Value Of Systemic Immune-inflammation Index Research Articles

Performance of nutritional and inflammatory markers in patients with pancreatic cancer.

Systemic inflammation and nutrition play pivotal roles in cancer progression and can increase the risk of delayed recovery after surgical procedures. To assess the significance of inflammatory and nutritional indicators for the prognosis and postoperative recovery of patients with pancreatic cancer (PC). Patients who were diagnosed with PC and underwent surgical resection at our hospital between January 1, 2019, and July 31, 2023, were enrolled in this retrospective observational cohort study. All the data were collected from the electronic medical record system. Seven biomarkers - the albumin-to-globulin ratio, prognostic nutritional index (PNI), systemic immune-inflammation index (SII), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), nutritional risk index (NRI), and geriatric NRI were assessed. A total of 446 patients with PC met the inclusion criteria and were subsequently enrolled. Patients with early postoperative discharge tended to have higher PNI values and lower SII, NLR, and PLR values (all P < 0.05). Through multivariable logistic regression analysis, the SII value emerged as an independent risk factor influencing early recovery after surgery. Additionally, both univariable and multivariable Cox regression analyses revealed that the PNI value was the strongest prognostic marker for overall survival (OS; P = 0.028) and recurrence-free survival (RFS; P < 0.001). The optimal cutoff PNI value was established at 47.30 using X-tile software. Patients in the PNI-high group had longer OS (P < 0.001) and RFS (P = 0.0028) times than those in the PNI-low group. Preoperative systemic inflammatory-nutritional biomarkers may be capable of predicting short-term recovery after surgery as well as long-term patient outcomes.

Role of paranasal abnormalities and systemic inflammation on primary acquired nasolacrimal duct obstruction

BackgroundTo determine the paranasal changes and inflammatory markers that may cause primary acquired nasolacrimal duct obstruction (PANDO) and to determine their relationship with success rates on different types of surgeries.Main bodyWe retrospectively reviewed the blood sample and computed tomography (CT) results on 92 patients who underwent dacryocystorhinostomy (DCR) surgery for PANDO and 82 healthy controls. Age, gender, paranasal abnormalities, hemogram values, International Normalized Ratio (INR) values, type of surgery, and recurrence rate were recorded; systemic Immune-inflammation Index (SII), neutrophil-to-lymphocyte ratio (NLR), monocytes-to- lymphocyte ratio (MLR) and platelet-to-lymphocyte ratio (PLR) were calculated in both groups. In the case group, total white blood cells, monocytes, and INR values were significantly lower (p < 0.05). Platelet, lymphocyte, neutrophil, PLR, MLR, NLR, and SII values did not differ significantly between the control and case groups (p > 0.05). There was no significant difference in the CT results between the groups (p > 0.05). No correlation was found between CT findings and inflammatory markers. Dacryocystitis (DC) was seen in 20% of patients and they were all in the case group. No correlation was found between recurrence rate and age, gender, type of surgery, CT findings, and blood results (p > 0.05). The recurrence rate was significantly higher in patients with bilateral PANDO and with DC (p < 0.05).Short conclusionThe incidence of PANDO may not be directly related to paranasal abnormalities and systemic inflammation. Low INR values may cause obstruction in the nasolacrimal duct. Age, gender, type of surgery, CT findings, and inflammation level do not affect the success of the surgery.

Effect of adalimumab treatment on inflammatory and hematological parameters in patients with Hidradenitis suppurativa

