Meta-analysis of the association between pretreatment systemic immune inflammation index and prognosis in esophageal cancer_West China Medical Journal

Authors：

WANG Yan ¹ , WANG Yanwen ² , ZHENG Zhiyao ² , WANG Xin ² , JING Weina ² , LI Pengfei ¹ , SHEN Cheng ¹ ,  CHE Guowei ¹

1. Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. West China School of Medicine, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

CHE Guowei, Email: hx_guowei_che@foxmail.com

Keywords：

Esophageal cancer; Systemic immune inflammation index; Prognosis; Meta-analysis

DOI：

10.7507/1002-0179.201901175

Video：

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ObjectiveTo explore the correlation of pretreatment systemic immune inflammation index (SII) with prognosis in esophageal cancer patients.MethodsWe searched the PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP, Chinese Biology Medicine, and Wanfang databases to identify eligible studies evaluating the relation between pretreatment SII and prognosis in patients with esophageal cancer from establishment of databases to December 2018. SII was defined as the absolute neutrophil count multiplied by the absolute platelet count divided by the absolute lymphocyte count. The primary endpoint was overall survival (OS), and the secondary endpoints were cancer-specific survival and disease-free survival. The Stata 12.0 software was applied for the meta-analysis, and the hazard ratio (HR) and 95% confidence interval (CI) were assessed.ResultsA total of six retrospective studies involving 2 376 esophageal cancer patients were included and all patients were from China or Japan. The results revealed that elevated pretreatment SII was significantly associated with poor OS in esophageal cancer [HR=1.50, 95%CI (1.15, 1.95), P=0.002]. Subgroup analyses of OS indicated that SII had a high prognostic value in patients who received surgery [HR=1.54, 95%CI (1.14, 2.08), P=0.005] and were diagnosed as esophageal squamous cell carcinoma [HR=1.50, 95%CI (1.11, 2.02), P=0.007]; however, no significant relation was observed between SII and prognosis in esophageal cancer patients who were treated with radiotherapy [HR=1.318, 95%CI (0.611, 2.841), P=0.482]. Furthermore, compared with neutrophil to lymphocyte ratio and platelet to lymphocyte ratio, SII showed a higher predictive value for the prognosis of esophageal cancer.ConclusionsPretreatment SII may serve as an independent risk factor for prognosis of Chinese and Japanese esophageal cancer patients, especially patients who were treated with surgery and with esophageal squamous cell carcinoma. However, more prospective studies with big samples from other countries or regions are still needed to verify our findings.

Citation： WANG Yan, WANG Yanwen, ZHENG Zhiyao, WANG Xin, JING Weina, LI Pengfei, SHEN Cheng, CHE Guowei. Meta-analysis of the association between pretreatment systemic immune inflammation index and prognosis in esophageal cancer. West China Medical Journal, 2019, 34(3): 315-321. doi: 10.7507/1002-0179.201901175 Copy

