted multivariate logistic regression model, SII was not sensibly associated with moderate/severe periodontitis among the continuous and quartile Q1-Q4 groups (OR = 0.97, 95% CI (0.91, 1.02)). The continuous variable of SIRI (OR = 1.11, 95% CI (1.06, 1.17)) and the quartile Q4 group (OR = 1.58, 95% CI (1.28, 1.94)) had a deemed significant positive association with moderate to severe periodontitis. In addition, other inflammatory indicators, especially NLR, PPN, PLR, MLR, PC, NC, and MC were observed to be notably involved moderate/severe periodontist in this research.

CONCLUSION

We explored the association between periodontitis and two novel comprehensive markers of inflammation (SII and SIRI).

CLINICAL RELEVANCE

These inflammatory markers are expected to serve as tools to assist clinicians in diagnosing periodontitis.

Prognostic and clinicopathological role of pretreatment systemic immune-inflammation index in patients with oral squamous cell carcinoma: a meta-analysis

Background

There are many studies regarding the use of systemic immune-inflammation index (SII) to help predict oral squamous cell carcinoma (OSCC) prognosis, but findings have been inconsistent. The present meta-analysis was conducted to determine whether SII could contribute to predicting OSCC prognosis.

Methods

PubMed, Embase, Cochrane Library and Web of Science databases were thoroughly searched from their inceptions through August 20, 2023. The role of SII in predicting OSCC prognosis was determined through combined hazard ratios (HRs) with relevant 95% confidence intervals (CIs). Correlations of SII with clinicopathological characteristics of OSCC patients were analyzed based on combined odds ratios (ORs) with 95% CIs.

Results

This meta-analysis utilized 11 articles in total, involving 3,464 patients. According to the results, an elevated SII was markedly associated with dismal overall survival (OS) (HR=1.85, 95%CI=1.48-2.29, p<0.001) and poor disease-free survival (DFS) (HR=1.77, 95%CI=1.20-2.61, p=0.004) of OSCC. Moreover, a higher SII was markedly correlated with stage T3-T4 (OR=2.47, 95%CI=1.40-4.37, p=0.002), TNM stage III-IV (OR=2.29, 95%CI=1.53-3.44, p<0.001), and low differentiation (OR=1.74, 95%CI=1.25-2.43, p=0.001).

Conclusion

According to the present meta-analysis, an increased SII is significantly associated with dismal OS and DFS, advanced tumor stage and poor differentiation in OSCC. SII could be a potential and important biomarker for clinical management and predicting the prognosis of patients with OSCC.

Systematic review registration

https://inplasy.com/inplasy-2023-9-0033/), identifier INPLASY202390033.

Unraveling the clinical significance and prognostic value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, systemic immune-inflammation index, systemic inflammation response index, and delta neutrophil index: An extensive literature review

In the field of critical care medicine, substantial research efforts have focused on identifying high-risk patient groups. This research has led to the development of diverse diagnostic tools, ranging from basic biomarkers to complex indexes and predictive algorithms that integrate multiple methods. Given the ever-evolving landscape of medicine, driven by rapid advancements, changing treatment strategies, and emerging diseases, the development and validation of diagnostic tools remains an ongoing and dynamic process. Specific changes in complete blood count components, such as neutrophils, lymphocytes, monocytes, and platelets, are key immune system responses influenced by various factors and crucial in systemic inflammation, injury, and stress. It has been reported that indices such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and delta neutrophil index calculated using various ratios of these elements, are important predictors of various outcomes in conditions where the inflammatory process is at the forefront. In this narrative review, we concluded that NLR, PLR, SII, and SIRI show promise in predicting outcomes for different health conditions related to inflammation. While these tests are accessible, reliable, and cost-effective, their standalone predictive performance for a specific condition is limited.

High Expression of NLR and SII in patients With Nasopharyngeal Carcinoma as Potential Prognostic Observations

PURPOSE

To assess the value of pretreatment neutrophil-to-lymphocyte ratio (NLR) and systemic immunoinflammatory index (SII) in the prognosis of nasopharyngeal carcinoma (NPC) patients.

METHODS

This retrospective study analyzed a total of 185 NPC patients who visited the clinic from June 2015 to December 2018 and were selected as study subjects. The NLR and SII were calculated based on the collection of demographic information, clinical characteristics, and pre-treatment lymphocyte counts, neutrophil counts, and platelet counts. Predictive efficacy was evaluated using the receiver operating characteristic (ROC) curve, and survival analysis was performed through life table methods and Cox risk-proportional regression.

RESULTS

Using the X-tile software, significant differences were found in clinical factors among NPC patients based on NLR (>2.91) and SII (>535.47). Age, TNM staging, SII, and NLR were identified as independent prognostic factors in a Cox regression analysis. SII had the highest area under the curve (AUC) for predicting 1-year survival, TNM staging had the highest AUC for predicting 3-year survival, and NLR had the highest AUC for predicting 5-year survival. The combined model showed superior predictive accuracy across all time points.

CONCLUSION

NLR and SII, as biomarkers of inflammation and immune status, have significant clinical applications in the prognostic assessment of NPC. The integrated prediction model combining age, TNM staging, SII, and NLR significantly improved the accuracy of survival prediction and provided a reliable basis for individualised treatment of NPC.

