Systemic Inflammatory Score Research Articles

Prognostic value of systemic inflammation score in patients with esophageal cancer.

The systemic inflammatory score (SIS), a new inflammatory marker based on a combination of the lymphocyte-to-monocyte ratio (LMR) and serum albumin concentration, has been reported to be a useful prognostic marker for several malignancies. The authors conducted this retrospective study on data from a cohort of esophageal cancer patients undergoing potentially curative resection to clarify the value of SIS as a prognostic marker for clinical outcome in this population. This retrospective cohort study included 32 patients who underwent thoracoscopic esophagectomy after neoadjuvant chemotherapy for esophageal cancer between January 2016 and December 2019. Blood samples were collected within one week prior to the initiation of preoperative chemotherapy. Three inflammatory and nutritional markers; SIS, the neutrophil-to-lymphocyte ratio (NLR), and prognostic nutrition index (PNI) were examined in this study. Disease-free survival was assessed using the Kaplan-Meier method, and univariable and multivariable Cox models were applied to evaluate the predictive value of SIS, NLR and PNI. NLR and PNI were not associated with recurrence, while SIS scores of 1 and 2 were significantly associated with recurrence. In multivariate analysis, SIS scores of 1 or 2 were found to be independently associated with recurrence, each with a hazard ratio of 1.98. In addition, when examining immunologic and nutritional factors and survival rates, there was no significant difference in the survival rate for NLR and PNI; for SIS, however, the survival rate was significantly worse in patients with SIS scores of 1 or 2. The authors demonstrated that a novel and easily obtained prognostic score, termed SIS, based on pre-treatment serum albumin and LMR, can serve as an independent prognostic factor in postoperative esophageal cancer patients. It could be incorporated into conventional clinical and pathological algorithms to enhance the prognostic accuracy in this population.

Role of hemogram parameters as predictive markers for propofol injection pain in reproductive and postmenopausal women: a prospective study

Aims: In clinical practice, propofol injection pain (PIP) is a frequent condition that clinicians could face every day. The aim of this prospective study was to investigate the correlation between PIP and hemogram parameters in reproductive and postmenopausal women.
 Methods: In this prospective study, 40 reproductive and 40 postmenopausal female patients who underwent elective surgery were enrolled. Baseline data including age, weight, height, hemogram parameters, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and systemic immune inflammatory score (SII) were recorded preoperatively. The pain was classified as 0: no pain, 1: mild pain, 2: moderate pain, 3: severe pain. Patients were previously informed about the questioning of pain scores during propofol.
 Results: The proportion of patients experiencing PIP in postmenopausal (n=16;40%) group was significantly higher than those in the reproductive group (n=6;15%) (p=0.009). When reproductive and postmenopausal groups were compared according to the presence or absence of pain, no difference was found between the groups in terms of hemogram ratios and platelet indices (p>0.05). The NLR, PLR and SII ratios were not significant in predicting the presence of PIP. 
 Conclusion: The findings of our study showed that the occurrence of PIP in postmenopausal women was higher compared to women in reproductive age. Hemogram values, NLR platelet, PLR and SII ratios were not significantly associated with the presence of PIP.

Monocyte Count and Systemic Immune-Inflammation Index Score as Predictors of Delayed Cerebral Ischemia after Aneurysmal Subarachnoid Hemorrhage.

Delayed cerebral ischemia (DCI) is a major cause of disability in patients who survive aneurysmal subarachnoid hemorrhage (aSAH). Systemic inflammatory markers, such as peripheral leukocyte count and systemic immune-inflammatory index (SII) score, have been considered predictors of DCI in previous studies. This study aims to investigate which systemic biomarkers are significant predictors of DCI. We conducted a retrospective, observational, single-center study of 170 patients with SAH admitted between May 2018 and March 2022. We analyzed the patients' clinical and laboratory parameters within 1 hour and 3-4 and 5-7 days after admission. The DCI and non-DCI groups were compared. Variables showing statistical significance in the univariate logistic analysis (p<0.05) were entered into a multivariate regression model. Hunt-Hess grade "4-5" at admission, modified Fisher scale grade "3-4" at admission, hydrocephalus, intraventricular hemorrhage, and infection showed statistical significance (p<0.05) on a univariate logistic regression. Lymphocyte and monocyte count at admission, SII scores and C-reactive protein levels on days 3-4, and leukocyte and neutrophil counts on days 5-7 exhibited statistical significance on the univariate logistic regression. Multivariate logistic regression analysis revealed that monocyte count at admission (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.04-2.65; p=0.036) and SII score at days 3-4 (OR, 1.55; 95% CI, 1.02-2.47; p=0.049) were independent predictors of DCI. Monocyte count at admission and SII score 3-4 days after rupture are independent predictors of clinical deterioration caused by DCI after aSAH. Peripheral monocytosis may be the primer for the innate immune reaction, and the SII score at days 3-4 can promptly represent the propagated systemic immune reaction toward DCI.