Objective Hidradenitis suppurativa (HS), a chronic inflammatory disease that typically manifests after puberty, is characterised by painful nodules, abscesses, draining sinus tracts, and scars in areas rich in apocrine glands such as the axillary and inguinal regions. In recent years, blood-based biomarkers such as the Neutrophil/Lymphocyte Ratio (NLR), Platelet/Lymphocyte Ratio (PLR), Monocyte/Lymphocyte Ratio (MLR), Mean Platelet Volume (MPV), Systemic Immune-Inflammation Index (SII) and Pan-Immune-Inflammation Value (PIV) have been used as significant indicators of systemic inflammation. While there are few studies evaluating these biomarkers in HS, the response of these markers to treatment has only been assessed in one study to date. Our study aims to investigate the effect of adalimumab treatment on blood-based systemic inflammation biomarkers in HS, where inflammation plays a significant role. Methods The study included 42 adult patients who received adalimumab treatment at our dermatology and venereology clinic between January 2020 and January 2023. Medical records for complete blood count results of the patients were retrospectively reviewed. All systemic inflammation-based biomarkers were calculated from the absolute values of the complete blood count. The SII was calculated with the following formula: (neutrophil count × platelet count/lymphocyte count). The PIV was calculated as follows: (neutrophil count × platelet count × monocyte count/lymphocyte count). Values before the treatment and at the 12th week of treatment were compared. Results When the changes in the inflammatory parameters of the patients were examined, it was found that NLR (2.13 ± 0.87 vs 2.26 ± 1.12), PLR (111.01 ± 39.89 vs 99.43 ± 35.34), MLR (0.27 ± 0.11 vs 0.28 ± 0.12), MPV (9.59 ± 0.71 vs 9.70 ± 0.79), SII (680.79 ± 330.18 vs 687.89 ± 442.66), and PIV (552.02 ± 330.71 vs 605.05 ± 415.96) values did not change statistically significantly after treatment (p > 0.05). While there was a significant decrease in platelet count compared to before treatment, no statistically significant difference was found in the other evaluated blood cells. Conclusion Adalimumab treatment has not had a significant effect on systemic inflammation markers in HS, an inflammatory disease. More studies are needed to evaluate the effect of adalimumab on these markers in HS.

Prognostic Value of Systemic Immune-inflammation Index in Patients with Pediatric Blunt Abdominal Trauma

Prognostic Value of Systemic Immune-inflammation Index in Patients with Pediatric Blunt Abdominal Trauma

Comparison of the Clinical Features and Prognostic Value of Inflammation-Based Markers in Uterine Leiomyosarcoma

Aim: Inflammation-related markers are the factors affecting prognosis in many types of cancer. In this study, we aimed to investigate the relationship between inflammation-related markers, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and prognostic nutritional index (PNI) with prognosis of patients with uterine leiomyosarcoma (uLMS). Methods: Patients diagnosed with uLMS were reviewed retrospectively. NLR, PLR, SII, and PNI values were calculated at the diagnosis and before treatment. Totally 35 patients were included in the study. Results: Median overall survival (OS) in the low-NLR (

Systemic immune inflammation index is a valuable marker for predicting hemodialysis patients with depression: a cross-sectional study.

Maintenance hemodialysis (MHD) patients suffer from enormous physical, mental stress and poor quality of life, so an increasing number of patients are in a long-term state of depression. A prominent feature of MHD patients is chronic persistent inflammation, which is also an important mechanism for the onset of depression. Therefore, finding economically convenient inflammatory markers to predict and diagnose the onset of depression in MHD patients is of great value. As a novel inflammatory marker, systemic immune inflammation index (SII) can more comprehensively reflect the inflammation and immunity level of patients. This study aims to explore the relationship between SII and depressive symptoms in MHD patients. A cross-sectional study was conducted on 206 MHD patients from three dialysis centers. Based on the Hospital Anxiety and Depression Scale (HADS) scores, patients were divided into non-depression and depression groups. Inter group comparison and multivariate logistic regression analysis were performed to determine whether SII is an independent risk factor for depression in MHD patients. Receiver operating characteristic (ROC) curve was used to evaluate the predictive value of SII on depression symptoms in MHD patients. According to the HADS scale score, 38.83% of the included patients were in a state of depression. After adjusting for all confounding factors, MHD patients with SII>963.93 had a 4.709 times higher risk of depression than those with SII ≤ 478.32 (OR=4.709, 95% CI 1.821-12.178, P<0.01). ROC analysis showed that SII>685.11 was the best cutoff value for MHD depression patients, and the area under the curve (AUC) was 0.681. High SII is an independent risk factor for depressed MHD patients and an ideal inflammatory marker for predicting and identifying depression in MHD patients as assessed by the HADS scale.

Systemic immune-inflammation index values are associated with non-melanoma skin cancers: evidence from the National Health and Nutrition Examination Survey 2010-2018.