1.	Enzinger PC, Mayer RJ. Esophageal cancer. N Engl J Med, 2003, 349(23): 2241-2252.
2.	Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer, 2015, 136(5): E359-E386.
3.	Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in diﬀerent geographic regions of the world. J Clin Oncol, 2006, 24(14): 2137-2150.
4.	Dutta S, Crumley AB, Fullarton GM, et al. Comparison of the prognostic value of tumour- and patient-related factors in patients undergoing potentially curative resection of oesophageal cancer. World J Surg, 2011, 35(8): 1861-1866.
5.	Feng JF, Chen QX. Significance of the prognostic nutritional index in patients with esophageal squamous cell carcinoma. Ther Clin Risk Manag, 2014, 10: 1-7.
6.	McMillan DC. The systemic inflammation-based Glasgow Prognostic Score: a decade of experience in patients with cancer. Cancer Treat Rev, 2013, 39(5): 534-540.
7.	Zhang X, Jiang Y, Wang Y, et al. Prognostic role of neutrophil-lymphocyte ratio in esophageal cancer: a systematic review and meta-analysis. Medicine (Baltimore), 2018, 97(49): e13585.
8.	Deng J, Zhang P, Sun Y, et al. Prognostic and clinicopathological significance of platelet to lymphocyte ratio in esophageal cancer: a meta-analysis. J Thorac Dis, 2018, 10(3): 1522-1531.
9.	Hirahara N, Matsubara T, Kawahara D, et al. Prognostic significance of preoperative inflammatory response biomarkers in patients undergoing curative thoracoscopic esophagectomy for esophageal squamous cell carcinoma. Eur J Surg Oncol, 2017, 43(2): 493-501.
10.	Yu X, Wen Y, Lin Y, et al. The value of preoperative Glasgow Prognostic Score and the C-reactive protein to albumin ratio as prognostic factors for long-term survival in pathological T1N0 esophageal squamous cell carcinoma. J Cancer, 2018, 9(5): 807-815.
11.	Zhang F, Chen Z, Wang P, et al. Combination of platelet count and mean platelet volume (COP-MPV) predicts postoperative prognosis in both resectable early and advanced stage esophageal squamous cell cancer patients. Tumour Biol, 2016, 37(7): 9323-9331.
12.	Toyokawa T, Kubo N, Tamura T, et al. The pretreatment Controlling Nutritional Status (CONUT) score is an independent prognostic factor in patients with resectable thoracic esophageal squamous cell carcinoma: results from a retrospective study. BMC Cancer, 2016, 16: 722.
13.	Geng Y, Shao Y, Zhu D, et al. Systemic immune-inflammation index predicts prognosis of patients with esophageal squamous cell carcinoma: a propensity score-matched analysis. Sci Rep, 2016, 6: 39482.
14.	Wang L, Wang C, Wang J, et al. A novel systemic immune-inflammation index predicts survival and quality of life of patients after curative resection for esophageal squamous cell carcinoma. J Cancer Res Clin Oncol, 2017, 143(10): 2077-2086.
15.	Feng JF, Chen S, Yang X. Systemic immune-inflammation index (SII) is a useful prognostic indicator for patients with squamous cell carcinoma of the esophagus. Medicine (Baltimore), 2017, 96(4): e5886.
16.	耿晓如, 张鑫君, 李连涛, 等. 系统免疫炎症指数与老年食管癌预后的关系. 徐州医科大学学报, 2017, 37(12): 779-782.
17.	Zhang H, Shang X1, Ren P, et al. The predictive value of a preoperative systemic immune-inflammation index and prognostic nutritional index in patients with esophageal squamous cell carcinoma. J Cell Physiol, 2019, 234(2): 1794-1802.
18.	Ishibashi Y, Tsujimoto H, Hiraki S., et al Prognostic value of preoperative systemic immunoinflammatory measures in patients with esophageal cancer. Ann Surg Oncol, 2018, 25(11): 3288-3299.
19.	Wells GA, Shea B, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis. (2014-09-16)[2019-01-20]. http://www.ohri.ca/ programs/clinical_epidemiology/oxford.asp.
20.	Wang J, Sheng Z, Yang W, et al. Elevated serum concentration of chitinase 3-like 1 is an independent prognostic biomarker for poor survival in lung cancer patients. Cell Physiol Biochem, 2016, 38(2): 461-468.
21.	Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics, 1994, 50(4): 1088-1101.
22.	Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ, 1997, 315(7109): 629-634.
23.	Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell, 2010, 140(6): 883-899.
24.	Zheng L, Zou K, Yang C, et al. Inflammation-based indexes and clinicopathologic features are strong predictive values of preoperative circulating tumor cell detection in gastric cancer patients. Clin Transl Oncol, 2017, 19(9): 1125-1132.
25.	Lolli C, Basso U, Derosa L, et al. Systemic immune-inflammation index predicts the clinical outcome in patients with metastatic renal cell cancer treated with sunitinib. Oncotarget, 2016, 7(34): 54564-54571.
26.	Huang L, Liu S, Lei Y, et al. Systemic immune-inflammation index, thymidine phosphorylase and survival of localized gastric cancer patients after curative resection. Oncotarget, 2016, 7(28): 44185-44193.
27.	Jain S, Harris J, Ware J. Platelets: linking hemostasis and cancer. Arterioscler Thromb Vasc Biol, 2010, 30(12): 2362-2367.
28.	Wojtukiewicz MZ, Sierko E, Hempel D, et al. Platelets and cancer angiogenesis nexus. Cancer Metastasis Rev, 2017, 36(2): 249-262.
29.	Mantovani A, Cassatella MA, Costantini C, et al. Neutrophils in the activation and regulation of innate and adaptive immunity. Nat Rev Immunol, 2011, 11(8): 519-531.
30.	De Giorgi U, Mego M, Scarpi E, et al. Relationship between lymphocytopenia and circulating tumor cells as prognostic factors for overall survival in metastatic breast cancer. Clin Breast Cancer, 2012, 12(4): 264-269.