Lymphocyte-to-monocyte ratio as a prognostic and potential tumor microenvironment indicator in advanced soft tissue sarcoma treated with first-line doxorubicin therapy

Prognostic value of hematologic indices and their association with the tumor microenvironment (TME) remain unclear in advanced soft tissue sarcoma (STS). We aimed to evaluate their prognostic value and correlation with the TME status in advanced STS treated with first-line doxorubicin (DXR) therapy. Clinical data and three hematological indices, including lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio, and neutrophil-to-lymphocyte ratio, were collected from 149 patients with advanced STS. The TME status was pathologically examined by CD3, CD68, and CD20 staining of resected tumor slides. In a multivariate Cox analysis, low LMR and absence of primary tumor resection were independently associated with worse overall survival (OS) (HR 3.93, p = 0.001; HR 1.71, p = 0.03). A prognostic model using these variables predicted OS with greater area under curves than those obtained using Systemic Inflammatory Score and Glasgow Prognostic Score. The LMR significantly correlated with the tumoral CD3/CD68-positive cell ratio in surgical specimens (R = 0.959, p = 0.04). In conclusion, LMR was a prognostic factor in advanced STS treated with first-line DXR therapy. LMR could partially reflect anti-tumor immunity in the TME and have the prognostic value. The potential role of LMR as an indicator of TME status warrants further investigation.

A prognostic systemic inflammation score (SIS) in patients with advanced intrahepatic cholangiocarcinoma

PurposeSystemic-inflammatory response parameters (SIR) are known prognostic markers in different tumour entities, but have not been evaluated in patients with iCCA treated with systemic chemotherapy. Therefore, we evaluated the impact of different SIR markers on the clinical course of patients with advanced iCCA treated at our center.MethodsSIR markers were retrospectively evaluated in 219 patients with iCCA at the West-German-Cancer-Center Essen from 2014 to 2019. Markers included neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR), CRP, and the modified Glasgow-Prognostic-Score (mGPS), which were correlated with clinico-pathological findings, response to chemotherapy (ORR), progression-free (PFS) and overall survival (OS) using Kaplan–Meier analyses, and Cox proportional models.ResultsMedian overall survival (OS) of the entire cohort was 14.8 months (95% CI 11.2–24.4). Median disease-free survival (DFS) in 81 patients undergoing resection was 12.3 months (95% CI 9.7–23.1). The median OS from start of palliative CTX (OSpall) was 10.9 months (95% 9.4–14.6). A combined Systemic Inflammatory Score (SIS) comprising all evaluated SIR markers correlated significantly with ORR, PFS, and OSpall. Patients with a high SIS (≥ 2) vs. SIS 0 had a significantly inferior OSpall (HR 8.7 95% CI 3.71–20.38, p < 0.001). Multivariate analysis including known prognostic markers (ECOG, CA19-9, LDH, and N- and M-status) identified the SIS as an independent prognostic factor.ConclusionsInflammatory markers associate with inferior survival outcomes in patients with iCCA. A simple SIS may guide treatment decisions in patients treated with systemic chemotherapy.

Prognostic value of nutritional and inflammatory scores in Transcatheter aortic valve replacement patients