The systemic immune-inflammation index (SII), based on peripheral lymphocyte, neutrophil, and platelet counts, has recently been investigated as a prognostic marker in several tumors. However, the SII has rarely been reported in skin cancers. In this study, we aimed to assess the association between SII values and the risk of occurrence of skin cancers. This cross-sectional study was based on National Health and Nutrition Examination Survey data from 2010 to 2018 and involved 32,012 participants. The SII was calculated as the platelet count × neutrophil count/lymphocyte count. A weighted multivariate logistic analysis was conducted to examine the relationship between SII values and the occurrence of skin cancers. In addition, a subgroup analysis and a sensitivity analysis were conducted to identify underlying moderators and the stability of the relationship, respectively. Compared with participants in the lowest quartile of SII values, the odds ratios for non-melanoma skin cancer were 1.650 (95% CI: 1.158-2.352) for participants in the quartile with the highest SII values after multivariate adjustments. In subgroup analyses, we found significant interactions between log-transformed SII values and age (p < 0.001 for interaction), race (p < 0.001 for interaction), education level (p < 0.001 for interaction), marital status (p < 0.001 for interaction), and annual household incomes (p < 0.001 for interaction) in the association with non-melanoma skin cancer. Our findings suggest a positive association between high SII values and skin cancers in the U.S. population. Age, levels of education, marital status, and annual household incomes affect the positive association between high SII values and non-melanoma skin cancers.

Evaluation of Serum Inflammatory Markers and Their Relationship to Treatment Response in Alopecia Areata Patients.

Alopecia areata is a type of non-scarring alopecia which is thought to be associated with T-cell mediated immune response. This study aimed to compare the levels of serum inflammatory markers before and after treatment in patients with alopecia areata. The study explored the utility of the systemic immune-inflammation index (SII) in assessing the severity and treatment response in alopecia areata patients. The study included 60 alopecia areata patients and 40 control patients diagnosed with tinea unguium, aged between 18 and 65 years. Sociodemographic characteristics such as age, sex, and medical history were recorded for both groups. For alopecia areata patients, serum inflammatory markers were recorded before and at the third month of treatment. Serum inflammatory markers for the control group were also recorded. Furthermore, the Severity of Alopecia Tool (SALT) score was calculated for alopecia areata patients before and at the third month of treatment. The alopecia areata group had a significantly higher neutrophil-lymphocyte ratio, mean platelet volume, and SII values compared to the control group, while high-density lipoprotein (HDL) values were significantly lower. Serum inflammatory markers, assessed at the third month of treatment in the alopecia areata group, were lower, and HDL values were significantly higher compared to pre-treatment levels. A statistically significant correlation was observed between disease severity and the SII. The SII is a cost-effective marker that can be utilized in assessing the severity of alopecia areata and treatment response.

The relationship between peripheral immune cell markers and cognitive functions in patients with schizophrenia.

The purpose of this study was to investigate the relationship between peripheral immune cell markers and cognitive functions in patients with schizophrenia and healthy controls. Thirty-five patients diagnosed with schizophrenia with a stable course and a control group of 35 individuals matched in terms of sex, education, and age were included in this cross-sectional study. The Wisconsin Card Sorting Test (WCST), the Rey Auditory Verbal Learning Test (RAVLT), and the Stroop Test were used for neuropsychological evaluation. Blood neutrophil and lymphocyte percentages, neutrophil-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) values were calculated. The female patients exhibited significantly higher NLR and neutrophil percentages than the female controls and higher NLR, neutrophil percentage, and SII than the male patients. The increased neutrophil percentages and NLR and decreased lymphocyte percentages in the female patients were significantly correlated with worsening Stroop interference and RAVLT 1 scores. Additionally, a longer duration of illness was significantly correlated with elevated NLR, SII, and neutrophil percentage and a decreased lymphocyte percentage. A higher number of previous hospitalizations was correlated with elevated SII and decreased lymphocyte percentages. Regression analysis showed a significant association between neutrophil percentages and Stroop interference scores used to evaluate attentional functions in patients with schizophrenia. These study results suggest that gender and the course of the illness may affect NLR and SII values. An elevated neutrophil percentage may be one of the factors affecting attentional dysfunction in patients with schizophrenia. Prospective studies are now needed to verify these findings.

Prognostic value of systemic immune-inflammation index, neutrophil-lymphocyte ratio, and thrombocyte-lymphocyte ratio in critically ill patients with moderate to severe traumatic brain injury.

