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Abstract：
OBJECTIVE: The cardiotoxicity related to 5-Fluorouracil (5-FU) in cancer patients has garnered widespread attention. The systemic immune-inflammation index (SII) has recently been identified as a novel predictive marker for the development of cardiovascular illnesses in individuals without pre-existing health conditions. However, it remains unclear whether the levels of SII are linked to cardiotoxicity related to 5-FU. This retrospective study aims to fill this knowledge gap by examining the correlation between SII and cardiotoxicity related to 5-FU in a colorectal cancer cohort.
METHODS: The study comprised colorectal cancer patients who received 5-FU-based chemotherapy at the affiliated cancer hospital of Guizhou Medical University between January 1, 2018 and December 31, 2020. After adjustment for confounders and stratification by tertiles of the interactive factor, linear regression analyses, curve fitting and threshold effect analyses were conducted.
RESULTS: Of the 754 patients included final analysis, approximately 21% (n = 156) of them ultimately experienced cardiotoxicity related to 5-FU. Monocytes (M) was found as an influential element in the interaction between SII and cardiotoxicity related to 5-FU. In the low tertile of M (T1: M ≤ 0.38 × 109/L), increasing log SII was positively correlated with cardiotoxicity related to 5-FU (Odds Ratio [OR], 8.04; 95% confidence interval [95%CI], 1.68 to 38.56). However, a curvilinear relationship between log SII and cardiotoxicity was observed in the middle tertile of M (T2: 0.38 < M ≤ 0.52 × 109/L). An increase in log SII above 1.37 was shown to be associated with a decreased risk of cardiotoxicity (OR, 0.14; 95%CI, 0.02 to 0.88), indicating a threshold effect. In the high tertile of M (T3: M > 0.52 × 109/L), there was a tendency towards a negative linear correlation between the log SII and cardiotoxicity was observed (OR, 0.85; 95%CI, 0.37 to 1.98).
CONCLUSIONS: Our findings suggest that SII may serve as a potential biomarker for predicting cardiotoxicity related to 5-FU in colorectal cancer patients. SII is an independent risk factor for cardiotoxicity related to 5-FU with low monocytes levels (T1). Conversely, in the middle monocytes levels (T2), SII is a protective factor for cardiotoxicity related to 5-FU but with a threshold effect.
METHODS: The study comprised colorectal cancer patients who received 5-FU-based chemotherapy at the affiliated cancer hospital of Guizhou Medical University between January 1, 2018 and December 31, 2020. After adjustment for confounders and stratification by tertiles of the interactive factor, linear regression analyses, curve fitting and threshold effect analyses were conducted.
RESULTS: Of the 754 patients included final analysis, approximately 21% (n = 156) of them ultimately experienced cardiotoxicity related to 5-FU. Monocytes (M) was found as an influential element in the interaction between SII and cardiotoxicity related to 5-FU. In the low tertile of M (T1: M ≤ 0.38 × 109/L), increasing log SII was positively correlated with cardiotoxicity related to 5-FU (Odds Ratio [OR], 8.04; 95% confidence interval [95%CI], 1.68 to 38.56). However, a curvilinear relationship between log SII and cardiotoxicity was observed in the middle tertile of M (T2: 0.38 < M ≤ 0.52 × 109/L). An increase in log SII above 1.37 was shown to be associated with a decreased risk of cardiotoxicity (OR, 0.14; 95%CI, 0.02 to 0.88), indicating a threshold effect. In the high tertile of M (T3: M > 0.52 × 109/L), there was a tendency towards a negative linear correlation between the log SII and cardiotoxicity was observed (OR, 0.85; 95%CI, 0.37 to 1.98).
CONCLUSIONS: Our findings suggest that SII may serve as a potential biomarker for predicting cardiotoxicity related to 5-FU in colorectal cancer patients. SII is an independent risk factor for cardiotoxicity related to 5-FU with low monocytes levels (T1). Conversely, in the middle monocytes levels (T2), SII is a protective factor for cardiotoxicity related to 5-FU but with a threshold effect.
摘要：
目的：癌症患者与5-氟尿嘧啶（5-FU）相关的心脏毒性已引起广泛关注。全身免疫炎症指数（SII）最近已被确定为在没有预先存在的健康状况的个体中心血管疾病发展的新型预测标志物。然而,目前尚不清楚SII水平是否与5-FU相关的心脏毒性相关.这项回顾性研究旨在通过检查结直肠癌队列中SII与5-FU相关的心脏毒性之间的相关性来填补这一知识空白。
方法：研究对象为2018年1月1日至2020年12月31日在贵州医科大学附属肿瘤医院接受5-FU化疗的结直肠癌患者。在对混杂因素和交互因子的三元分层进行调整后，线性回归分析，进行曲线拟合和阈值效应分析。
结果：754名患者纳入最终分析，约21%(n=156)的患者最终经历了与5-FU相关的心脏毒性。发现单核细胞（M）是SII与5-FU相关的心脏毒性之间相互作用的影响因素。在M的低三分位数(T1:M≤0.38×109/L)中，增加的logSII与与5-FU相关的心脏毒性呈正相关(赔率比[OR]，8.04；95%置信区间[95CI]，1.68至38.56）。然而,在M的中间三分位观察到logSII与心脏毒性之间的曲线关系（T2：0.380.52×109/L)中，观察到logSII与心脏毒性之间存在负线性相关的趋势（OR，0.85；95CI，0.37至1.98）。
结论：我们的研究结果表明，SII可能作为预测结直肠癌患者与5-FU相关的心脏毒性的潜在生物标志物。SII是与低单核细胞水平（T1）的5-FU相关的心脏毒性的独立危险因素。相反，在中间单核细胞水平（T2），SII是与5-FU相关的心脏毒性的保护因素，但具有阈值效应。
方法：研究对象为2018年1月1日至2020年12月31日在贵州医科大学附属肿瘤医院接受5-FU化疗的结直肠癌患者。在对混杂因素和交互因子的三元分层进行调整后，线性回归分析，进行曲线拟合和阈值效应分析。
结果：754名患者纳入最终分析，约21%(n=156)的患者最终经历了与5-FU相关的心脏毒性。发现单核细胞（M）是SII与5-FU相关的心脏毒性之间相互作用的影响因素。在M的低三分位数(T1:M≤0.38×109/L)中，增加的logSII与与5-FU相关的心脏毒性呈正相关(赔率比[OR]，8.04；95%置信区间[95CI]，1.68至38.56）。然而,在M的中间三分位观察到logSII与心脏毒性之间的曲线关系（T2：0.38
结论：我们的研究结果表明，SII可能作为预测结直肠癌患者与5-FU相关的心脏毒性的潜在生物标志物。SII是与低单核细胞水平（T1）的5-FU相关的心脏毒性的独立危险因素。相反，在中间单核细胞水平（T2），SII是与5-FU相关的心脏毒性的保护因素，但具有阈值效应。
