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Journals / Turkish Journal of Clinics and Laboratory / 2026 / Cilt: 16 Sayı: 2

Prognostic role of systemic immune-inflammation index in patients with nasopharyngeal cancer

Nazofarenks kanserli hastalarda sistemik immün-inflamasyon indeksinin prognostik rolü

Günay Kozan(Dicle üniversitesi)0000-0002-8676-6175
Berzan Haznedar(UNIVERSITY OF HEALTH SCIENCES, DİYARBAKIR GAZİ YAŞARGİL HEALTH RESEARCH CENTER)0000-0002-4990-5260
Pages
370–376
Publication Date
2025-06-30
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Higher pre-treatment SII values were significantly associated with poorer overall survival (OS) and progression-free survival (PFS).

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: This study aimed to evaluate the prognostic significance of the systemic immune-inflammation index (SII) in patients with nasopharyngeal carcinoma (NPC).
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Key Findings & Data:Material and Methods: This retrospective study included 42 patients diagnosed with NPC between January 2014 and January 2020.
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Conclusion & Impact:Higher pre-treatment SII values were significantly associated with poorer overall survival (OS) and progression-free survival (PFS).
🔬Design:Araştırma Makalesi
📍Scope:2014 Verileri
⚙️Variables:nazofarenks karsinomu · sistemik immün-inflamasyon indeksi · prognoz

Abstract

Aim: This study aimed to evaluate the prognostic significance of the systemic immune-inflammation index (SII) in patients with nasopharyngeal carcinoma (NPC). Material and Methods: This retrospective study included 42 patients diagnosed with NPC between January 2014 and January 2020. Clinical data, hematological parameters, and survival outcomes were collected. Disease stage was classified using the 8th edition of the American Joint Committee on Cancer (AJCC) Staging System. Pre-treatment SII values were calculated using complete blood count data (platelets × neutrophils / lymphocytes). Results: The mean patient age was 54.0 ± 13.8 years, with a male predominance (66.7%). Most patients presented with advanced disease (AJCC Stage III–IV). Higher pre-treatment SII values were significantly associated with poorer overall survival (OS) and progression-free survival (PFS). Multivariate Cox regression analysis confirmed that elevated SII independently predicted reduced OS (HR: 1.06; 95% CI: 1.02–1.09; p 610 for OS (sensitivity: 73.9%, specificity: 60.0%) and >580 for PFS (sensitivity: 75.0%, specificity: 57.1%). Kaplan–Meier analysis demonstrated significantly lower OS and PFS in patients with elevated SII (log-rank p < 0.001). Conclusion: Elevated SII is a strong and independent prognostic marker for poor outcomes in NPC patients and may guide personalized clinical management.

Özet

Amaç: Bu çalışmanın amacı, nazofarenks karsinomlu (NPC) hastalarda sistemik immün-inflamasyon indeksinin (SII) prognostik önemini değerlendirmektir. Gereç ve Yöntemler: Bu retrospektif çalışmaya Ocak 2014 ile Ocak 2020 arasında NPC tanısı alan 42 hasta dahil edildi. Klinik veriler, hematolojik parametreler ve sağkalım sonuçları toplandı. Hastalığın evresi, Amerikan Kanser Ortak Komitesi (AJCC) Evreleme Sisteminin 8. baskısı kullanılarak sınıflandırıldı. Tedavi öncesi SII değerleri, tam kan sayımı verileri (trombositler × nötrofiller / lenfositler) kullanılarak hesaplandı. Bulgular: Hastaların ortalama yaşı 54,0 ± 13,8 yıl olup, erkek hastalar çoğunluktaydı (%66,7). Hastaların çoğunluğu ileri evrede (AJCC Evre III-IV) tanı aldı. Yüksek tedavi öncesi SII değerleri, anlamlı olarak daha kötü genel sağkalım (OS) ve progresyonsuz sağkalım (PFS) ile ilişkili bulundu. Çok değişkenli Cox regresyon analizinde, artmış SII’nin bağımsız olarak azalmış OS’yi öngördüğü gösterildi (HR: 1,06; %95 GA: 1,02–1,09; p 610 (%73,9 sensitivite, %60,0 spesifisite), PFS için >580 (%75,0 sensitivite, %57,1 spesifisite) olarak belirlendi. Kaplan-Meier analizinde yüksek SII olan hastaların OS ve PFS süreleri anlamlı derecede düşük bulundu (log-rank p < 0,001). Sonuç: Artmış SII, NPC hastalarında kötü prognozun güçlü ve bağımsız bir belirtecidir ve kişiselleştirilmiş klinik tedavi yönetiminde yol gösterici olabilir.