Traumatic brain injury (TBI) is a significant health problem with a high mortality rate. Inflammatory markers can predict the prognosis of TBI where neuroinflammation is essential. In this study, the prognostic value of the systemic immune-inflammation index (SII), neutrophil-lymphocyte ratio (NLR), and platelet-lymphocyte ratio (PLR) at admission in patients with critical TBI was investigated. Patients with moderately severe TBI in the intensive care unit (ICU) of a tertiary center between June 2020 and June 2022 were retrospectively reviewed. Patients were classified into survivor and mortality groups. The predictive performance of SII, PLR, and NLR levels calculated from blood results at admission and 28-day mortality and patient outcomes were analyzed. One hundred sixty-one patients were included in this study. The median age of the entire population was 41 (18-90) years, and 80.7% (n = 130) of the patients were male. Falls (42.2%) and traffic accidents (40.4%) were the most common causes of TBI. The most common primary diagnoses in patients with TBI were acute subdural hematoma (30.4%) and subarachnoid hemorrhage (26.1%). The SII and NLR levels were significantly higher in the mortality group, and PLR levels were significantly lower (P = .004, P < .001, P < .001, respectively). In multivariate regression analysis, SII and PLR were independent predictors of mortality (P = .031 and P < .001, respectively). In the receiver operating characteristics (ROC) curve analysis, the cutoff value for SII was ≥ 2951, and the area under the curve (AUC) was 0.662 (95% CI, 0.540-0.784). The cutoff value for NLR was ≥ 9.85, AUC was 0.717 (95% CI, 0.600-0.834), and the cutoff value for PLR was ≤ 130.4, AUC was 0.871 (95% CI, 0.796-0.947). 28-day mortality was 21.1%. Neuroinflammation is essential in patients with critical TBI, and inflammatory markers SII, NLR, and PLR have prognostic importance. SII and PLR are independent predictors of mortality. Early detection of those with a poor prognosis in critically ill TBI patients and planning aggressive treatments may contribute to reducing mortality.

Evaluation of inflammatory markers obtained from complete blood count in different stages of schizophrenia

Objective Systemic inflammatory biomarkers recently studied in schizophrenia include neutrophil/lymphocyte ratio (NLR), monocyte/lymphocyte ratio (MLR), platelet/lymphocyte ratio (PLR), systemic immune inflammation index (SII), and systemic inflammation response index (SIRI). SIRI, a novel inflammatory marker, has not been studied in different stages of schizophrenia. We aimed to compare NLR, MLR, PLR, SII, and SIRI values between psychotic exacerbation and remission values of the same patients with schizophrenia and a healthy control group. Method In this study, 86 patients with schizophrenia who were hospitalized due to psychotic relapse, the same patient group who were in remission after treatment, and 86 age-sex-matched healthy control subjects were analyzed. Inflammatory marker values of the patient group in both the psychotic exacerbation (PE) and the remission (R) period were analyzed and compared with healthy controls (HC). Results NLR, MLR, PLR, SII, and SIRI values were significantly higher in the schizophrenia-PE group than in the HC group. NLR, MLR, SII, and SIRI values were significantly higher in the schizophrenia-PE group than in the schizophrenia-R group. MLR values were significantly higher in the schizophrenia-R group than in the HC group. Conclusion These findings may be interpreted as NLR, SII, and SIRI, which may be considered as state biomarkers, and MLR may be a trait marker for schizophrenia.

SENSITIVITY OF PLATELET-LYMPHOCYTE RATIO, MONOCYTE-LYMPHOCYTE RATIO, NEUTROPHIL-LYMPHOCYTE RATIO, RED BLOOD CELL DISTRIBUTION WIDTH AND SYSTEMIC IMMUNE INFLAMMATORY INDEX IN MULTIPLE SCLEROSIS PATIENTS: RELATIONSHIP WITH DISEASE SUBTYPES AND DISABILITY

