Development and validation of immune inflammation–based index for predicting the clinical outcome in patients with nasopharyngeal carcinoma

Abstract

Inflammation indicators, such as systemic inflammation response index (SIRI), systemic immune‐inflammation index (SII), neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐lymphocyte ratio (PLR), are associated with poor prognosis in various solid cancers. In this study, we investigated the predictive value of these inflammation indicators in nasopharyngeal carcinoma (NPC). This retrospective study involved 559 patients with NPC and 500 patients with chronic rhinitis, and 255 NPC patients were followed up successfully. Continuous variables and qualitative variables were measured by t test and chi‐square test, respectively. The optimal cut‐off values of various inflammation indicators were determined by receiver operating characteristic (ROC) curve. Moreover, the diagnostic value for NPC was decided by the area under the curves (AUCs). The Kaplan‐Meier methods and the log‐rank test were used to analyse overall survival (OS) and disease‐free survival (DFS). The independent prognostic risk factors for survival and influencing factors of side effects after treatment were analysed by Cox and logistic regression analysis, respectively. Most haematological indexes of NPC and rhinitis were significantly different between the two groups, and PLR was optimal predictive indicators of diagnosis. In the multivariable Cox regression analysis, PLR, WBC, RDW, M stage and age were independent prognostic risk factors. Many inflammation indicators that affected various side effects were evaluated by logistic regression analysis. In conclusion, the combined inflammation indicators were superior to single haematological indicator in the diagnosis and prognosis of NPC. These inflammation indicators can be used to supply the current evaluation system of the TNM staging system to help predict the prognosis in NPC patients.

The Prognostic Value of Preoperative Systemic Inflammatory Response Index (SIRI) in Patients With High-Grade Glioma and the Establishment of a Nomogram

“…The focus of the study was to explore the predictive value of SIRI in high-grade gliomas. Our results were consistent with other retrospective studies exploring the predictive value of SIRI in malignant tumors (13)(14)(15)(24)(25)(26)(27)(28). Our study found that preoperative SIRI was an independent prognostic factor for high-grade glioma.…”

Prognostic value of neutrophils for patients with nasopharyngeal carcinoma

“…Currently, relevant studies have indicated that some factors such as EB‐DNA, PTV have clinical significance to the evaluations of curative effect and prognosis among NPC patients 7,18,19 . Furthermore, hematological markers, systemic inflammatory markers have attracted increasing attention for prediction of tumor prognosis 6,20 . Recent studies have proposed that absolute inflammatory cell counts in peripheral blood (neutrophils, white blood cells, lymphocytes and monocytes) and ratios based on these cell counts may play a crucial role in predicting the overall survival of patients with tumors, including head and neck cancer, 21 non‐small cell lung cancer 22 and esophageal cancer 23 .…”

“…The TNM staging system of the American Joint Committee on Cancer (AJCC) is generally accepted as the most widely used tool for cancer staging and plays a key role in guiding treatment and determining the prognosis of NPC in clinical practice 5 . However, many authors proposed that TNM stage, based on anatomical structures, is insufficient to predict the prognosis 6‐8 . At present, the Epstein‐Barr virus (EBV) DNA is the only proven tumor biomarker in NPC 9‐11 .…”

An Association Between Inflammation and Cerebral Venous Thrombosis: A Retrospective Study 

“…Indicating the balance of the neutrophils (the active component of the in ammation) with the lymphocytes (the regulatory and protective component), NLR was found to be a good prognostic factor in functional outcomes and mortality in patients with severe traumatic brain injury [38]. Zeng et al [17] demonstrated that both NLR and PLR can be used to predict the diagnosis and prognosis of nasopharyngeal carcinoma [17]. Many studies revealed that DVT improves the levels of NLR and PLR [11,39].…”

“…The neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/high-density lipoprotein (HDL) ratio (MHR) and systemic immune-in ammation index (SII = platelets * neutrophils/lymphocytes) were widely studied as in ammation indicators in recent years, considering their objectivity, low cost, effectiveness, and repeatability. So far, NLR, PLR, and SII were found to be prognostic factors for diseases such as different neurologic disorders, malignancies, and deep venous thrombosis (DVT) [9][10][11][12][13][14][15][16][17]. Besides, decreased HDL levels and increased monocyte counts were also found to be relevant to in ammation, thus MHR was potently suggested to be a novel in ammatory biomarker [18,19].…”