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Cite This Article

Kozan, G., Haznedar, B. (2025). Prognostic role of systemic immune-inflammation index in patients with nasopharyngeal cancer. Turkish Journal of Clinics and Laboratory, Cilt: 16 Sayı: 2, 370–376. https://doi.org/10.18663/tjcl.1719828

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References (28)

  1. Chen YP, Chan ATC, Le QT, Blanchard P, Sun Y, Ma J. Nasopharyngeal carcinoma. Lancet 2019;394:64-80.
  2. Lee AW, Ma BB, Ng WT, and Chan AT. Management of Nasopharyngeal Carcinoma: Current Practice and Future Perspective. J Clin Oncol 2015;33:3356-64.
  3. Yuan X, Yang H, Zeng F, et al. Prognostic value of systemic inflammation response index in nasopharyngeal carcinoma with negative Epstein-Barr virus DNA. BMC Cancer. 2022;22:858.
  4. Wu Y and Zhou BP. Inflammation: a driving force speeds cancer metastasis. Cell Cycle 2009;8:3267-73.
  5. Liang C, Kan J, Wang J, Lu W, Mo X, and Zhang B. Nasopharyngeal carcinoma-associated inflammatory cytokines: ongoing biomarkers. Front Immunol 2024;15:1448012.
  6. Li Q, Yu L, Yang P, Hu Q. Prognostic Value of Inflammatory Markers in Nasopharyngeal Carcinoma Patients in the Intensity-Modulated Radiotherapy Era. Cancer Manag Res 2021;13:6799-810.
  7. Liew KY, Zulkiflee AB. Neutrophil-lymphocyte ratios in the prognostication of primary non-metastatic nasopharyngeal carcinoma. Braz J Otorhinolaryngol 2018;84:764-71.
  8. Pan XB, Huang ST, and Zhu XD. Neutrophil-to-lymphocyte ratio predicts the prognosis of stage II nasopharyngeal carcinoma. Cancer Manag Res 2019;11:8269-75.
  9. Yan Q, Ertao Z, Zhimei Z, et al. Systemic immune-inflammation index (SII): A More Promising Inflammation-Based Prognostic Marker for Patients with synchronic colorectal peritoneal carcinomatosis. J Cancer 2020;11:5264-72.
  10. Zeng Z, Xu S, Wang D, and Qin G. Prognostic significance of systemic immune-inflammation index in patients with nasopharyngeal carcinoma: a meta-analysis. Syst Rev 2022;11:247.
  11. Wang L, Qin X, Zhang Y, Xue S, Song X. The prognostic predictive value of systemic immune index and systemic inflammatory response index in nasopharyngeal carcinoma: A systematic review and meta-analysis. Front Oncol 2023;13:1006233.
  12. Diakos CI, Charles KA, McMillan DC, and Clarke SJ. Cancer-related inflammation and treatment effectiveness. Lancet Oncol 2014;15:e493-503.
  13. Gong L, Kwong DL, Dai W et al. The Stromal and Immune Landscape of Nasopharyngeal Carcinoma and Its Implications for Precision Medicine Targeting the Tumor Microenvironment. Front Oncol 2021;11:744889.
  14. Labelle M, Begum S, and Hynes RO. Platelets guide the formation of early metastatic niches. Proc Natl Acad Sci U S A. 2014;111:E3053-61.
  15. Xie X, Zeng X, Cao S et al. Elevated pretreatment platelet distribution width and platelet count predict poor prognosis in nasopharyngeal carcinoma. Oncotarget. 2017;8:106089-97.