OBJECTIVE: Multiple sclerosis (MS) is a chronic inflammatory autoimmune disease of the central nervous system (CNS). Although it is not clear how autoimmune responses occur, it is known that peripheral blood cells may promote the initiation and exacerbation of the inflammatory response in MS. The aim of this study was to evaluate the sensitivity and specificity of neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), erythrocyte distribution width (RDW) and systemic immune inflammation index (SIII) in MS and to determine their relationship with disability. MATERIAL AND METHODS: In this single-center, retrospective case-control study, 104 patients with MS and 65 healthy individuals were included. Disability was assessed with the Expanded Disability Status Scale (EDSS) score, and patients were classified as mild (EDSS&amp;lt;3), moderate (3.5 ≤ EDSS ≥4.5), and severe (EDSS≥5) disabilities. NLR, MLR, PLR, RDW and SIII values were calculated according to the complete blood counts of the patients and the control group. Inflammation markers between the control group and MS patients, MS subtypes, and relapsing-remitting MS (RRMS) attack and remission periods were compared. the relationship between these markers and duration of illness, number of attacks and disability was examined. RESULTS: MLR and RDW were higher in MS than the controls. There was no significant difference in these values between MS subtypes. It was observed that RDW increased as the disease duration, number of attacks and EDSS increased. CONCLUSIONS: In our study, in evaluating inflammation it was seen that MLR and RDW were more determinative than PLR, NLR and SIII. The fact that RDW is higher in MS patients and is affected by disease disability indicates that RDW may have an important role in the follow-up of MS patients and in evaluating the degree of disability.

Analysis of the immune-inflammatory indices for patients with metastatic hormone-sensitive and castration-resistant prostate cancer

BackgroundInflammation plays a pivotal role in the progression of prostate cancer (PCa). Several immune-inflammatory indices, including neutrophil to lymphocyte ratio (NLR), derived neutrophil to lymphocyte ratio (dNLR), lymphocyte to monocyte ratio (LMR) and platelet to lymphocyte ratio (PLR), lung immune prognostic index (LIPI), systemic inflammation response index (SIRI) and systemic immune inflammation index (SII), have demonstrated their prognostic values in several solid malignancies. However, Comparisons of superiority with these seven indices’ predictive efficacy within metastatic hormone-sensitive PCa (mHSPC) and metastatic castration-resistant PCa (mCRPC) remain uncertain.MethodsWe retrospectively included 407 patients diagnosed with mHSPC and 158 patients with mCRPC at West China Hospital from 2005 to 2022. The seven immune-inflammatory indices were computed based on hematological data of mHSPC at initial diagnosis and mCRPC at progression to CRPC. Prognostic value for castration-resistant prostate cancer-free survival (CFS), overall survival (OS), prostate-specific antigen progression-free survival (PSA-PFS) and prostate-specific antigen (PSA) response was assessed using Kaplan–Meier curves, Cox regression models, and chi-square tests. The predictive performance of each immune-inflammatory index was assessed using the area under the curve (AUC) in time-dependent receiver operating characteristic curve (ROC) analysis and C-index calculation.ResultsAll seven immune-inflammatory indices were significantly associated with CFS and OS in the mHSPC cohort, as well as with PSA response, PSA-PFS, and OS in the mCRPC cohort. In the mHSPC cohort, LIPI consistently exhibited higher AUC values compared to NLR, dNLR, LMR, PLR, SII, and SIRI for predicting CFS and OS. This indicates that LIPI had a superior discriminative ability compared to the other indices (C-index of LIPI: 0.643 and 0.686 for CFS and OS, respectively). Notably, the predictive advantage of LIPI over other indices in the mHSPC stage diminished in the mCRPC stage.ConclusionsThis study firstly confirmed the prognostic value of SII, SIRI and LIPI in mHSPC and mCRPC, and revealed that LIPI had a higher predictive power than NLR, dNLR, LMR, PLR, SII and SIRI in mHSPC. These non-invasive indices can enable clinicians to quickly assess the prognosis of patients.

The importance of SII and FIB-4 scores in predicting mortality in idiopathic pulmonary fibrosis patients

IntroductionQuick and simple parameters are needed to predict mortality in patients with idiopathic pulmonary fibrosis (IPF). In this way, risky patients will have the opportunity to receive early and effective treatment. In this study, we examined whether the Fibrosis-4 index (FIB-4) and systemic immune inflammation index (SII) are associated with mortality in IPF patients. Materials and methodsThe study was designed retrospectively. 100 patients diagnosed with IPF were included in the study. Variables between living patients and deceased patients were examined. ResultsOut of a total of 100 patients, 67 were divided into the surviving group and 33 into the non-surviving group. In multivariate analysis, high FIB-4 and SII values were significantly associated with an increased risk of death. ConclusionFIB-4 and SII are parameters that can predict mortality in IPF patients. In this way, IPF patients with high mortality risk will be identified earlier and more effective methods will be used in follow-up and treatment.

