Relationship Between Preoperative Systemic Immune-inflammation Index And Clinicopathological Characteristics Of Colorectal Cancer

Object: To explore the relationship between preoperative systemic immune-inflammation index(SII)and clinicopathological characteristics of colorectal cancer(CRC),and to provide a new immune-inflammatory index for clinical prevention and treatment of CRC.Method:This retrospective analysis include 805 patients with CRC who underwent radical resection of colorectal cancer in the Department of Gastrointestinal Surgery of our hospital from January 1,2015 to August 31,2021 was used as the case group,and 202 healthy adults who underwent physical examination were selected as the control group.The clinical data,preoperative laboratory examination results,postoperative pathological examination results,hospital stay and postoperative complications of the two groups were recorded.The SII value was calculated according to the counts of platelets,neutrophils and lymphocytes in the preoperative blood routine(SII=platelet count×neutrophil count/lymphocyte count),and the tumor size,TNM and Dukes staging of CRC were compared and analyzed.The correlation between SII and hospital stay and postoperative complications in CRC patients was analyzed.Spearman correlation analysis method was used to analyze the correlation between SII and CRC tumor maximum diameter and length of stay.The Kruskal-Wallis-way ANOVA nonparametric test was used to compare the differences in SII between the groups,and the Bonferroni correction was used to adjust the P value for multiple comparisons.The receiver-operating characteristic curve(ROC)analysis method was used to calculate the cut-off value,AUC,sensitivity and specificity of preoperative SII in predicting the degree of differentiation,staging and postoperative complications of CRC.Result:1.The maximum tumor diameter of CRC was positively correlated with SII(rho=0.271 P=0.000).2.The hospitalization time of CRC patients was positively correlated with SII(rho=0.159,P=0.000).3.SII was associated with the degree of differentiation of CRC.The SII in the moderately differentiated and poorly differentiated group were higher than that in the control group,with statistical difference(P<0.001).ROC curve analysis showed that the cut-off value,AUC,sensitivity and specificity of SII in predicting the degree of differentiation of CRC were respectively 548.42,0.697,0.495,0.842 for moderately differentiated group;712.00,0.891,0.995,0.005 for poorly differentiated group.4.SII was associated with the T stage of CRC.The SII in T2,T3 and T4 stage were higher than that in the control group,with statistical difference(P<0.05 in T2 stage,P<0.001 in T3 stage,and P<0.001 in T4 stage).ROC curve analysis showed that the cut-off value,AUC,sensitivity and specificity of SII for predicting T stage of CRC were respectively T2stage: 548.73,0.598,0.429,0.842;T3 stage: 549.38,0.713,0.507,0.842;T4 stage:659.09,0.762,0.500,0.941.5.SII was associated with regional lymph node metastasis of CRC,and the SII in N0-N2 stage was higher than that in the control group,with statistical difference(P<0.001).The ROC curve analysis showed that the cut-off value,AUC,sensitivity and specificity of SII for predicting the N stage of CRC were respectively N0 stage: 548.42,0.671,0.470,0.842;N1 stage: 546.32,0.723,0.530,0.837;N2 stage: 559.42,0.760,0.579,0.851.6.SII was associated with distant metastasis of CRC.The SII in M0 and M1 stages are higher than that in the control group,with statistical difference(P<0.001),and the SII in M1 stage is higher than that in M0 stage,with statistical difference(P<0.01).ROC curve analysis showed that the cut-off value,AUC,sensitivity and specificity of SII for predicting M stage of CRC were respectively M0 stage: 548.417,0.689,0.490,0.842;M1 stage: 716.594,0.791,0.485,0.995.7.SII was associated with the clinical staging of CRC.The SII of stage Ⅱ,Ⅲ and Ⅳ was higher than that of the control group,with statistical difference(P<0.001).ROC curve analysis showed that the cut-off value,AUC,sensitivity and specificity of SII for predicting the clinical stage of CRC were respectively stage II: 548.42,0.705,0.496,0.842;stage III: 558.88,0.724,0.523,0.851;stage IV: 716.59,0.791,0.485,0.995.8.SII was correlated with Dukes staging of CRC.The SII of Dukes B,C and D stages was higher than that of the control group,with statistical difference(P<0.001).ROC curve analysis showed that the cut-off value,AUC sensitivity and specificity of SII for predicting Dukes staging of CRC were respectively B stage: 548.42,0.688,0.483,0.842;C stage: 558.88,0.724,0.523,0.851;D stage: 716.59,0.791,0.485,0.995.9.SII is associated with postoperative complications of colorectal cancer patients.The SII of the complication group and the non-complication group are higher than that of the control group,with a statistical difference(P<0.001),and the SII of the complication group is higher then that in non-complicated group,there was a statistical difference(P<0.01).ROC curve analysis showed that the cut-off value,AUC,sensitivity and specificity of SII for predicting postoperative complications in CRC patients were respectively 704.27,0.589,0.473,0.698.Conclusion: Preoperative SII has certain clinical significance in predicting the clinicopathological characteristics of colorectal cancer.