Background: Aortic Stenosis (AS) is a common heart valve disease that especially affects the elderly population and is seen with the aging of the society. In recent years Transcatheter aortic valve replacement patients (TAVR) has been increasingly applied worldwide as a procedure for the treatment of severe AS. Recently, various biomarkers and derived marker approaches have been studied in AS patient groups as in many cardiovascular diseases. Since it has been previously shown that increased inflammatory scores and poor nutritional scores are closely associated with the development process and prognosis of cardiovascular diseases, we hypothesized that these scores may be associated with prognosis after TAVR. Therefore, in this study, we aimed to make a detailed evaluation in terms of mortality determinants after TAVR.&#x0D; Methods and Results: 118 TAVR patients were included in the analysis. Median follow-up of 118 patients was 40.5 months. In terms of inflammatory status scores, the systemic immune inflammatory (SII) score (p= 0.027), the neutrophil/lymphocyte ratio (NLR) score (p= 0.012), and the platelet/lymphocyte ratio (PLR) score (p= 0.012) in the death group was found to be significantly higher. As nutritional status scores, the prognostic nutritional index (PNI) score (p= 0.003) was lower in the death group and the median Controlling Nutritional Status (CONUT) score (p= 0.002)) found significantly higher.&#x0D; Conclusion: In severe and high-risk AS patients undergoing TAVR, measurement of malnutrition with the CONUT score and increased inflammatory status with the SII score was associated with an increased risk of all causes mortality in long-term follow-up. It has been determined that the development of complications related to the procedure is an indicator of increased mortality not only in the short term but also in the long-term follow-up.

The Role of Inflammatory Markers and the Modified Systemic Inflammatory Score in Bethesda Category 3 And 4 Patients for Prediction of Malignancy

Management of Bethesda Category 3 and 4 patients remains a challenge. The modified systemic inflammatory score (mSIS) and other inflammatory parameters are used for prognosis assessment in various cancers. This retrospective study aims to explore prediction strength of the inflammatory parameters in Category 3 and 4 patients. One hundred and twenty three patients had undergone thyroidectomy for Category 3 and 4 fine needle aspiration biopsy (FNAB). The data of inflammatory markers including Neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), albumin to globulin ratio (AGR) and mSIS were evaluated retrospectively. There were no statistically significant difference in inflammatory parameters between benign and malignant patients and none of the inflammatory parameters had predictivity for thyroid cancer. Also in mSIS groups, thyroid cancer incidence were similar (P=0.684). Inflammatory parameters and mSIS were failed to predict thyroid cancer in patients who had category 3 and 4 FNAB.

Inflammatory markers may predict post-operative complications and recurrence in Crohn's disease patients undergoing gastrointestinal surgery.

Most Crohn's Disease (CD) patients will require surgical intervention over their lifetime, with considerably high rates of post-operative complications. Risk stratification with reliable prognostic tools may facilitate clinical decision making in these patients. Blood cell interaction based inflammatory markers have proven useful in predicting patient outcomes in oncological and benign diseases. The aim of this study was to investigate their prognostic value in CD patients undergoing surgery. A retrospective single institution study of CD patients who underwent surgery between the years 2008 and 2019 was conducted. Data were collected from medical records and analysed for association of Platelet-to-Lymphocyte Ratio (PLR), Neutrophil-to-Lymphocyte Ratio (NLR), Lymphocyte-to-Monocyte Ratio (LMR) and the modified Systemic Inflammatory Score (mSIS) with post-operative outcomes. A total of 81 patients were included in the analysis. Half were females; mean age was 36 ± 15.54 years. Fifty seven percent (n= 46) were operated in expedited settings, with 23.5% developing post-operative complications. In elective patients, higher pre-operative NLR (P= 0.029) and PLR (P= 0.034) were associated with major post-operative complications, higher NLR (P= 0.029) and PLR (P= 0.034) were associated with re-operation and higher PLR correlated with Clavien-Dindo score (P= 0.032). In patients operated in expedited operations, higher pre-operative NLR (P= 0.021) and lower pre-operative LMR (P= 0.018) were associated with thromboembolic events and higher mSIS was associated with major post-operative complications (P= 0.032). Blood cell interaction based inflammatory markers confer an association with post-operative complications in CD patients undergoing surgery. These indices may facilitate patient selection and optimization when considering the risks and benefits of surgical interventions.

THE MODIFIED SYSTEMIC INFLAMMATION SCORE CAN BE USED TO PREDICT THE PRESENCE OF INVASIVE CARCINOMA IN COLORECTAL POLYPS WITH HIGH-GRADE DYSPLASIA