The Aggregate Index of Systemic Inflammation as a Predictor of Mortality in Stroke Patients.

Background and objectives Stroke, a leading cause of mortality and disability, involves significant inflammation both before and after onset. This study investigates the relationship between the aggregate index of systemic inflammation (AISI) and mortality in stroke patients. The objective is to determine if AISI, an easily accessible biomarker, can predict stroke prognosis. Materials and methods In this retrospective study, the medical records of patients who presented to Harran University Neurology Clinic between January 2018 and September 2023 were reviewed. A total of 200 patients, 106 of whom were diagnosed as having an ischaemic stroke and 94 of whom were diagnosed as having a haemorrhagic stroke, were included in the study. A control group was also formed, which consisted of 100 people of similar age and sex with the patient group. The controls had neither chronic disease nor chronic drug use. Using biochemical and full blood count parameters, neutrophil-to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), lymphocyte to monocyte ratio (LMR), monocyte to lymphocyte ratio (MLR), neutrophil to high-density cholesterol ratio (NHR), monocyte to high-density cholesterol ratio, systemic immune inflammation index (SII), systematic immune response index (SIRI) and the AISIwere calculated for all patients and the control group. Results A comparison of the two groups revealed significantly higher NLR, NHR, PLR, LMR, MLR, SII, SIRI and AISI values compared with the controls. NLR, PLR, SII, SIRI and AISI values were significantly higher in haemorrhagic stroke than in ischaemic stroke. Elevated NLR level and SII were correlated to mortality (respectively p:0.000, p = 0.017). SIRI (p = 0.189) and AISI (p = 0.162) were not correlated to mortality. However, receiver operating characteristic curve analysis determined that mortality increased for patients with AISI values above 507.45 (p = 0.003). Conclusions The AISI was found to be high among stroke patients, especially in haemorrhagic strokes. A relationship was observed between the increase in AISI above a certain value and mortality. The AISI is an accessible biomarker that shows inflammation in stroke patients. Therefore, it can be used to predict the prognosis of stroke.

Usefulness of the Systemic Inflammation Response Index and the Systemic Immune Inflammation Index in Predicting Restenosis After Stent Implantation.

The systemic inflammation response index (SIRI) and the systemic immune inflammation index (SII) are indicators that reflect the body's overall systemic inflammatory response. Inflammation plays an important role in the pathogenesis of in-stent restenosis (ISR). The aim of this study was to investigate the predictive value of preoperative SIRI and SII for the occurrence of ISR in patients undergoing coronary stent implantation. We retrospectively analyzed the clinical, hematological, and angiographic data of 387 patients who underwent coronary angiography for recurrent angina after coronary stent implantation at Qilu Hospital of Shandong University. Receiver operating characteristic curve (ROC) analysis was used to determine the optimal cutoff values for SIRI and SII to predict ISR. Based on the optimal cutoff values for SIRI and SII, patients were categorized into high-SIRI, low-SIRI, high-SII, and low-SII groups. Multivariate logistic regression models were constructed to assess the predictive value of SIRI and SII for ISR >50% and ISR >70%. This study included a total of 387 patients who underwent coronary angiography and follow-up at Qilu Hospital of Shandong University. Patients in the high-SIRI group had a higher incidence of ISR than those in the low-SIRI group (ISR >50%: 44.8% vs 30.7%, p = 0.018; ISR >70%: 41.5% vs 4.5%, p < 0.001). In addition, ISR occurred more frequently in patients with a higher SII than in patients with a lower SII (ISR >50%: 52.6% vs 35.7%, p = 0.001; ISR >70%: 51.9% vs 23%, p < 0.001). In multivariate logistic regression analysis, SIRI and SII were found to be independent predictive factors for ISR, both as continuous and categorical variables. In the ROC analysis, the optimal cutoff value for SIRI was set at 0.54 (sensitivity: 84.5%, specificity: 27%), and the optimal cutoff value for SII was set at 545.29 (sensitivity: 44.1%, specificity: 71.7%). Elevated preoperative SIRI and SII values help predict ISR and may serve as a useful screening tool to perform interventional procedures based on the patient's risk of ISR after stent implantation.

