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Abstract：
BACKGROUND: Inflammation plays a pivotal role in the progression of prostate cancer (PCa). Several immune-inflammatory indices, including neutrophil to lymphocyte ratio (NLR), derived neutrophil to lymphocyte ratio (dNLR), lymphocyte to monocyte ratio (LMR) and platelet to lymphocyte ratio (PLR), lung immune prognostic index (LIPI), systemic inflammation response index (SIRI) and systemic immune inflammation index (SII), have demonstrated their prognostic values in several solid malignancies. However, Comparisons of superiority with these seven indices\' predictive efficacy within metastatic hormone-sensitive PCa (mHSPC) and metastatic castration-resistant PCa (mCRPC) remain uncertain.
METHODS: We retrospectively included 407 patients diagnosed with mHSPC and 158 patients with mCRPC at West China Hospital from 2005 to 2022. The seven immune-inflammatory indices were computed based on hematological data of mHSPC at initial diagnosis and mCRPC at progression to CRPC. Prognostic value for castration-resistant prostate cancer-free survival (CFS), overall survival (OS), prostate-specific antigen progression-free survival (PSA-PFS) and prostate-specific antigen (PSA) response was assessed using Kaplan-Meier curves, Cox regression models, and chi-square tests. The predictive performance of each immune-inflammatory index was assessed using the area under the curve (AUC) in time-dependent receiver operating characteristic curve (ROC) analysis and C-index calculation.
RESULTS: All seven immune-inflammatory indices were significantly associated with CFS and OS in the mHSPC cohort, as well as with PSA response, PSA-PFS, and OS in the mCRPC cohort. In the mHSPC cohort, LIPI consistently exhibited higher AUC values compared to NLR, dNLR, LMR, PLR, SII, and SIRI for predicting CFS and OS. This indicates that LIPI had a superior discriminative ability compared to the other indices (C-index of LIPI: 0.643 and 0.686 for CFS and OS, respectively). Notably, the predictive advantage of LIPI over other indices in the mHSPC stage diminished in the mCRPC stage.
CONCLUSIONS: This study firstly confirmed the prognostic value of SII, SIRI and LIPI in mHSPC and mCRPC, and revealed that LIPI had a higher predictive power than NLR, dNLR, LMR, PLR, SII and SIRI in mHSPC. These non-invasive indices can enable clinicians to quickly assess the prognosis of patients.
METHODS: We retrospectively included 407 patients diagnosed with mHSPC and 158 patients with mCRPC at West China Hospital from 2005 to 2022. The seven immune-inflammatory indices were computed based on hematological data of mHSPC at initial diagnosis and mCRPC at progression to CRPC. Prognostic value for castration-resistant prostate cancer-free survival (CFS), overall survival (OS), prostate-specific antigen progression-free survival (PSA-PFS) and prostate-specific antigen (PSA) response was assessed using Kaplan-Meier curves, Cox regression models, and chi-square tests. The predictive performance of each immune-inflammatory index was assessed using the area under the curve (AUC) in time-dependent receiver operating characteristic curve (ROC) analysis and C-index calculation.
RESULTS: All seven immune-inflammatory indices were significantly associated with CFS and OS in the mHSPC cohort, as well as with PSA response, PSA-PFS, and OS in the mCRPC cohort. In the mHSPC cohort, LIPI consistently exhibited higher AUC values compared to NLR, dNLR, LMR, PLR, SII, and SIRI for predicting CFS and OS. This indicates that LIPI had a superior discriminative ability compared to the other indices (C-index of LIPI: 0.643 and 0.686 for CFS and OS, respectively). Notably, the predictive advantage of LIPI over other indices in the mHSPC stage diminished in the mCRPC stage.
CONCLUSIONS: This study firstly confirmed the prognostic value of SII, SIRI and LIPI in mHSPC and mCRPC, and revealed that LIPI had a higher predictive power than NLR, dNLR, LMR, PLR, SII and SIRI in mHSPC. These non-invasive indices can enable clinicians to quickly assess the prognosis of patients.