Objective&#x0D; In recent years, the prognostic and predictive values&#x0D; of scoring systems such as systemic inflammation&#x0D; score (SIS) and modified systemic inflammation&#x0D; score (mSIS) have been investigated in colorectal&#x0D; cancers. To investigate the efficacy of the modified&#x0D; systemic inflammatory score (mSIS) calculated by&#x0D; simple laboratory tests in predicting the presence of&#x0D; invasive carcinoma in colon polyps with high-grade&#x0D; dysplasia (HGD).&#x0D; Materials and Methods&#x0D; The postoperative data of 44 patients with colorectal&#x0D; polyps who underwent surgery with the diagnosis&#x0D; of preoperative HGD between January 2019 and&#x0D; October 2021 were retrospectively analyzed.&#x0D; According to the results of the postoperative&#x0D; histopathological examination, the patients were&#x0D; divided into two groups as HGD/intramucosal&#x0D; carsinom (Tis)/adenomatous polyp and invasive&#x0D; carcinoma. mSIS calculation was made as follows:&#x0D; mSIS 0 [albumin (ALB)≥4.0 g/dL and lymphocyte/&#x0D; monocyte ratio (LMR)≥3.4], mSIS 1 (ALB

Systemic Inflammatory Score Predicts Response and Prognosis in Patients With Lung Cancer Treated With Immunotherapy.

This study aimed to investigate useful prognostic factors of immunotherapy in patients with lung cancer. We retrospectively observed 73 patients who underwent immunotherapy (nivolumab, pembrolizumab, and atezolizumab) for lung cancer. The systemic inflammatory score (SIS) was calculated as the sum of the following factors scored one point each: Hemoglobin <12.5 g/dl and serum albumin <3.6 g/dl, resulting in scores of 0-2. We examined the correlation between the SIS and initial tumor response and progression-free and overall survival with other existing markers, namely tumor programmed death-ligand 1 (PD-L1) expression level; neutrophil-to-lymphocyte ratio (NLR); modified Glasgow prognostic score; and prognostic nutritional index, etc. Results: SIS ≤1 was significantly associated with better initial tumor response. In multivariate analysis, PD-L1 expression ≥50% (p=0.010), SIS ≤1 (p=0.028) and NLR <5.6 (p=0.047) were significantly associated with longer progression-free survival, and SIS ≤1 (p=0.030) and NLR <5.6 (p=0.037) were associated with longer overall survival. SIS is a useful marker of the efficacy of immunotherapy that can be obtained via routine blood tests.

Systemic combining inflammatory score (SCIS): a new score for prediction of oncologic outcomes in patients with high-risk non-muscle-invasive urothelial bladder cancer.

BackgroundAn accurate and early diagnosis of bladder cancer (BC) is essential to offer patients the most appropriate treatment and the highest cure rate. For this reason, patients need to be best stratified by class and risk factors. We aimed to develop a score able to better predict cancer outcomes, using serum variables of inflammation.MethodsA total of 1,510 high-risk non-muscle invasive bladder cancer (NMIBC) patients were included in this retrospective observational study. Patients with pathologically proven T1 HG/G3 at first TURBT were included. Systemic combined inflammatory score (SCIS) was calculated according to systemic inflammatory markers (SIM), modified Glasgow prognostic score (mGPS), and prognostic nutritional index (PNI) dichotomized (final score from 0 to 3).ResultsAfter 48 months of follow-up (IQR 40.0–73.0), 727 patients recurred (48.1%), 485 progressed (32.1%), 81 died for cancer (7.0%), and 163 died for overall causes (10.8%). Overall, 231 (15.3%) patients had concomitant Cis, 669 (44.3%) patients had multifocal pathology, 967 (64.1%) patients had tumor size >3 cm. Overall, 357 (23.6%) patients received immediate-intravesical therapy, 1,356 (89.8%) received adjuvant intravesical therapy, of which 1,382 (91.5%) received BCG, 266 (17.6%) patients received mitomycin C, 4 (0.5%) patients received others intravesical therapy. Higher SCIS was independently predictive of recurrence (hazard ratio HR 1.5, 1.3 and 2.2) and cancer specific mortality for SCIS 0 and 3 (HR: 1.61 and 2.3), and overall mortality for SCIS 0 and 3 (HR: 2.4 and 3.2). Conversely, SCIS was not associated with a higher probability of progression.ConclusionsThe inclusion of the SCIS in clinical practice is simple to apply and can help improve the prediction of cancer outcomes. It can identify patients with high-grade BC who are more likely to experience disease mortality.

Systemic Inflammatory Score predicts Overall Survival in patients with Cervical Cancer.