Systemic Immune-Inflammation Index (SII) as Prognostic Indicator for BCG Therapy in Bladder Cancer: A Systematic Review and Meta-analysis

Background: Bacillus Calmette-Guérin (BCG) immunotherapy is a standard treatment for high-risk non-muscle invasive bladder cancer (NMIBC) after tumor resection. However, not all patients respond to BCG therapy. Reliable prognostic markers are needed to predict treatment outcomes. Objectives: This study reviewed the prognostic value of systemic immune-inflammation index (SII) and related markers in BCG response. Methods: A systematic literature search was conducted in PubMed, Web of Science, and Scopus databases from inception to October 2023 for studies on SII index, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) in bladder cancer patients receiving BCG therapy. Four retrospective studies involving 1124 patients met the inclusion criteria and were included in qualitative synthesis. Three studies were included in the meta-analysis of progression-free survival (PFS) and recurrence-free survival (RFS). Data on study characteristics and demographics, follow-up duration, cancer stage/grade, and pre-treatment marker levels were extracted. Hazard ratios (HRs) were pooled using a random effects model. Results: Elevated pre-treatment SII was associated with significantly worse PFS (HR: 3.72, 95% CI: 1.74-7.98, P&lt;0.001) and RFS (HR: 3.72, 95% CI: 1.42-9.77, P=0.007). However, significant heterogeneity was found among trials in the overall survival (OS) (I2 =83.49, P=0.002) and RFS (I2 =89.69%, P=0.002). In multivariate analysis, SII&gt;672.75 was an independent predictor of BCG failure (OR: 2.229, 95% CI: 1.172-4.238, P=0.015). NLR, PLR, and MLR also showed potential prognostic value with area under the curve (AUC) values ranging from 0.592 to 0.663 for predicting non-response to BCG therapy. Specifically, NLR&gt;3.0435, PLR&gt;123.4398, and MLR&gt;0.1995 were significantly associated with non-response to BCG (P&lt;0.001 for all). In univariate analysis, BCG non-response was associated with high pre-treatment levels of PLR, NLR, and MLR (P&lt;0.001). Conclusion: Pre-treatment SII and other inflammatory markers may predict poor outcomes after BCG immunotherapy in bladder cancer patients. SII holds promise as an accessible prognostic biomarker that can guide treatment decisions. Further large prospective studies are warranted to validate these preliminary findings.

Systemic Immune-Inflammation Index as A Predictor of Mortality and Rehospitalization in Heart Failure Patients

ABSTRACT Systemic Immune-Inflammation Index as A Predictor of Mortality and Rehospitalization in Heart Failure Patients Background Heart failure (HF) is a disease closely associated with inflammation and the Systemic Immune inflammation Index (SII) is a novel inflammatory marker. SII is a combined inflammatory indicator that incorporates three significant immune cells namely neutrophils, lymphocytes and platelets. SII is considered an excellent indicator of local immune response and systemic inflammation. SII is an inexpensive and easily accessible laboratory test in peripheral health facilities. Research Objective This study aims to determine whether SII can be used as a predictor of clinical outcomes, which are mortality and rehospitalization in patients with chronic heart failure. Research Methods This study is a retrospective cohort study using data of chronic heart failure patients who underwent hospitalization from the HF (Heart Failure) registry of Dr. Sardjito Hospital for the period January 2022 - February 2023. SII was calculated as platelet count × absolute neutrophil count / absolute lymphocyte count. Results There were 188 patients who met the inclusion criteria as research subjects from 282 chronic heart failure patients who underwent hospitalization. Subjects had a mean age of 58.80 ± 11.48 years. A total of 67,6% (n=127) of the subjects were male. SII value for mortality based on receiver operating characteristic (ROC) cut-off was 1459,59 (area under curve (AUC) 0.600, sensitivity (Sn) 55,6%, specificity (Sp) 68,8%) and the ROC cut-off for rehospitalization was 0,474. Kaplan-Meier analysis of SII with mortality, subjects with high SII values (&gt;1459.59) had a 50,5% survival rate with a mean survival of 8,5 months and low SII (&lt;1459.59) had a 74% survival rate with a mean survival of 9,9 months. Multivariate regression analysis found SII as an independent predictor of mortality odds ratio (OR 3,08, 95% confidence interval (CI) 1,59 – 5,95, p=&lt;0.001) but not significant for rehospitalization. Conclusion Systemic Immune-inflammation Index (SII) is an independent predictor of mortality, but not a predictor of rehospitalization in chronic heart failure patients undergoing hospitalization. Keywords: Systemic Immune-inflammation Index (SII), heart failure (HF), mortality and rehospitalization

Fibrinogen-to-albumin ratio (FAR) is the best biomarker for the overall survival of patients with non-small-cell lung cancer.

