May High Levels of Systemic Immune-Inflammation Index and Hematologic Inflammation Markers Suggest a Further Stage in Testicular Tumours?

Abstract

<b><i>Introduction:</i></b> Due to variety of treatment alternatives for testicular tumours, parameters other than existing staging criteria are also needed. Most studies have revealed the correlation between cancer and inflammation. In this study, we aimed to investigate the value of preoperative inflammatory markers between early-stage testicular tumours and patients with advanced-stage, their relationship with tumour pathology and their importance in predicting stage. To calculate the differences between inflammatory markers, stage 1 tumours localized to the testis and advanced-stage tumours spread beyond the testis were classified into 2 groups according to tumour pathology. <b><i>Materials and Methods:</i></b> The data of 112 patients undergoing inguinal orchiectomy in between 2008 and 2018 were recorded retrospectively. Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR) and systemic immune-inflammation index (SII) were calculated by using the numbers of blood cell counts based systemic markers of inflammation. The differences between markers of inflammation were calculated by dividing tumours into 2 groups including early-stage and advanced- stage testicle tumours. <b><i>Results:</i></b> According to the results of preoperative inflammatory markers in predicting the stage; in the seminoma group, the difference between the median NLR (2.37 vs. 4.39, <i>p</i> = 0.012), LMR (3.80 vs. 2.40, <i>p</i> = 0.018) and SII (612 vs. 1,127, <i>p</i> = 0.009) of stage 1 and advanced stage were statistically significant, while in the non-seminoma group, only the difference between median PLR (99 vs. 154, <i>p</i> = 0.002) of stage 1 and advanced stage was statistically significant. Sensitivity and specificity of predicting advanced stage according to cut-off values of markers were 69 and 75% in NLR (3.21), 83 and 75% in LMR, and 59 and 75% in SII in the seminoma group; on the other hand, in the non-seminoma group, the sensitivity, and specificity of predicting the advanced stage of PLR cut-off (104) were 71 and 88% respectively. <b><i>Conclusions:</i></b> The clinical use of inflammatory biomarkers in testicular tumours may represent an important step in understanding germ cell tumours biology and in supporting staging criteria and prognostic criteria.

Immunotherapy in Testicular Germ Cell Tumors

“…Statistically significant differences were shown between the median neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and systemic immuneinflammation index (SII) in early vs. advanced stages of seminomatous tumors, while within the nonseminomas, only a difference between the median platelet-to-lymphocyte ratio (PLR) was described. These data are in concordance with findings describing more intense immune cell infiltration in seminomatous than in nonseminomatous testicular tumors (25).…”

Systemic immune-inflammation index (SII): A More Promising Inflammation-Based Prognostic Marker for Patients with synchronic colorectal peritoneal carcinomatosis

“…Although significant progresses have been made in terms of developing non-invasive prognostic biomarkers for CRC, the clinical appliance of the systematic inflammatory indices were regularly used, with its advantage of inexpensive, reliable, reproducible, robust and convenience 17 - 19 . Among all the systematic inflammatory indices, NLR and PLR were the most commonly used as prognostic biomarkers in CRC, which even had a discriminatory ability superior to other inflammatory biomarkers in resectable CRC 20 .…”

A lower systemic immune-inflammation index level is associated with response to cardiac resynchronization theraphy

“…SII, a novel inflammation-based biomarker combining platelet, neutrophil and lymphocyte counts, has been reported to be associated with clinical outcomes in several malignancies in many studies [9][10][11][12]. This is the first study to report a lower SII is associated with response to CRT in patients with HF.…”

“…It is calculated by the formula platelet count x neutrophil count /lymphocyte count and may be considered a combination NLR and PLR [9]. Many recent studies have demonstrated that SII is a strong independent predictor of major adverse events and prognosis in patients with several malignancies [9][10][11][12]. Patients with higher SII have increased recurrence rates, reduced survival and worse treatment response than patients with lower SII [9][10][11][12].…”

“…On the other hand, a novel parameter, combining neutrophil, lymphocyte and platelet counts, systemic immune-inflammation index (SII), as a promising inflammatory biomarker, has been described in recent years [9]. It has been reported that SII is associated with worse clinical outcomes in several malignancies [9][10][11][12]. However, the relationship between SII and response to CRT has not yet been investigated.…”