Background: To evaluate the prognostic value of the systemic inflammatory score (SIS) in cervical cancer patients.Methods: A total of 264 patients with FIGO stage (2009) IB-IIA cervical cancer undergoing radical resection from January 2014 to December 2017 were recruited. The optimal cutoff values for inflammatory biomarkers were calculated by X-tile software. The prognostic factors were investigated using univariate and multivariate Cox analyses. Time-dependent receiver operating characteristic (time-ROC) analysis and the concordance index (C-index) were used to compare the prognostic impact of factors.Results: In total, 264 patients with cervical cancer were included in the study. The optimal cutoff value for lymphocyte-to-monocyte ratio (LMR) was 4.1. In multivariate analysis, FIGO stage, lymphovascular invasion, lymph node metastasis, preoperative serum albumin (Alb), and LMR were independent prognostic factors (P<0.05). Then, we combined preoperative Alb and LMR to establish the SIS. Multivariate analysis showed that the SIS was an independent factor that affected survival (P<0.05). When stratified by FIGO stage, significant differences in survival were also found for patients with different SISs (P<0.05). When the SIS and FIGO stage were combined, the time-ROC curve was superior to that of FIGO stage only. The C-index of the model combining the SIS and FIGO stage was 0.786 (95% CI 0.699-0.873), which was significantly higher than that of the model with FIGO stage only (0.676, 95% CI 0.570-0.782, P=0.0049).Conclusions: The preoperative SIS is a simple and useful prognostic factor for postoperative survival in patients with cervical cancer. It might assist in the identification of high-risk patients among patients with the same FIGO stage.

Prognostic value of modified systemic inflammatory score in patients with newly diagnosed high-grade gliomas

BackgroundWe aimed to build a modified systemic inflammatory score(mSIS) based on preoperative albumin, fibrinogen, lactate dehydrogenase, and neutrophil–lymphocyte ratio in patients with high-grade glioma. Material and MethodsData of 318 patients with high-grade gliomas were retrospectively analyzed. The SIS was developed and its associations with clinicopathological features and overall survival (OS) were evaluated. ResultsThe mSIS consisted of serum albumin, fibrinogen, lactate dehydrogenase and neutrophil–lymphocyte ratio. A high mSIS was significantly associated with age(p < 0.001), sex(p = 0.048), lymphocyte-monocyte ratio (LMR)(p = 0.025), C-reactive protein(p < 0.001), tumor grade(p = 0.006) and served as an independent prognostic factor of reduced overall survival and progression-free survival (PFS). Subgroup analysis showed that the mSIS could significantly stratify patient prognosis in different tumor grades and adjuvant therapies. ConclusionsmSIS may predict survival and disease regression in high-grade glioma patients undergoing surgery. Management of HGG patients may need consideration of host inflammatory status.

A Prospective Study on the Predictability of Propofol Injection Pain.

IntroductionIn this prospective study, we aimed to determine if there was a link between pain on propofol injection (POPI) and various hemogram parameters and ratios.MethodsThe study was designed to include 100 consecutive male patients undergoing surgery in a tertiary hospital in February 2017. Preoperatively collected data included patients’ age, weight, height, hemogram parameters (white blood cell (WBC) count, neutrophil count, lymphocyte count, platelet count, mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), hemoglobin, and hematocrit). All patients’ hemograms were performed using the same device. The neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, and systemic immune inflammatory score (SII) were calculated from this data.Patients received prior information that pain would be questioned during propofol injection. The pain was grouped between 0 and 3 (0 no pain, 1 mild pain, 2 moderate pain, 3 severe pain).Patients were questioned by the anesthesiologist about their level of pain at five-second intervals until loss of consciousness occurred. The same anesthesiologist also used the McCririck and Hunter’s verbal rating score (VRS) to evaluate pain. The patients’ heart rate and blood pressure were also recorded after induction.ResultsAn extremely significant correlation was found between the presence of POPI and neutrophil-lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR) and SII ratios (p<0.001). All three parameters were found to be significant in predicting the presence of POPI. The higher area under the curve (AUC) was found for SII.The cutoff value for SII’s prediction of POPI was calculated to be 479,000, with a sensitivity of 68% and a specificity of 68%. Patients with an NLR of >497000 had a 4.63 times higher risk of POPI (odds ratio: 4.63, 95% CI: 1.6714 - 12.7982).ConclusionOur study is the first to show that POPI can be predicted by using NLR, PLR, and SII. Our data also support other studies that have reported a relationship between the inflammatory biomarker NLR and pain perception.

A Novel Systemic Inflammatory Score Combined With Immunoinflammatory Markers Accurately Reflects Prognosis in Patients With Esophageal Cancer.