The inflammatory response and the nutritional status are associated with overall survival (OS) in patients with non-small cell lung cancer (NSCLC), but it is unclear which biomarkers are better suited to predict prognosis. This study sought to determine which of the commonly existing inflammatory and nutritional indicators best predicted the OS. This study included 15 compound indicators based on inflammation or nutrition, with cutoff points obtained through the receiver operating characteristic (ROC) curve. Univariate and multivariate Cox proportional risk models were used to evaluate the relationship between these predictors and OS. Kaplan-Meier curves were used for survival analysis, and log-rank tests were used to compare differences between groups. The C-index was calculated to evaluate the predictive ability of the different indicators. The study included 899 patients with NSCLC. In the univariate analysis, all 15 measures were significantly associated with the OS of patients (all p < 0.05). The results of the C-index analysis showed that the fibrinogen-to-albumin ratio (FAR), the systemic immune-inflammation index (SII), and the albumin-to-alkaline phosphatase ratio (AAPR) were the three indices with the best predictive performance. Among them, FAR (C-index = 0.639) had the best predictive power for OS in patients with NSCLC. In the different subgroups, FAR had the highest C-index in male, non-smoking, adenocarcinoma, and stage II patients. The C-index of the platelet-to-lymphocyte ratio (PLR) in female patients was the highest. SII was the highest in smokers, in those aged <65 and ≥65 years, and in stage III patients. The C-index of AAPR was the highest in non-adenocarcinomas. The C-index of the pan-immune-inflammation value (PIV) was the highest in stage I patients. In the multivariate Cox regression analysis, among FAR, SII, and AAPR, only FAR was an independent predictor of OS in patients with NSCLC. A high FAR was associated with a higher risk of death in patients with NSCLC (HR = 1.601, 95% CI = 1.028-2.495). In order to further evaluate the potential prognostic value of FAR, SII, and AAPR in patients with different stages, Cox regression analysis was performed for those with stage I-II and stage III NSCLC. The results showed that FAR was an independent prognostic factor for OS in patients with stage I-II NSCLC. For all patients with NSCLC, the prognostic power of FAR was superior to that of other inflammatory and nutritional indicators.

Prognostic Value of NLR, PLR, SII, and dNLR in Urothelial Bladder Cancer Following Radical Cystectomy

BackgroundInflammation plays a crucial role in tumor development and progression, with inflammatory markers showing promise in predicting cancer prognosis. However, their significance in muscle-invasive bladder cancer (MIBC), especially in the context of neoadjuvant chemotherapy (NAC), remains poorly understood. This study aims to evaluate the prognostic utility of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune inflammation index (SII), and derived neutrophil-to-lymphocyte ratio (dNLR) for overall survival (OS) in bladder cancer (BC) patients undergoing radical cystectomy (RC) in the NAC era. Patients and MethodsA retrospective review analyzed prospectively-collected data from our institutional BC registry, covering patients with MIBC undergoing RC with curative intent from March 1st, 2016, to December 31st, 2022. Blood samples were collected preoperatively to calculate NLR, PLR, SII, and dNLR. OS was defined from surgery to last follow-up or death. Statistical analyses included ROC curves, Kaplan-Meier Curves, and Cox proportional hazards regression models. ResultsA total of 187 patients with median duration follow-up of 14.7 month were included in this study and 50.8% experienced death. NAC was administered in 50.3% of cases. The ideal cut-off for dichotomizing NLR, PLR, SII, and dNLR was 1.76, 104.30, 410.66, and 1.30, respectively. In multivariable analysis each of these biomarkers emerged as an independent prognostic factor for predicting OS. The results showed a correlation between higher NLR, PLR, SII, and dNLR levels and a deterioration in OS. ConclusionElevated values of these inflammatory markers indicate poorer survival, highlighting their potential as indicators of disease aggressiveness. Identifying patients with elevated markers can help healthcare providers personalize treatment strategies, improving patient outcomes and survival rates.