Abstract
IntroductionNasopharyngeal carcinoma (NPC) is a common malignancy in China and known prognostic factors are limited. In this study, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune inflammation index (SII), and systemic inflammation response index (SIRI) were evaluated as prognostic factors in locally advanced NPC patients.Materials and MethodsNPC patients who received curative radiation or chemoradiation between January 2012 and December 2015 at the Second Xiangya Hospital were retrospectively reviewed, and a total of 516 patients were shortlisted. After propensity score matching (PSM), 417 patients were eventually enrolled. Laboratory and clinical data were collected from the patients’ records. Receiver operating characteristic curve analysis was used to determine the optimal cut-off value. Survival curves were analyzed using the Kaplan-Meier method. The Cox proportional hazard model was used to identify prognostic variables.ResultsAfter PSM, all basic characteristics between patients in the high SIRI group and low SIRI group were balanced except for sex (p=0.001) and clinical stage (p=0.036). Univariate analysis showed that NLR (p=0.001), PLR (p=0.008), SII (p=0.001), and SIRI (p<0.001) were prognostic factors for progression-free survival (PFS) and overall survival (OS). However, further multivariate Cox regression analysis showed that only SIRI was an independent predictor of PFS and OS (hazard ratio (HR):2.83; 95% confidence interval (CI): 1.561-5.131; p=0.001, HR: 5.19; 95% CI: 2.588-10.406; p<0.001), respectively.ConclusionOur findings indicate that SIRI might be a promising predictive indicator of locally advanced NPC patients.
Highlights
Nasopharyngeal carcinoma (NPC) is a common malignancy in China and known prognostic factors are limited
Univariate analysis showed that neutrophil-to-lymphocyte ratio (NLR) (p=0.001), platelet-to-lymphocyte ratio (PLR) (p=0.008), systemic immune inflammation index (SII) (p=0.001), and systemic inflammation response index (SIRI) (p
Further multivariate Cox regression analysis showed that only SIRI was an independent predictor of PFS and OS (hazard ratio (HR):2.83; 95% confidence interval (CI): 1.561-5.131; p=0.001, HR: 5.19; 95% CI: 2.588-10.406; p
Summary
Nasopharyngeal carcinoma (NPC) is a common malignancy in China and known prognostic factors are limited. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune inflammation index (SII), and systemic inflammation response index (SIRI) were evaluated as prognostic factors in locally advanced NPC patients. An increasing number of studies have demonstrated the value of inflammatory response biomarkers as predictive markers for prognosis in cancers. It has been shown that the neutrophil-tolymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune inflammation index (SII) can predict the prognosis in various types of cancers [7,8,9]. The systemic inflammation response index (SIRI) is a new systemic inflammatory response biomarker based on peripheral blood cells counts, and it was demonstrated to be effective in predicting the prognosis of esophagogastric junction adenocarcinoma [10], esophageal cancer [11] and cervical cancer [12]. There is minimal evidence of SIRI as a prognostic marker in NPC from a previous study [13]
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