Correlation of Systemic Immune Inflammatory Index and Tumor Markers with Bone Metastasis of Lung Cancer / 肿瘤防治研究

Objective To evaluate the value of the systemic immune-inflammatory index (SII), CEA, Cyfra21-1, and NSE in predicting and diagnosing bone metastasis of lung cancer. Methods The clinical data of 618 patients with lung cancer were retrospectively analyzed. According to the bone metastasis at baseline, the data of the diagnosis group (patients with bone metastasis at baseline and patients without bone metastasis during follow-up) and the prediction group (patients with bone metastasis during follow-up and patients without bone metastasis during follow-up) were analyzed to determine the correlation between the above indicators and lung cancer bone metastasis. Results Predictive group: SII≥850 and NSE≥58.64 ng/ml were independent risk factors and independent predictors for lung cancer bone metastasis. The AUC of the combined SII+NSE model was 0.662, with a sensitivity of 54.5% and a specificity of 74.5%; it was superior to the predictive value of single factor (95%CI: 0.596-0.728; P < 0.001). Diagnostic group: lung adenocarcinoma, SII≥951.6, CEA≥5.14 ng/ml, NSE≥20.15 ng/ml, and Cyfra21-1≥3.94 ng/ml were independent risk factors for bone metastasis in lung cancer patients (P < 0.05). The AUC of SII alone in the diagnosis of lung cancer bone metastasis was 0.754. The AUC of the SII+Cyfra21-1 combined model was 0.82 which was the largest, with a sensitivity of 74% and a specificity of 78.5%; it was superior to any univariate AUC (P < 0.05). Conclusion The levels of SII, CEA, Cyfra21-1, and NSE in the bone metastasis group are significantly higher than those in the non-bone metastasis group. The predictive and diabnostic values would be improved further when SII combined with other single risk factors.

Construction and efficiency analysis of prediction model for venous thromboembolism risk in the elderly after hip fracture / 中南大学学报(医学版)

OBJECTIVES@#To screen the risk factors for predicting venous thromboembolism (VTE) risk after hip fracture in the elderly, to establish a prediction model based on these factors, and to analyze its prediction efficacy.@*METHODS@#A total of 52 hip fracture patients over 60 years old with VTE admitted to the Department of Orthopaedic Trauma, Xiangya Hospital, Central South University from March 2017 to April 2019 were selected as a thrombus group, and another 52 hip fracture patients over 60 years old without VTE were selected as a control group. The differences of hospitalization data and examination results between the 2 groups were compared. Logistic regression model was used to explore the influence of risk factors on VTE risk after hip fracture in the elderly and construct the prediction model based on these factors. The receiver operating characteristic curve was used to analyze the predictive effectiveness of model, Hosmer-lemeshow goodness of fit test was used to evaluate the fitting degree of prediction model.@*RESULTS@#Univariate analysis showed that injury-admission interval, Caprini score, WBC count, platelet count, neutrophil count, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, systemic immune-inflammatory index (SII), and fibrinogen in the thrombus group were higher than those in the control group (all @*CONCLUSIONS@#SII, Caprini score, and injury-admission interval are independent predictors of VTE after hip fracture in the elderly. The prediction model based on these 3 factors has a good efficacy on the prediction of VTE risk, and could provide important reference for the prevention, management, and treatment of VTE after hip fracture in the elderly.

Correlation between systemic immune-inflammation index and prognosis in patients with hepatic alveolar echinococcosis / 临床肝胆病杂志

ObjectiveTo investigate the correlation between systemic immune-inflammation index (SII) and prognosis in patients with hepatic alveolar echinococcosis. MethodsA retrospective analysis was performed for the clinical data of 242 patients who were admitted to Department of Hepatopancreatobiliary Surgery, Qinghai University Affiliated Hospital, from January 2015 to December 2018 and underwent surgery for hepatic alveolar echinococcosis, and SII was calculated. The chi-square test was used for comparison of categorical data between two groups, and a Spearman correlation analysis was performed. The receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value of SII; the Kaplan-Meier method was used to plot survival curves and analyze overall survival time in the two groups, and the log-rank test was used for comparison of survival rates between the two groups; univariate and multivariate Cox regression analyses were used to identify the influencing factors for the prognosis of patients with hepatic alveolar echinococcosis. ResultsThe Spearman correlation analysis showed that SII was positively correlated with the postoperative fatality rate of patients with hepatic alveolar echinococcosis (r=0.267, P＜0.001). The ROC curve showed that the optimal cut-off value of SII before surgery was 758.92, and based on this, 242 patients with hepatic alveolar echinococcosis were divided into low SII (SII ≤758.92) group with 126 patients and high SII (SII ＞758.92) group with 116 patients. The low SII group had 1-, 3-, and 5-year survival rates of 98.20%, 88.47%, and 6610%, respectively, and the high SII group had 1-, 3-, and 5-year survival rates of 90.80%, 53.05%, and 27.40%, respectively. The low SII group had a cumulative survival rate of ＞50% and a mean survival time of 55.584 months (95% confidence interval［CI］: 53550-57.617), while the high SII group had a cumulative survival rate of ＜50%, a mean survival time of 39.384 months (95% CI: 35.070-43.698), and a median survival time of 43 months (95% CI: 34.694-51.306). The low SII group had a significantly better survival rate than the high SII group, and there was a significant difference in overall survival rate between the two groups (χ2=46.979, P＜005). The univariate analysis showed that SII ＞758.92 (hazard ratio ［HR］=5.907, 95% CI: 3.386-10.306, P=0.001) was an influencing factor for the overall survival time of patients with hepatic alveolar echinococcosis, and the multivariate Cox regression analysis showed that preoperative peripheral blood SII (HR=3.507, 95% CI: 1.911-6.435, P=0.001) was an independent risk factor for the overall survival rate of patients with hepatic alveolar echinococcosis. ConclusionPreoperative SII level is clearly correlated with the prognosis of patients with hepatic alveolar echinococcosis and can thus be used as a clinical indicator to evaluate the prognosis of patients. The higher the peripheral blood SII before surgery, the worse the prognosis of patients.

