|Table of Contents|

Nomogram for predicting postoperative prognosis of gastric cancer patients based on SII and NLR

Journal Of Modern Oncology[ISSN:1672-4992/CN:61-1415/R]

Issue:
2024 16
Page:
3038-3051
Research Field:
Publishing date:

Info

Title:
Nomogram for predicting postoperative prognosis of gastric cancer patients based on SII and NLR
Author(s):
SONG Buyun1; SONG Chao1; LIU Wenbo1; LI Yong1; WANG Bingyu1; ZHANG Zaibo1; CUI Jiaxiang1; ZHAO Qun1; 2; ZHAO Xiaohan3; TAN Bibo1; 2
1.Third Department of Surgery,the Fourth Hospital of Hebei Medical University,Hebei Shijiazhuang 050011,China;2.Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer,Hebei Shijiazhuang 050011,China;3.Department of Radiotherapy,the Fourth Hospital of Hebei Medical University,Hebei Shijiazhuang 050011,China.
Keywords:
gastric cancer; systemic immune inflammation index; neutrophil to lymphocyte ratio; nomogram
PACS:
R735.2
DOI:
10.3969/j.issn.1672-4992.2024.16.017
Abstract:
Objective:To evaluate the prognostic value of the nomogram model which corporates the preoperative systemic immune inflammation index (SII) and neutrophil to lymphocyte ratio (NLR) in patients with gastric cancer who received radical gastrectomy.Methods:According to 7∶3 radio,323 GC patients were randomly divided into training cohort and validation cohort.The optimal cut-off values for SII and NLR were calculated by X-Tile software,patients were divided into high and low groups according to the cut-off values.Univariate and multivariate regression analysis were performed to construct the nomogram which forecast the overall survival (OS) and the progression-free survival (PFS) of patients.The nomogram and the TNM staging system were compared by C-index,ROC,calibration curves and DCA were used to evaluate the dynamic nomogram.Results:6 independent risk factors were filtered including SII and PLR(P＜0.05).C-index of OS nomogram (training cohort:0.804,95%CI：0.786~0.822,validation cohort:0.780,95%CI：0.746~0.814),C-index of PFS nomogram (training cohort:0.806,95%CI：0.787~0.823,validation cohort:0.778,95%CI：0.746~0.810)，suggested that the nomogram performed better than the traditional TNM staging system.The ROC,calibration curves and DCA also indicated the clinical effectiveness of the model.Conclusion:SII and NLR are independent influencing factors of patients with gastric cancer who received radical gastrectomy.The nomogram model constructed based on SII and NLR provides higher predictive value for the prognosis of patients after radical gastrectomy.

References:

［1］ WU T,DAI Y.Tumor microenvironment and therapeutic response ［J］.Cancer Lett,2017,387:61-68.
［2］ PITT JM,MARABELLE A,EGGERMONT A,et al.Targeting the tumor microenvironment:removing obstruction to anticancer immune responses and immunotherapy ［J］.Ann Oncol,2016,27(8):1482-1492.
［3］ MAAS RR,SOUKUP K,FOURNIER N,et al.The local microenvironment drives activation of neutrophils in human brain tumors ［J］.Cell,2023,186(21):4546-4566.e4527.
［4］ IASONOS A,SCHRAG D,RAJ GV,et al.How to build and interpret a nomogram for cancer prognosis ［J］.J Clin Oncol,2008,26(8):1364-1370.
［5］ FENG F,TIAN Y,XU G,et al.Diagnostic and prognostic value of CEA,CA19-9,AFP and CA125 for early gastric cancer ［J］.BMC Cancer,2017,17(1):737.
［6］ AJANI JA,D'AMICO TA,BENTREM DJ,et al.Gastric cancer,version 2.2022,NCCN clinical practice guidelines in oncology ［J］.J Natl Compr Canc Netw,2022,20(2):167-192.
［7］ BRAY F,FERLAY J,SOERJOMATARAM I,et al.Global cancer statistics 2018:GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries ［J］.CA Cancer J Clin,2018,68(6):394-424.
［8］ LI L,YU R,CAI T,et al.Effects of immune cells and cytokines on inflammation and immunosuppression in the tumor microenvironment ［J］.Int Immunopharmacol,2020,88:106939.
［9］ KIM J,BAE JS.Tumor-associated macrophages and neutrophils in tumor microenvironment ［J］.Mediators Inflamm,2016,2016:6058147.
［10］ COFFELT SB,WELLENSTEIN MD,DE VISSER KE.Neutrophils in cancer:neutral no more ［J］.Nat Rev Cancer,2016,16(7):431-446.
［11］ WANG M,CHANG M,LI C,et al.Tumor-microenvironment-activated reactive oxygen species amplifier for enzymatic cascade cancer starvation/chemodynamic /immunotherapy ［J］.Adv Mater,2022,34(4):e2106010.
［12］ LAZENNEC G,RAJARATHNAM K,RICHMOND A.CXCR2 chemokine receptor-a master regulator in cancer and physiology ［J］.Trends Mol Med,2024,30(1):37-55.
［13］ GAY LJ,FELDING-HABERMANN B.Contribution of platelets to tumour metastasis ［J］.Nat Rev Cancer,2011,11(2):123-134.
［14］ CEDERVALL J,HAMIDI A,OLSSON AK.Platelets,NETs and cancer ［J］.Thromb Res,2018,164 Suppl 1:S148-s152.
［15］ WANG L,WANG X,GUO E,et al.Emerging roles of platelets in cancer biology and their potential as therapeutic targets ［J］.Front Oncol,2022,12:939089.
［16］ UPTON JEM,E GRUNEBAUM,G SUSSMAN,et al.Platelet activating factor (PAF):A mediator of inflammation ［J］.Biofactors,2022,48(6):1189-1202.
［17］ LI Y,ZHAO L,LI XF.Hypoxia and the tumor microenvironment ［J］.Technol Cancer Res Treat,2021,20:15330338211036304.
［18］ YANG L,PANG Y,MOSES HL.TGF-beta and immune cells:an important regulatory axis in the tumor microenvironment and progression ［J］.Trends Immunol,2010,31(6):220-227.
［19］ 张宇，汪亦民，薛英威.全身免疫炎症指数（SII）与胃癌患者临床病理因素及预后的相关性［J］.现代肿瘤医学，2021,29(3):441-445. ZHANG Y,WANG YM,XUE YW.Relationship between systemic immune-inflammatory index(SII) and clinical pathological features and prognosis in patients with gastric cancer［J］.Modern Oncology,2021,29(3):441-445.
［20］ 张立志,刘平,吉慧军,等.全身免疫炎症指数（SII）对胶质瘤患者临床预后的影响及与p53突变的关系［J］.现代肿瘤医学，2018,26（24）：3937-3943.ZHANG LZ,LIU P,JI HJ,et al.Systemic immune-inflammation index（SII) in patients with glioma and its relationship with p53 mutation［J］.Modern Oncology,2018,26（24）：3937-3943.
［21］ CHEN JH,ZHAI ET,YUAN YJ,et al.Systemic immune-inflammation index for predicting prognosis of colorectal cancer ［J］.World J Gastroenterol,2017,23(34):6261-6272.
［22］ LI W,MA G,DENG Y,et al.Systemic immune-inflammation index is a prognostic factor for breast cancer patients after curative resection ［J］.Front Oncol,2021,11:570208.
［23］ ANPALAKHAN S,SIGNORI A,CORTELLINI A,et al.Using peripheral immune-inflammatory blood markers in tumors treated with immune checkpoint inhibitors:An INVIDIa-2 study sub-analysis ［J］.iScience,2023,26(11):107970.
［24］ HU B,YANG XR,XU Y,et al.Systemic immune-inflammation index predicts prognosis of patients after curative resection for hepatocellular carcinoma ［J］.Clin Cancer Res,2014,20(23):6212-6222.
［25］ SUN W,ZHANG P,YE B,et al.Systemic immune-inflammation index predicts survival in patients with resected lung invasive mucinous adenocarcinoma ［J］.Transl Oncol,2024,40:101865.

［26］ BISWAS T,KANG KH,GAWDI R,et al.Using the systemic immune-inflammation index (SII) as a mid-treatment marker for survival among patients with stage-III locally advanced non-small cell lung cancer (NSCLC) ［J］.Int J Environ Res Public Health,2020,17(21).
［27］ CRISTINZIANO L,MODESTINO L,ANTONELLI A,et al.Neutrophil extracellular traps in cancer ［J］.Semin Cancer Biol,2022,79:91-104.
［28］ MIYAMOTO R,INAGAWA S,SANO N,et al.The neutrophil-to-lymphocyte ratio (NLR) predicts short-term and long-term outcomes in gastric cancer patients ［J］.Eur J Surg Oncol,2018,44(5):607-612.
［29］ RUBENICH DS,DE SOUZA PO,OMIZZOLLO N,et al.Tumor-neutrophil crosstalk promotes in vitro and in vivo glioblastoma progression ［J］.Front Immunol,2023,14:1183465.
［30］ 唐文超,李远伟,陈佳,等.术前预后营养指数及中性粒－淋巴细胞比值在非肌层浸润性膀胱癌患者复发中的预测价值［J］.现代肿瘤医学，2022，30（12）：2218-2223. TANG WC,LI YW,CHEN J，et al.The predictive value of preoperative PNI and NLR for recurrence of non-muscular invasive bladder cancer［J］.Modern Oncology,2022，30（12）：2218-2223.

Memo

Memo:
-
Last Update: 1900-01-01