The Prognostic and Clinicopathological Significance of Systemic Immune-Inflammation Index in Bladder Cancer

Abstract

BackgroundSystemic immune-inflammation index (SII) has recently emerged as a biomarker for the prognosis of a variety of malignant tumors. However, the role of SII in bladder cancer (BC) remains unclear. To this end, we performed a pooled analysis to investigate the prognostic value of preoperative SII in patients with BC.MethodsA comprehensive search of electronic databases (PubMed/Medline, Web of Science, Scopus, and Cochrane Central Register of Controlled Trials) was conducted to determine the eligible studies that were published until January 2022. Pooled hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to evaluate the association between preoperative SII and the prognosis and clinicopathological characteristics of BC.ResultsTen studies with 7,087 patients were included in this analysis. SII was observed to be correlated with inferior overall survival (HR = 1.22, 95% CI 1.04–1.44, p = 0.013), cancer-specific survival (HR = 1.68, 95% CI 1.14–2.47, p = 0.009), and recurrence-free survival (HR = 1.29, 95% CI 1.03–1.61, p = 0.027). An increased preoperative SII was also associated with poor tumor differentiation, higher tumor stage, presence of lymph node involvement, and tumor size ≥3 cm (all p < 0.05).ConclusionsAn elevated preoperative SII is significantly associated with worse survival outcomes and adverse pathological features in patients with BC. Hence, SII may serve as a strong independent prognostic predictor for patients with BC after surgery.

Preoperative systemic immune‐inflammation index for predicting the prognosis of thymoma with radical resection

“…Also, a previous meta‐analysis showed that a high SII was correlated with poor OS 59 and a higher SII implies higher platelet/neutrophil and/or lower lymphocyte counts. 54 , 60 Thus, a higher SII indirectly represents a deficiency of immune function and increased tumor aggressiveness in patients with thymoma.…”

“…47 In this study, SII was used to predict OS and compared to PLR and NLR, SII effectively integrated blood-based markers of inflammation instead of only calculating the ratio of the two types of immune cells, therefore has better predictive and prognostic capabilities. 54 SII has been used for various tumors such as lung adenocarcinoma, 55 hepatocellular carcinoma, 56 oesophagal squamous cell carcinoma (ESCC) and cervical cancer, and is superior to PLR and NLR as a predictive biomarker in ESCC and cervical cancer. 57,58 This was also the case in our study.…”

Threshold effect of systemic immune inflammatory index on hypertension in American adults (NHANES 2017–2020)

“…In the subgroups of sex, age, BMI and diabetes, there is a stable nonlinear association. SII indicators are usually used to predict the prognosis of cancer patients [13][14][15][16] and patients with CVD [17][18][19][20], and without exception, higher SII levels are associated with poor prognosis, and there has never been a nonlinear association between SII and prognosis.…”

“…SII was calculated according to the counts of lymphocytes, neutrophils and platelets. SII usually serves as a prognostic factor for cancer patients [14][15][16] and patients with cardiovascular disease (CVD) [17][18][19][20]. Only Xu et al [21] investigated the association between various immune-inflammatory indices, including SII, and hypertension using NHANSE patients' data from 1999 to 2010.…”

Prognostic value of lymphocyte-to-C-reactive-protein ratio in cancers

“…A number of immune in ammation markers have been evaluated for their potential as tumor prognostic biomarkers, such as systemic immune in ammation index(SII), C-reactive protein/albumin ratio(CAR), brinogen with neutrophil-lymphocyte ratio (F-NLR) and prognostic nutritional index (PNI) [10,11,12,13]. However, due to limitations, these indicators are not widely used in clinical practice.…”