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Abstract：
OBJECTIVE: The purpose of our study was to investigate the clinical significance and prognostic role of the systemic immune-inflammation index (SII) in patients who underwent surgical resection for nonfunctioning pancreatic neuroendocrine tumors (pNETs).
METHODS: We conducted a retrospective analysis of 364 patients with nonfunctioning pNETs. The association between the SII level and clinical parameters was investigated. The receiver operating characteristic (ROC) curve was used to calculate the optimal SII value. Cox proportional hazard analysis was performed to evaluate the prognostic factors.
RESULTS: Our study included 364 patients with nonfunctioning pNETs who underwent surgery. The median age was 51.0 (43.0, 59.3), and 164 (45.1%) were male. The optimal threshold of SII determined by ROC analysis was 523.95. Higher SII levels were significantly associated with older age (p = 0.001), sex (p = 0.011), tumor size (p = 0.032), and tumor grade (p = 0.002). Recurrence was observed in 70 (19.2%) patients following a median follow-up of 98 months. Univariate analysis showed that higher SII (p < 0.0001), tumor size >4 cm (p = 0.015), and G2/G3 grade (p = 0.002) were significantly associated with disease-free survival (DFS). Multivariate analysis revealed that higher SII (HR: 7.35; 95% CI: 3.44, 15.70; p < 0.0001) and G2/G3 grade (HR: 3.11; 95% CI: 1.42, 6.82; p = 0.005) remained significantly associated with tumor recurrence. Furthermore, 46 (12.6%) patients died during the follow-up. Higher SII (HR: 8.43; 95% CI: 3.19, 22.72; p < 0.0001) and G2/G3 grade (HR: 3.16; 95% CI: 1.01, 9.86; p = 0.048) were independent predictors of overall survival (OS) by multivariate analysis.
CONCLUSIONS: In conclusion, our study revealed that a higher SII level was associated with tumor-related features (larger tumor size and advanced grade) and subsequent shorter DFS and OS in patients with nonfunctioning pNETs. These results indicated that the SII could serve as an efficient prognostic biomarker for nonfunctioning pNETs.
METHODS: We conducted a retrospective analysis of 364 patients with nonfunctioning pNETs. The association between the SII level and clinical parameters was investigated. The receiver operating characteristic (ROC) curve was used to calculate the optimal SII value. Cox proportional hazard analysis was performed to evaluate the prognostic factors.
RESULTS: Our study included 364 patients with nonfunctioning pNETs who underwent surgery. The median age was 51.0 (43.0, 59.3), and 164 (45.1%) were male. The optimal threshold of SII determined by ROC analysis was 523.95. Higher SII levels were significantly associated with older age (p = 0.001), sex (p = 0.011), tumor size (p = 0.032), and tumor grade (p = 0.002). Recurrence was observed in 70 (19.2%) patients following a median follow-up of 98 months. Univariate analysis showed that higher SII (p < 0.0001), tumor size >4 cm (p = 0.015), and G2/G3 grade (p = 0.002) were significantly associated with disease-free survival (DFS). Multivariate analysis revealed that higher SII (HR: 7.35; 95% CI: 3.44, 15.70; p < 0.0001) and G2/G3 grade (HR: 3.11; 95% CI: 1.42, 6.82; p = 0.005) remained significantly associated with tumor recurrence. Furthermore, 46 (12.6%) patients died during the follow-up. Higher SII (HR: 8.43; 95% CI: 3.19, 22.72; p < 0.0001) and G2/G3 grade (HR: 3.16; 95% CI: 1.01, 9.86; p = 0.048) were independent predictors of overall survival (OS) by multivariate analysis.
CONCLUSIONS: In conclusion, our study revealed that a higher SII level was associated with tumor-related features (larger tumor size and advanced grade) and subsequent shorter DFS and OS in patients with nonfunctioning pNETs. These results indicated that the SII could serve as an efficient prognostic biomarker for nonfunctioning pNETs.
摘要：
目的：我们的研究目的是探讨全身免疫炎症指数（SII）在无功能胰腺神经内分泌肿瘤（pNETs）手术切除患者中的临床意义和预后作用。
方法：我们对364例无功能pNETs患者进行了回顾性分析。研究了SII水平与临床参数之间的关联。使用受试者工作特性（ROC）曲线计算最佳SII值。进行Cox比例风险分析以评估预后因素。
结果：我们的研究包括364名接受手术治疗的无功能pNETs患者。中位年龄为51.0（43.0，59.3），男性164人(45.1%)。通过ROC分析确定的SII的最佳阈值为523.95。较高的SII水平与年龄显着相关（p=0.001），性别（p=0.011），肿瘤大小（p=0.032），和肿瘤分级（p=0.002）。在中位随访98个月后，70例（19.2％）患者出现复发。单因素分析表明，SII较高(p<0.0001)，肿瘤大小>4厘米（p=0.015），G2/G3级(p=0.002)与无病生存率(DFS)显著相关。多变量分析显示，较高的SII（HR：7.35；95％CI：3.44，15.70；p<0.0001）和G2/G3等级（HR：3.11；95％CI：1.42，6.82；p=0.005）与肿瘤复发显著相关。此外，46例(12.6%)患者在随访期间死亡。通过多变量分析，较高的SII（HR：8.43；95％CI：3.19，22.72；p<0.0001）和G2/G3等级（HR：3.16；95％CI：1.01，9.86；p=0.048）是总生存期（OS）的独立预测因子。
结论：结论：我们的研究显示,在pNETs无功能的患者中,较高的SII水平与肿瘤相关特征(较大的肿瘤大小和晚期分级)以及随后较短的DFS和OS相关.这些结果表明，SII可以作为无功能pNETs的有效预后生物标志物。
方法：我们对364例无功能pNETs患者进行了回顾性分析。研究了SII水平与临床参数之间的关联。使用受试者工作特性（ROC）曲线计算最佳SII值。进行Cox比例风险分析以评估预后因素。
结果：我们的研究包括364名接受手术治疗的无功能pNETs患者。中位年龄为51.0（43.0，59.3），男性164人(45.1%)。通过ROC分析确定的SII的最佳阈值为523.95。较高的SII水平与年龄显着相关（p=0.001），性别（p=0.011），肿瘤大小（p=0.032），和肿瘤分级（p=0.002）。在中位随访98个月后，70例（19.2％）患者出现复发。单因素分析表明，SII较高(p<0.0001)，肿瘤大小>4厘米（p=0.015），G2/G3级(p=0.002)与无病生存率(DFS)显著相关。多变量分析显示，较高的SII（HR：7.35；95％CI：3.44，15.70；p<0.0001）和G2/G3等级（HR：3.11；95％CI：1.42，6.82；p=0.005）与肿瘤复发显著相关。此外，46例(12.6%)患者在随访期间死亡。通过多变量分析，较高的SII（HR：8.43；95％CI：3.19，22.72；p<0.0001）和G2/G3等级（HR：3.16；95％CI：1.01，9.86；p=0.048）是总生存期（OS）的独立预测因子。
结论：结论：我们的研究显示,在pNETs无功能的患者中,较高的SII水平与肿瘤相关特征(较大的肿瘤大小和晚期分级)以及随后较短的DFS和OS相关.这些结果表明，SII可以作为无功能pNETs的有效预后生物标志物。