1. Enzinger PC, Mayer RJ. Esophageal cancer. N Engl J Med, 2003, 349(23): 2241-2252.
2. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer, 2015, 136(5): E359-E386.
3. Kamangar F, Dores GM, Anderson WF. Patterns of cancer incidence, mortality, and prevalence across five continents: defining priorities to reduce cancer disparities in diﬀerent geographic regions of the world. J Clin Oncol, 2006, 24(14): 2137-2150.
4. Dutta S, Crumley AB, Fullarton GM, et al. Comparison of the prognostic value of tumour- and patient-related factors in patients undergoing potentially curative resection of oesophageal cancer. World J Surg, 2011, 35(8): 1861-1866.
5. Feng JF, Chen QX. Significance of the prognostic nutritional index in patients with esophageal squamous cell carcinoma. Ther Clin Risk Manag, 2014, 10: 1-7.
6. McMillan DC. The systemic inflammation-based Glasgow Prognostic Score: a decade of experience in patients with cancer. Cancer Treat Rev, 2013, 39(5): 534-540.
7. Zhang X, Jiang Y, Wang Y, et al. Prognostic role of neutrophil-lymphocyte ratio in esophageal cancer: a systematic review and meta-analysis. Medicine (Baltimore), 2018, 97(49): e13585.
8. Deng J, Zhang P, Sun Y, et al. Prognostic and clinicopathological significance of platelet to lymphocyte ratio in esophageal cancer: a meta-analysis. J Thorac Dis, 2018, 10(3): 1522-1531.
9. Hirahara N, Matsubara T, Kawahara D, et al. Prognostic significance of preoperative inflammatory response biomarkers in patients undergoing curative thoracoscopic esophagectomy for esophageal squamous cell carcinoma. Eur J Surg Oncol, 2017, 43(2): 493-501.
10. Yu X, Wen Y, Lin Y, et al. The value of preoperative Glasgow Prognostic Score and the C-reactive protein to albumin ratio as prognostic factors for long-term survival in pathological T1N0 esophageal squamous cell carcinoma. J Cancer, 2018, 9(5): 807-815.
11. Zhang F, Chen Z, Wang P, et al. Combination of platelet count and mean platelet volume (COP-MPV) predicts postoperative prognosis in both resectable early and advanced stage esophageal squamous cell cancer patients. Tumour Biol, 2016, 37(7): 9323-9331.
12. Toyokawa T, Kubo N, Tamura T, et al. The pretreatment Controlling Nutritional Status (CONUT) score is an independent prognostic factor in patients with resectable thoracic esophageal squamous cell carcinoma: results from a retrospective study. BMC Cancer, 2016, 16: 722.
13. Geng Y, Shao Y, Zhu D, et al. Systemic immune-inflammation index predicts prognosis of patients with esophageal squamous cell carcinoma: a propensity score-matched analysis. Sci Rep, 2016, 6: 39482.
14. Wang L, Wang C, Wang J, et al. A novel systemic immune-inflammation index predicts survival and quality of life of patients after curative resection for esophageal squamous cell carcinoma. J Cancer Res Clin Oncol, 2017, 143(10): 2077-2086.
15. Feng JF, Chen S, Yang X. Systemic immune-inflammation index (SII) is a useful prognostic indicator for patients with squamous cell carcinoma of the esophagus. Medicine (Baltimore), 2017, 96(4): e5886.
16. 耿晓如, 张鑫君, 李连涛, 等. 系统免疫炎症指数与老年食管癌预后的关系. 徐州医科大学学报, 2017, 37(12): 779-782.
17. Zhang H, Shang X1, Ren P, et al. The predictive value of a preoperative systemic immune-inflammation index and prognostic nutritional index in patients with esophageal squamous cell carcinoma. J Cell Physiol, 2019, 234(2): 1794-1802.
18. Ishibashi Y, Tsujimoto H, Hiraki S., et al Prognostic value of preoperative systemic immunoinflammatory measures in patients with esophageal cancer. Ann Surg Oncol, 2018, 25(11): 3288-3299.
19. Wells GA, Shea B, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies in meta-analysis. (2014-09-16)[2019-01-20]. http://www.ohri.ca/ programs/clinical_epidemiology/oxford.asp.
20. Wang J, Sheng Z, Yang W, et al. Elevated serum concentration of chitinase 3-like 1 is an independent prognostic biomarker for poor survival in lung cancer patients. Cell Physiol Biochem, 2016, 38(2): 461-468.
21. Begg CB, Mazumdar M. Operating characteristics of a rank correlation test for publication bias. Biometrics, 1994, 50(4): 1088-1101.
22. Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ, 1997, 315(7109): 629-634.
23. Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell, 2010, 140(6): 883-899.
24. Zheng L, Zou K, Yang C, et al. Inflammation-based indexes and clinicopathologic features are strong predictive values of preoperative circulating tumor cell detection in gastric cancer patients. Clin Transl Oncol, 2017, 19(9): 1125-1132.
25. Lolli C, Basso U, Derosa L, et al. Systemic immune-inflammation index predicts the clinical outcome in patients with metastatic renal cell cancer treated with sunitinib. Oncotarget, 2016, 7(34): 54564-54571.
26. Huang L, Liu S, Lei Y, et al. Systemic immune-inflammation index, thymidine phosphorylase and survival of localized gastric cancer patients after curative resection. Oncotarget, 2016, 7(28): 44185-44193.
27. Jain S, Harris J, Ware J. Platelets: linking hemostasis and cancer. Arterioscler Thromb Vasc Biol, 2010, 30(12): 2362-2367.
28. Wojtukiewicz MZ, Sierko E, Hempel D, et al. Platelets and cancer angiogenesis nexus. Cancer Metastasis Rev, 2017, 36(2): 249-262.
29. Mantovani A, Cassatella MA, Costantini C, et al. Neutrophils in the activation and regulation of innate and adaptive immunity. Nat Rev Immunol, 2011, 11(8): 519-531.
30. De Giorgi U, Mego M, Scarpi E, et al. Relationship between lymphocytopenia and circulating tumor cells as prognostic factors for overall survival in metastatic breast cancer. Clin Breast Cancer, 2012, 12(4): 264-269.

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