  16. Yang D, Li P, Meng Z et al. Combined pretreatment neutrophil-lymphocyte ratio and platelet-lymphocyte ratio predicts survival and prognosis in patients with non-metastatic nasopharyngeal carcinoma: a retrospective study. Sci Rep. 2024;14:9898.
  17. Chang H, Gao J, Xu BQ et al. Haemoglobin, neutrophil to lymphocyte ratio and platelet count improve prognosis prediction of the TNM staging system in nasopharyngeal carcinoma: development and validation in 3,237 patients from a single institution. Clin Oncol (R Coll Radiol). 2013;25:639-46.
  18. Liu J, Wei C, Tang H, Liu Y, Liu W, Lin C. The prognostic value of the ratio of neutrophils to lymphocytes before and after intensity modulated radiotherapy for patients with nasopharyngeal carcinoma. Medicine (Baltimore). 2020;99:e18545.
  19. Xu F, Ni W, Hua X et al. A single center retrospective study assessing the prognostic significance of pre-treatment neutrophil/lymphocyte ratio in locally advanced nasopharyngeal carcinoma. Transl Cancer Res. 2023;12:1672-83.
  20. Jiang Y, Qu S, Pan X, Huang S, Zhu X. Prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in intensity modulated radiation therapy for nasopharyngeal carcinoma. Oncotarget. 2018;9:9992-10004.
  21. Jiang W, Chen Y, Huang J et al. Systemic immune-inflammation index predicts the clinical outcome in patients with nasopharyngeal carcinoma: a propensity score-matched analysis. Oncotarget. 2017;8:66075-86.
  22. Lu A, Li H, Zheng Y et al. Prognostic Significance of Neutrophil to Lymphocyte Ratio, Lymphocyte to Monocyte Ratio, and Platelet to Lymphocyte Ratio in Patients with Nasopharyngeal Carcinoma. Biomed Res Int. 2017;2017:3047802.
  23. Cocuzza S, Parisi FM, Spatola C, et al. Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios as Predictors of Dysphagia Severity and Quality of Life in Nasopharyngeal Cancer Patients after Intensity Modulated Radiotherapy (IMRT). J Clin Med 2024;13
  24. Takenaka Y, Kitamura T, Oya R, et al. Prognostic role of neutrophil-lymphocyte ratio in nasopharyngeal carcinoma: A meta-analysis. PLoS One 2017;12:e0181478.
  25. Chen Y, Sun J, Hu D, et al. Predictive Value of Pretreatment Lymphocyte-to-Monocyte Ratio and Platelet-to-Lymphocyte Ratio in the Survival of Nasopharyngeal Carcinoma Patients. Cancer Manag Re. 2021;13:8767-79.
  26. Xiong Y, Shi LL, Zhu LS, Ding Q, Ba L, Peng G. Prognostic efficacy of the combination of the pretreatment systemic Immune-Inflammation Index and Epstein-Barr virus DNA status in locally advanced Nasopharyngeal Carcinoma Patients. J Cancer. 2021;12:2275-84.
  27. Akçay M, Eti̇z D, Özen A, Şaylisoy S. Neutrophil/Lymphocyte Ratio and Prognosis in Patients with Non-Metastatic Nasopharyngeal Cancer: A Single-Center Experience. Turkish Journal of Oncology/Türk Onkoloji Dergisi. 2019;34
  28. Gundog M and Basaran H. The prognostic value of neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio in nasopharyngeal cancer. J BUON. 2020;25:367-75.