The Value Of Systemic Immune-inflammation Index(SII) In Evaluating The Prognostic Of Patients With Endometrial Cancer After Surgery

Objective: The purpose of this research is to evaluate the capacity of preoperative and postoperative systemic immune-inflammation indicators in predicting the prognosis of patients with endometrial carcinoma after operation and build a nomogram model to assist clinical practice.Methods: The retrospective study included 362 consecutive patients with surgically resected endometrial cancer between January 2010 to June 2015 at The Affiliated Cancer Hospital of Shantou University Medical College.Blood routine was examined within 1 week before surgery to calculate SSII,NLR,PLR,MLR and within 3 days after surgery to measure SSII.The pearson?sχ2 test or Fisher?s exact test was used to explore the relationship between preoperative SSII,NLR,PLR,MLR and postoperative SSII and clinical variables.The univariate and multivariate survival analyses were performed by Cox regression analysis to identify the independent prognostic indicators.The Kaplan-Meier method with the log-rank test was used to generate the overall survival(OS)curves.R software was used to generate the receiver operating characteristic(ROC)curve of preoperative SSII,NLR,PLR,MLR and postoperative SSII and then got the value of the optimum cutoff value through the maximum Youden index.A nomogram model was formed with systemic immune inflammation and clinical factors.Results: The preoperative SSII was related to age(p=0.009),FIGO stage(p=0.02)and menopause(p=0.014).The postoperative SSII was associated with menopause(p=0.014).Univariate analysis indicated that FIGO stage,lymphatic invasion,depth of myometrial invasion,postoperative chemotherapy,postoperative radiotherapy,preoperative SSII,NLR,PLR,MLR,CRP,CA125 and postoperative SSII were predictors of overall survival(OS)(p<0.05).Multivariate analysis showed that lymphatic invasion,postoperative SSII were independent prognostic factors of OS(p<0.05).The nomogram model was visualized and precisely to reflect the prognosis,with C-index value of 0.866 in this model.Conclusion: The postoperative SSII is the independent prognostic factor in patients with endometrial carcinoma after operation and contributes to poor outcomes.However,the preoperative SSII,NLR,PLR and MLR are not associated with OS endometrial carcinoma after surgery.To make good use of the nomogram model would contribute to better subsequent therapy.