A Novel Prognostic Marker Systemic Inflammation Response Index (SIRI) for Operable Cervical Cancer Patients.

Bei Chao,Xin Xu,Lirong Zhang,Xiaoli Ju,Yan Zhao

doi:10.3389/fonc.2020.00766

Abstract

It has been confirmed that the systemic inflammation response index (SIRI) based on peripheral blood neutrophil, monocyte and lymphocyte counts can be used for the prognostication of patients with various malignant tumors. However, the prognostic value of SIRI in cervical cancer patients has not yet been reported. This study found that a higher SIRI was related to lymphovascular invasion and was also significantly associated with FIGO stage, radiotherapy, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and monocyte/lymphocyte ratio (MLR) but not related to other clinical and pathological parameters. According to the Kaplan-Meier survival analysis, a high SIRI was associated with the poor prognosis of cervical cancer patients in the primary and validation groups. SIRI, NLR, PLR, and MLR can all be used to determine the prognosis of patients with operable cervical cancer. Moreover, it was confirmed that only SIRI was an independent prognostic factor for patients with operable cervical cancer. The same result was obtained in the propensity score matching (PSM) analysis. In the ROC curve analysis, SIRI was more accurate in predicting the prognosis of cervical cancer patients. Then, a nomogram was established based on SIRI, FIGO stage and lymphovascular invasion, which could determine the prognosis of cervical cancer patients more accurately than FIGO stage. The validation cohort showed the same results. In addition, the changes in SIRI relative to the baseline value at 4–8 weeks after surgery were closely related to the survival of cervical cancer patients. Compared with those with unchanged SIRI (absolute value of variation <25%), cervical cancer patients with an increase in SIRI > 75% had worse OS (P < 0.001), while patients with a decrease in SIRI > 75% had a better prognosis (P < 0.001). SIRI can serve as a new independent prognostic index and a potential marker for therapeutic response monitoring in patients with curable cervical cancer. Compared with the traditional FIGO staging system, the nomogram integrating SIRI can predict the survival of cervical cancer patients more objectively and reliably after radical surgery.

Highlights

Cervical cancer is one of the most common cancers in females around the world, especially in China, with 530,000 new cases worldwide every year and 270,000 deaths
The level of systemic inflammation response index (SIRI) was related to lymphovascular invasion and significantly related to FIGO stage, radiotherapy, neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and monocyte/lymphocyte ratio (MLR)
This study confirmed that SIRI, NLR, PLR, and MLR could be used to determine the prognosis of patients with operable cervical cancer

Summary

Introduction

Cervical cancer is one of the most common cancers in females around the world, especially in China, with 530,000 new cases worldwide every year and 270,000 deaths. Many patients in the early stage (such as stage IA) experience recurrence in a short period of time after surgery and have poor prognosis, while some patients in the late stage have a longer survival time [3]. This finding indicates to some extent that the FIGO stage is not the only factor that affects prognosis and that FIGO stage alone cannot accurately determine the prognosis of patients. It is necessary to find economical and effective indexes for evaluating prognosis and guiding therapeutic regimens so that patients can undergo reasonable individual treatment, which is the key to improving survival

Methods

Results

Conclusion