Índice de inmunidad-inflamación sistémica en sepsis / Systemic immune inflammatory index in sepsis

Resumen ANTECEDENTES: se han estudiado índices de pronóstico de inflamación basados en células periféricas como predictores de disfunción endotelial, riesgo cardiovascular y mortalidad. En 2014 se desarrolló el índice de inmunidad-inflamación sistémica (IIS) que se ha propuesto como factor de pronóstico y de seguimiento en cáncer. OBJETIVO: determinar si existe modificación del índice de inmunidad-inflamación sistémica (IIS) en pacientes con sepsis. MATERIAL Y MÉTODO: estudio retrospectivo que incluyó aleatoriamente a pacientes hospitalizados de 2013 a 2015. Se verificó la homogeneidad de poblaciones demostrando que no existía diferencia estadística entre la edad y comorbilidades (distribución Kolmogorov-Smirnov), frecuencia de comorbilidades (χ2). Se calculó el IIS con la citometría hemática de ingreso. Se compararon las medias del IIS de pacientes con sepsis y sin sepsis (Wilcoxon) y se determinó si había correlación entre el IIS y sepsis (coeficiente de correlación biserial puntual). RESULTADOS: se incluyeron 242 pacientes (128 con sepsis, edad promedio de 70.1 años y 114 sin sepsis, edad promedio de 69.7 años). La media del índice de inmunidad-inflamación sistémica (IIS) en pacientes con sepsis fue 4444.06x109, en pacientes sin sepsis fue de 3013.94x109. Se demostró que existe correlación estadísticamente significativa entre el IIS y sepsis (rbp= 0.150253625, p=0.05), se demostró que la media del IIS fue significativamente más elevada en pacientes con sepsis (W=5,097, p=0.00001). CONCLUSIONES: el índice de inmunidad-inflamación sistémica (IIS), un índice innovador que ha mostrado mejor efectividad para describir el desequilibrio de inmunidad e inflamación, se propone como una herramienta que puede ser útil en pacientes con sepsis; sin embargo, se requieren estudios futuros para comprobar su potencial pronóstico y de seguimiento.

Abstract BACKGROUND: In the past several indices based on peripheral blood cells have been studied to prove their utility as prognostic factors in endothelial dysfunction, cardiovascular risk and mortality. In 2014 the systemic immune inflammatory index (SII) was developed and it has been proposed as a prognostic factor in the follow-up of patients with cancer. OBJECTIVE: To determine if there is a modification of the SII in patients with sepsis. MATERIAL AND METHOD: A retrospective study included randomized patients hospitalized from 2013 to 2015; homogeneity of populations was verified by demonstrating that there was no statistical difference between age and comorbidities (Kolmogorov-Smirnov distribution), frequency of comorbidities (χ2). IIS was calculated with the blood cell count on hospital admission. IIS was compared in sepsis and without sepsis patients (Wilcoxon), and we determined whether there was correlation between IIS and sepsis (correlation coefficient biserial point). RESULTS: There were included 242 patients (128 with sepsis, mean age 70.1 years and 114 without sepsis, mean age 69.7 years). The mean IIS in patients with sepsis was 4444.06x109 and without sepsis 301 3.94x109. We showed that there was statistically significant cor relation between IIS and sepsis (rbp=0.150253625, p=0.05), we also detailed that the mean IIS was significantly higher in patients with sepsis (W=5,097, p=0.00001). CONCLUSIONS: The IIS, an innovative index that has shown accuracy describing the imbalance of immunity and inflammation, is proposed as a tool that can be useful in patients with sepsis; however, further studies are required to prove its potential in prognosis and monitoring.