Abstract
BackgroundAlthough previous studies have evaluated the prognostic role of the systemic immune-inflammation index (SII) in patients with breast cancer, the results were inconsistent. Therefore, in this context, we aimed to identify the prognostic and clinicopathological value of the SII in patients with breast cancer by performing a meta-analysis.MethodsA literature search was using PubMed, Web of Science, EMBASE, and Cochrane Library databases for relevant articles, from their inception to May 12, 2020. The prognostic value of the SII in breast cancer was assessed by pooling the hazard ratios (HRs) with 95% confidence intervals (CIs). The clinical outcomes included the overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), and distant metastasis-free survival (DMFS). The methodological quality of all the included studies was evaluated using the Newcastle–Ottawa quality assessment scale. The odds ratios (ORs) with 95% CIs were combined to evaluate the correlation between the SII and clinicopathological characteristics of patients with breast cancer. Publication bias was evaluated using the Begg funnel plot and the Egger linear regression test. All statistical analyses were performed using Stata software, version 12.0 (Stata Corporation, College Station, TX, USA). A p value of < 0.05 was considered statistically significant.ResultsEight studies involving 2642 patients were included in the current meta-analysis. The combined data showed that patients with a high SII had worse OS (HR = 1.79, 95% CI 1.33–2.42, p < 0.001), poorer DFS/RFS (HR = 1.79, 95% CI 1.31–2.46, p < 0.001), and inferior DMFS (HR = 1.64, 95% CI 1.32–2.03, p < 0.001) than patients with a low SII. In addition, a high SII was correlated with the presence of lymph node metastasis (OR = 1.38, 95% CI 1.12–1.69, p = 0.002), higher T stage (OR = 1.49, 95% CI 1.17–1.89, p < 0.001), advanced TNM stage (OR = 1.37, 95% CI 1.07–1.77, p = 0.014), and higher histological grade (OR = 3.71, 95% CI 1.00–13.73, p = 0.049). However, there was no significant association between the SII and the pathological type (OR = 0.82, 95% CI 0.55–1.23, p = 0.345) or lymphatic invasion (OR = 1.30, 95% CI 0.82–2.08, p = 0.266).ConclusionsThe results of our meta-analysis suggest that an elevated SII predicts poor survival outcomes and is associated with clinicopathological features that indicate tumor progression of breast cancer.
Highlights
Previous studies have evaluated the prognostic role of the systemic immune-inflammation index (SII) in patients with breast cancer, the results were inconsistent
A total of 5 studies were removed owing to the following reasons: 4 studies [23,24,25, 27] did not provide sufficient data for the current meta-analysis, and 1 study [26] included patients with different cancers, rather than breast cancer only
The combined Odds ratio (OR) and 95% Confidence interval (CI) indicated that a high SII was correlated with the presence of lymph node metastasis
Summary
Previous studies have evaluated the prognostic role of the systemic immune-inflammation index (SII) in patients with breast cancer, the results were inconsistent. In this context, we aimed to identify the prognostic and clinicopathological value of the SII in patients with breast cancer by performing a meta-analysis. Novel and reliable prognostic parameters need to be identified for designing personalized treatment regimens and for improving the survival of patients with breast cancer. Several inflammatory cell parameters, including the neutrophil-lymphocyte ratio, plateletlymphocyte ratio, C-reactive protein/albumin ratio, and systemic immune-inflammation index (SII), are derived using these meditators. We performed the current meta-analysis to identify the prognostic impact of the SII in patients with breast cancer by aggregating all available data
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.