Cited by 416Inflammatory Biomarkers in Disease PrognosisCancer, Stress, Anesthesia, and Immune ResponseEndometrial and Cervical Cancer Treatments

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Prognostic Value of Preoperative Systemic Immune-Inflammation Index in Patients with Cervical Cancer

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Abstract

The systemic immune-inflammation index (SII) based on peripheral lymphocyte, neutrophil and platelet counts has been considered a good index that reflects the local immune response and systemic inflammation. However, the use of the SII has not been reported in cervical cancer. In this study, Kaplan-Meier survival analysis showed that a high SII was associated with poor prognosis in cervical cancer patients in the primary and validation cohorts. A higher SII had a significant correlation with larger tumours but had no correlation with other clinicopathological parameters. Among all systemic immune indexes, the SII is the only independent prognostic factor for cervical cancer patients. Compared with the area under the curve for the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), and monocyte/lymphocyte ratio (MLR), the area for the SII was larger at 3 and 5 years. In addition, the SII still retains it prognostic values across all FIGO stages. The SII can independently predict the overall survival of patients with cervical cancer receiving radical resection and is thus superior to existing systemic inflammatory indexes. The prognostic nomogram based on the SII is a reliable model for predicting the postoperative survival of patients with cervical cancer.

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Crossref · 10.1038/s41598-019-39150-0

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Figures

Figure 1 The prognostic significance of the SII (A), NLR (B), PLR (C), MLR (D) and TRL (E) in cervical cancer in the primary cohort. Predictive ability of the SII in cervical cancer was compared with PLR, NLR and MLR by ROC curves in 3-years (F) and 5-years (G) in the primary cohort.
Figure 1 The prognostic significance of the SII (A), NLR (B), PLR (C), MLR (D) and TRL (E) in cervical cancer in the primary cohort. Predictive ability of the SII in cervical cancer was compared with PLR, NLR and MLR by ROC curves in 3-years (F) and 5-years (G) in the primary cohort.CC BY · PubMed Central
Figure 2 Evaluation of nomogram integrated SII, FIGO stage and Lymph node metastasis in patients with cervical cancer. The risk factors in nomogram consisted of FIGO stage, lymph node metastasis and SII. According to the above three parameters of a patient, the corresponding values were found in each variable axis. Then, at each point of the three values, a vertical line was made upward to intersect with the upper ruler, and the intersection represented a score. Calculate the total score by adding the three scores, and find it on the lower ruler. Make a vertical line down to intersect with the 3-year survival rate and the 5-year survival rate lines. Finally, the predicted 3-year survival rate and 5-year survival rate of this patient were determined.
Figure 2 Evaluation of nomogram integrated SII, FIGO stage and Lymph node metastasis in patients with cervical cancer. The risk factors in nomogram consisted of FIGO stage, lymph node metastasis and SII. According to the above three parameters of a patient, the corresponding values were found in each variable axis. Then, at each point of the three values, a vertical line was made upward to intersect with the upper ruler, and the intersection represented a score. Calculate the total score by adding the three scores, and find it on the lower ruler. Make a vertical line down to intersect with the 3-year survival rate and the 5-year survival rate lines. Finally, the predicted 3-year survival rate and 5-year survival rate of this patient were determined.CC BY · PubMed Central
Figure 3 The prognostic significance of the SII based on FIGO IA (A), FIGO IB (B), and FIGO IIA (C) in cervical cancer in the primary cohort.
Figure 3 The prognostic significance of the SII based on FIGO IA (A), FIGO IB (B), and FIGO IIA (C) in cervical cancer in the primary cohort.CC BY · PubMed Central
Figure 4 The prognostic significance of the SII (A), NLR (B), PLR (C), MLR (D) and TRL (E) in cervical cancer in the validation cohort. Predictive ability of the SII in cervical cancer was compared with PLR, NLR and MLR by ROC curves in 3-years (F) and 5-years (G) in the validation cohort.
Figure 4 The prognostic significance of the SII (A), NLR (B), PLR (C), MLR (D) and TRL (E) in cervical cancer in the validation cohort. Predictive ability of the SII in cervical cancer was compared with PLR, NLR and MLR by ROC curves in 3-years (F) and 5-years (G) in the validation cohort.CC BY · PubMed Central

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Metadata

Authors
Huang, H., Liu, Q., Zhu, L., Zhang, Y., Lu, X., Wu, Y., & Liu, L.
Affiliations
Jiangsu University (CN)
Corresponding author
Liu, Li
Venue
Scientific Reports
Published
2019-03-01
Volume
9
Issue
1
Pages
3284-3284
ISSN
2045-2322 (ISSN-L)
OpenAlex
W2916589624
Cited by
408
References
38
Citations by year
2026: 28 · 2025: 73 · 2024: 105 · 2023: 90 · 2022: 48 · 2021: 40 · 2020: 20 · 2019: 4
FWCI
11.68
Type
journal article
Language
en
Open access
Locations
  • Scientific Reports (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
  • Suzhou Municipal Health Commission
  • Government of Jiangsu Province
Topics
  • Health Sciences › Medicine › Oncology › Inflammatory Biomarkers in Disease Prognosis
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Stress, Anesthesia, and Immune Response
  • Health Sciences › Medicine › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
Keywords
cervical cancer, systemic immune-inflammation index, prognostic factors, overall survival, systemic inflammation, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, radical resection, prognostic nomogram, FIGO stage
MeSH terms
Adult, Aged, Aged, 80 and over, Blood Cell Count, Uterine Cervical Neoplasms, Female, Follow-Up Studies, Humans, Inflammation, Middle Aged, Retrospective Studies, Survival Rate, Models, Immunological, Disease-Free Survival

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