To establish a novel systemic inflammatory score (SIS) combined with neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and C-reactive protein/albumin ratio (CAR) and to validate its prognostic value and relation with serum cytokine levels in patients who underwent esophagectomy for esophageal cancer (EC). Preoperative NLR, PLR, and CAR were evaluated in 102 patients undergoing esophageal resection for EC from 2009 to 2014. Receiver operating characteristic (ROC) curves censored for 5-year survival were plotted to determine the cutoff values of each measure. Each measure was scored 1 if it was above the cutoff value (NLR >3.12, PLR >230, and CAR >0.085) and scored 0 if it was below that. The SIS was defined as the sum of these values and was divided into the two groups: High SIS (SIS=2-3) and low SIS (SIS=0-1). Univariate and multivariate analyses were used to determine the prognostic significance. The area under the ROCs (AUROC) was compared to verify the discriminative power of survival prediction. In addition, we analyzed the relationship between SIS and perioperative serum interleukin (IL)-6 and IL-10 levels. In the clinicopathological findings, only tumor depth was significantly related to SIS (p=0.004). At 0.732, the AUROC of SIS was the highest (NLR=0.618, PLR=0.545), and CAR=0.712). The high-SIS group had a significantly poorer prognosis than the low-SIS group (p=0.011). SIS was identified as an independent prognostic factor in the multivariate analysis (hazard ratio=1.96, 95% confidence intervaI=1.11-3.41, p=0.020). The preoperative serum interleukin-6 level was significantly low (p=0.046) and postoperative serum interleukin-10 level was significantly high in the high-SIS group (p=0.047). SIS was a superior predictor of prognosis compared with existing immunoinflammatory markers and closely reflected the fluctuation of peripheral inflammatory cytokines in patients with EC.

Inflammatory serum markers and risk and severity of prostate cancer: The PROCA-life study.

Whether chronic inflammation mirrored by high levels of systemic inflammatory markers such as high sensitive-CRP (hs-CRP) and white blood cell count (WBC) are associated with prostate cancer development remains unclear. In the Prostate Cancer Study throughout Life (PROCA-life), a prospective population-based cohort study, 7,356 men were included. Prediagnostic WBC and hs-CRP were assessed from blood collected at study entry; 2,210 participants also had a second CRP measure during follow-up. During a mean 11.8 years follow-up, 509 men developed prostate cancer (mean age at diagnosis 71.7 years). Multivariable Cox proportional hazard regression models were used to study whether individual biomarkers (WBC, hs-CRP), a combined score based on analyte tertiles (score range 2-6), or change in CRP were associated with risk and severity of prostate cancer. We observed a positive dose-response relationship between hs-CRP and prostate cancer risk with a Hazard Ratio (HR) per mg/l of 1.3, 95% CI 1.00-1.07. Men with an increase in hs-CRP between two measurements (Δhs-CRP) of ≥1.00 mg/l had a 36% increased risk of prostate cancer (HR 1.36, 95% CI 1.02-1.82), compared to men with no change or decrease in hs-CRP. Men with a systemic inflammatory score of 5 or 6 had a 68% higher risk of being diagnosed with metastatic disease (HR 1.68, 95% CI, 1.04-2.73) compared to men with lower scores. Our study supports that hs-CRP including repeated measurements alone or in combination with WBC may be a useful inflammation-related biomarker for prostate cancer risk and prognosis.

The prognostic value of the systemic inflammatory score in patients with unresectable metastatic colorectal cancer.

Inflammation has been widely recognized as a contributor to cancer progression and several inflammatory markers have been reported as associated with the clinical outcomes in patients with various types of cancer. Recently, a novel inflammatory marker, the systemic inflammatory score (SIS), which is based on a combination of the lymphocyte-to-monocyte ratio (LMR) and the serum albumin concentration has been reported as a useful prognostic marker. The aim of the present study was to assess the prognostic value of the SIS in patients with unresectable metastatic colorectal cancer (mCRC). The retrospective cohort study included 160 patients who underwent combination chemotherapy for unresectable mCRC between January 2008 and December 2016. The SIS was used to classify the patients into three groups based on their LMR and the serum albumin concentration. Patients with high-LMR and high serum albumin level were given a score of 0; patients with low-LMR or low serum albumin level were given a score of 1; patients with low-LMR and low serum albumin level were given a score of 2. There were significant differences in the overall survival among the three SIS groups and the SIS was an independent prognostic factor for the overall survival. Although the SIS was significantly associated with the overall survival rate even when using the original cut-off values, the SIS according to the new cut-off values had a more accurate prognostic value. The present study determined that the SIS was a useful biomarker for predicting the survival outcomes in patients with unresectable mCRC, although the optimum cut-off value of the SIS according to the patients' background needs to be examined in further studies.

