The Correlation Between Inflammatory Factor Score And Prognosis In Small Cell Lung Cancer

Objective:To investigate the value of systemic immune-inflammation index(SII)、modified Glasgow Prognostic Score(mGPS)、high-sensitivity modified Glasgow Prognostic Score(HS-mGPS)in prognosis of small cell lung cancer(SCLC),in order to provide clinical prognostic clues.Methods:We retrospectively reviewed all patients who were diagnosed with SCLC from January 2015 to December 2018 in The First Affiliated Hospital of Nanchang University.Age,gender,smoking history,S-NSE,BMI,ECOG score,primary tumor size,stage,multiple metastasis,and treatment mode were included in basic clinical characteristics of patients by collecting their medical history,hematologic indexes and medical imaging data.To calculate the SII of the patients,patients were divided into low SII group and high SII group according to the optimal SII cut-off point which was determined by establishing receiver operating characteristic curve(ROC).The efficacy evaluation after 2 cycles of chemotherapy and overall survival(OS)were recorded.Chi-square test(χ2)was used to compare the differences in clinical basic characteristics and curative effect between different inflammatory cytokines groups.Univariate survival analysis of prognosis was performed by Kaplan-Meier curve and Log-rank test.Independent prognostic indicators were screened out by taking significant univariate indicators into Cox proportional risk model for multivariate analysis of prognosis.ROC and De Long test for different inflammatory factor indexes were performed to compare the differences in predictive efficacy.Results:(1)A total of 183 patients were included in this study,including 112 males and71 females.43 cases were in limited-stage,and 140 cases were in extensive-stage.Median OS 10.4 months.(2)ROC curve determined that the optimal cut-off point value of SII for predicting patients’ survival was 780.91×109/L.Patients were grouped according to the cut-off point value: 85 cases in the low SII group and 98 cases in the high SII group.(3)Comparison of clinical characteristics among different inflammatory factors showed that high SII was associated with more metastatic lesions(P=0.015),high MGPS was associated with more advanced stage(P=0.028)and more metastatic lesions(P=0.010),and high hs-MGPS was associated with more advanced stage(P< 0.001)and more metastatic lesions(P=0.012).(4)The objective response rate(ORR)and disease control rate(DCR)of patients with different SII,mGPS and HS-mGPS levels were compared.The results showed that the ORR of the low SII group were significantly higher than those of the high SII group(P = 0.004),and the ORR of the low mGPS group were obviously higher than those of the high mGPS group(P = 0.017(0vs1),< 0.001(0vs2),0.036(1vs2),respectively).The ORR of the low HS-mGPS group were distinctly higher than those of the high HS-mGPS group(P = < 0.001(0vs1),< 0.001(0vs2)and 0.044(1vs2),respectively).At meantime,the DCR of the low SII group were visibly higher than those of the high SII group(P = 0.001),and the DCR of the low mGPS group were clearly higher than those of the high mGPS group(P = 0.037(0vs1),< 0.001(0vs2),0.001(1vs2),respectively).The DCR of the low HS-mGPS group were overtly higher than those of the high HS-mGPS group(P = 0.034(0vs1),< 0.001(0vs2)and < 0.001(1vs2),respectively).(5)Univariate analysis showed that age,ECOG score,stage,multiple metastasis,treatment mode,SII,mGPS,and HS-mGPS were risk factors for prognosis in SCLC patients(P = 0.006,0.017,< 0.001,0.001,0.001,0.007,< 0.001,< 0.001,respectively).Multivariate analysis showed that stage,treatment mode,SII and HS-mGPS were independent predictor for prognosis in SCLC patients(P < 0.001,0.017,0.039,< 0.001,respectively).(6)The area under the curve(AUC)of ROC of SII,mGPS and HS-mGPS were0.667,0.697 and 0.775,respectively.De Long test showed that the AUC of HS-mGPS was significantly different from that of SII and MGPS(P = 0.030 and 0.039,respectively).Conclusion:(1)Inflammation is associated with metastasis of cancer cells.(2)The level of inflammation is correlated with the efficacy of SCLC.Low SII,low mGPS,and low HS-mGPS may indicate that patients are more sensitive to platinum-based first-line standard chemotherapy and have better treatment outcomes.(3)Age,ECOG score,stage,multiple metastasis,treatment mode,SII,mGPS,HS-mGPS were all related to the prognosis of SCLC patients.Stage,treatment mode,SII and HS-mGPS were independent predictor for prognosis of SCLC patients.(4)HS-mGPS is superior to SII and mGPS in predicting the prognosis of SCLC patients.