摘要：
背景：炎症在前列腺癌（PCa）的进展中起关键作用。几个免疫炎症指标，包括中性粒细胞与淋巴细胞比率（NLR），衍生中性粒细胞与淋巴细胞比率(dNLR)，淋巴细胞与单核细胞比率（LMR）和血小板与淋巴细胞比率（PLR），肺免疫预后指数（LIPI），全身炎症反应指数（SIRI）和全身免疫炎症指数（SII），已经证明了它们在几种实体恶性肿瘤中的预后价值。然而,在转移性激素敏感性PCa（mHSPC）和转移性去势抵抗PCa（mCRPC）中，这七个指标的预测功效的优势比较仍不确定。
方法：回顾性纳入2005-2022年华西医院诊断为mHSPC的407例和mCRPC的158例。根据最初诊断时的mHSPC和进展为CRPC时的mCRPC的血液学数据计算七个免疫炎症指标。去势抵抗性前列腺癌无生存期（CFS）的预后价值，总生存期（OS），使用Kaplan-Meier曲线评估前列腺特异性抗原无进展生存期（PSA-PFS）和前列腺特异性抗原（PSA）反应，Cox回归模型，和卡方检验。使用时间依赖性受试者工作特征曲线(ROC)分析和C指数计算中的曲线下面积(AUC)评估每个免疫炎症指数的预测性能。
结果：mHSPC队列中所有7项免疫炎症指标均与CFS和OS显著相关，以及PSA的反应，PSA-PFS,和操作系统在mCRPC队列中。在mHSPC队列中，与NLR相比，LIPI始终表现出更高的AUC值，dNLR,LMR,PLR,SII,和SIRI用于预测CFS和OS。这表明与其他指标相比，LIPI具有更好的辨别能力(LIPI的C指数：CFS和OS的0.643和0.686，分别)。值得注意的是,在mHSPC阶段，LIPI相对于其他指标的预测优势在mCRPC阶段减弱。
结论：这项研究首先证实了SII的预后价值，mHSPC和mCRPC中的SIRI和LIPI，并揭示LIPI比NLR有更高的预测能力，dNLR,LMR,PLR,SII和SIRI在mHSPC中。这些非侵入性指标可以使临床医生快速评估患者的预后。
方法：回顾性纳入2005-2022年华西医院诊断为mHSPC的407例和mCRPC的158例。根据最初诊断时的mHSPC和进展为CRPC时的mCRPC的血液学数据计算七个免疫炎症指标。去势抵抗性前列腺癌无生存期（CFS）的预后价值，总生存期（OS），使用Kaplan-Meier曲线评估前列腺特异性抗原无进展生存期（PSA-PFS）和前列腺特异性抗原（PSA）反应，Cox回归模型，和卡方检验。使用时间依赖性受试者工作特征曲线(ROC)分析和C指数计算中的曲线下面积(AUC)评估每个免疫炎症指数的预测性能。
结果：mHSPC队列中所有7项免疫炎症指标均与CFS和OS显著相关，以及PSA的反应，PSA-PFS,和操作系统在mCRPC队列中。在mHSPC队列中，与NLR相比，LIPI始终表现出更高的AUC值，dNLR,LMR,PLR,SII,和SIRI用于预测CFS和OS。这表明与其他指标相比，LIPI具有更好的辨别能力(LIPI的C指数：CFS和OS的0.643和0.686，分别)。值得注意的是,在mHSPC阶段，LIPI相对于其他指标的预测优势在mCRPC阶段减弱。
结论：这项研究首先证实了SII的预后价值，mHSPC和mCRPC中的SIRI和LIPI，并揭示LIPI比NLR有更高的预测能力，dNLR,LMR,PLR,SII和SIRI在mHSPC中。这些非侵入性指标可以使临床医生快速评估患者的预后。