Prognostic Significance Of Systemic Inflammatory Factors In Patients With Diffuse Large B Cell Lymphoma Treated By R-CHOP

BackgroundSystemic inflammatory factors such as C-reactive protein (CRP), ¥â2-microglobulin (B2MG), and ferritin were documented an prognostic factor in patients with hematologic malignancies including lymphoma. The purpose of this study was to find the significance of systemic inflammatory factors for predicting survival outcome in patients with diffuse large B cell lymphoma (DLBCL). MethodsA total of 188 patients who newly diagnosed DLBCL and received an rituximab combined chemotherapy at the South Korea between September 2004 and April 2012 were enrolled retrospectively in the current study. Pretreatment serum CRP, B2MG, and ferritin were measured within 4 weeks before the beginning of first line chemotherapy. ResultsThe median age of patients was 58 years (range, 14-84 years) and the mean level of serum CRP, B2MG, and ferritin at pre-treatment were 2.37 mg/dL (range: 0.01 – 29.80), 2.64 mg/L (range: 0.71 – 24.01), and 285.01 ng/ml (range: 5.34-4872.40). Systemic inflammatory factors score were given 1 point if serum levels were more than normal range (CRP; 0.8 mg/dL, B2MG; 2.5 mg/L and ferritin; 220 ng/ml). Systemic inflammatory risk were divided into three groups according to systemic inflammatory factors scores ; low risk was 0 score, intermediate risk was 1 or 2 score, and high risk was 3 score respectively. 5-year progression free survival rates (PFS) were 66.9%, 65.0% and 10.6% in risk groups respectively (p < 0.001). 5-year overall survival rates (OS) were 74.4%, 48.8% and 19.8% in risk groups respectively (p < 0.001). ConclusionsSystemic inflammatory factor (CRP, B2MG and ferritin) score were associated with survival outcomes in patients with DLBCL treated by R-CHOP. However, further studies are needed to confirm prognostic value of systemic factors such as CRP, B2MG and ferritin.IPI, international prognostic index; LDH, lactate dehydrogenase; ECOG, Eastern Cooperative Oncology Group (ECOG) performance status; CRP, C-reactive protein; BM, bone marrow; ALC, absolute lymphocyte counts; CHOP-like (cyclophosphamide, adriamycin, vincristine, prednisolone); RCHOP (rituximab plus CHOP)Systemic inflammatory factor (normal range); ¥â2-microglobulin (2.5mg/L), CRP (0.8mg/dL), ferritin (220 ng/mL)Systemic inflammatory factor score : given 1 point if more than normal rangeLow risk ; 0, Intermediate risk ; 1 or 2, High risk ; 3 [Display omitted] [Display omitted] Disclosures:No relevant conflicts of interest to declare.Table 1Patient characteristicsValue (%)N = 188Age, yearsMedian (range)58 (16 – 84)Gender (%)MaleFemale109 (58.0)79 (42.0)IPI (%)LowLow-intermediateHigh-intermediateHigh64 (34.0)49 (26.1)30 (16.0)45 (23.9)LDHNormalelevated80 (42.6)108 (57.4)ECOG (%)0 – 1¡Ã 280 (42.6)108 (57.4)Stage (%)< III¡Ã III87 (46.3)101 (53.7)Extranodal involvement (%)< 2¡Ã 2156 (83.0)32 (17.0)Bulky mass (%)< 10 cm¡Ã10 cm164 (87.2)24 (12.8)CRP, mg/dLMean (range)2.37 (0.01 – 29.80)¥â2-microglobulin, mg/LMean (range)2.64 (0.71 – 24.01)BM involvement (%)PresentAbsent27 (14.4)161 (85.6)ALC, x 103/mLMean (range)1706 (40 – 22365)Ferritin, ng/mLMean (range)285.01 (5.34 – 4872.40)Table 2Survival outcome according to systemic inflammatory factor score in patients with DLBCLRisk5yrs PFS (%)P-value5yrs OS (%)P-valueLowIntermediateHigh66.965.010.6< 0.00174.448.8 19.8< 0.001