High systemic immune-inflammation index predicts poor prognosis and response to intravesical BCG treatment in patients with urothelial carcinoma: a systematic review and meta-analysis

Background

The systemic immune-inflammation index (SII) has emerged as a promising marker predicting the prognosis of some cancers, while its role in urothelial carcinoma (UC) remains uncertain, especially in upper urinary tract urothelial carcinoma (UTUC). This meta-analysis aimed to investigate the association of SII with the prognosis of UC and the response to intravesical Bacillus Calmette-Guerin (BCG) therapy of non-muscle invasive bladder cancer (NMIBC).

Methods

A systematic search in PubMed, Embase, Web of Science, and the Cochrane Library was performed to identify relevant studies. The extracted hazard ratios (HRs) and 95% confidence intervals (CIs) were used to evaluate the association between SII and overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) of patients with UC. Additionally, we pooled odds ratios (ORs) and 95% CIs to assess the relationship between SII and BCG response in patients with NMIBC. Subgroup and sensitivity analyses were performed to explore potential sources of heterogeneity.

Results

Twenty studies comprising a total of 12,645 patients were eligible. This meta-analysis revealed that high SII levels independently increased the risk of OS (HR 1.55, 95%CI 1.25-1.92), CSS (HR 1.82, 95%CI 1.36-2.45), and RFS (HR 1.26, 95% CI 1.18-1.35) in patients with UC, including those with upper tract urothelial carcinoma. Additionally, elevated SII levels could predict a lower response to intravesical BCG treatment (OR 0.18, 95%CI 0.07-0.45) and higher disease recurrence (HR 1.61, 95%CI 1.31-1.98) in patients with NMIBC. Furthermore, elevated SII levels were positively associated with advanced age, lymphovascular invasion, hydronephrosis, and high tumor grade and stage (pT ≥ 3).

Conclusions

Elevated preoperative SII levels are associated with poor survival outcomes in patients with UC, as well as worse response to BCG treatment in patients with NMIBC. Therefore, SII can serve not only as an independent prognostic predictor of patients with UC but also as a guide for BCG therapy in NMIBC.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023409077, identifier CRD42023409077.

Prognostic significance of C-reactive protein in patients with cervical cancer: a meta-analysis

Background

Numerous studies have investigated the significance of pretreatment C-reactive protein (CRP) levels for determining the prognosis of cervical cancer (CC). The results of these studies, however, have been inconsistent. The present meta-analysis, therefore, focused on identifying the exact relationship of CRP levels with CC prognoses.

Methods

We searched the following databases from their inception until April 18, 2023: PubMed; Web of Science; Embase; and Cochrane Library. From the search results, we estimated the significance of CRP levels in determining the prognosis of CC, based on combined hazard ratios (HRs) and relevant 95% confidence intervals (CIs).

Results

The present meta-analysis included 12 studies, encompassing 2,204 patients. Based on combined data, an increased CRP level was significantly related to an unfavorable overall survival (OS) of patients with CC (HR = 1.63; 95% CI = 1.36-1.95; P < 0.001). Moreover, an increased CRP level was significantly associated with shortened progression-free survival (PFS) in patients with CC (HR = 1.68; 95% CI = 1.39-2.03; P < 0.001). According to the subgroup and sensitivity analyses, CRP level was a reliable factor in determining CC prognoses.

Conclusion

Based on the results of our present analyses, increased CRP levels were significant predictors of poor OS and PFS in patients with CC. CRP level, therefore, could be an independent and inexpensive factor for determining the prognosis of patients with CC in clinical settings.

Systematic review registration

INPLASY, identifier INPLASY202360074.

Association between systemic immune-inflammation index and risk of lower extremity deep venous thrombosis in hospitalized patients: a 10-year retrospective analysis

Background

The systemic immune-inflammation index (SII), as a novel inflammatory biomarker, has recently attracted attention in cardiovascular disease research. However, the relationship between SII and risk of lower extremity deep venous thrombosis (LEDVT) remains unclear to date. Thus, this study aimed to explore the association in a large sample over a 10-year period (2012-2022).

Methods

All hospitalized patients undergoing lower extremity compression ultrasonography (CUS) examination were consecutively screened by searching our hospital information system database. The receiver operating characteristic (ROC) curve analysis was used to identify the optimal cut-off value for high and low SII group. Multivariate logistic regression analyses were performed to investigate the relationship between SII and LEDVT risk. Propensity score matching (PSM), subgroup and sensitivity analyses were also conducted. Moreover, restricted cubic spline (RCS) regression and two-piecewise linear regression models were used to assess the dose-response relationship between natural log transformed SII [ln(SII)] and risk of LEDVT.

Results

A total of 16,725 consecutive hospitalized patients were included, and 1,962 LEDVT events occurred. After adjusting for confounding factors, patients in the high SII group (≥ 574.2 × 10⁹/L) showed a 1.740-fold risk of LEDVT (95% CI: 1.546-1.959, P < 0.001), and elevated ln(SII) was associated with a 36.1% increased risk of LEDVT (95% CI: 1.278-1.449, P < 0.001). PSM, subgroup and sensitivity analyses confirmed the robustness of the association. A non-linear relationship was observed (P _non-linear< 0.001), with a threshold value of 5.6 × 10⁹/L for all LEDVT events. Above the threshold, each unit increase in ln(SII) had a 1.369-fold higher risk of LEDVT (95% CI: 1.271-1.475, P < 0.001). The association also existed in both distal and proximal LEDVT.

Conclusion

Elevated SII is significantly associated with an increased risk of LEDVT in hospitalized patients. Additionally, the association is non-linear and exhibit a threshold effect.