Abstract
INTRODUCTION
Small cell lung cancer (SCLC) is a highly lethal form of lung cancer with very poor prognosis. Systemic inflammation is an important risk factor forcancer development.Circulating immune cells play an important role in fighting againstcancer.This study was designed to investigate the prognostic value of different peripheral blood leukocyte biomarkers as components of circulating immune cellsin small cell lung cancer.
METHODS
A total of 81 SCLC patients followed up at Dokuz Eylül University Hospital Department of Medical Oncologybetween 2012 and 2021 were included in this study. Peripheral blood tests of patients were recorded at the time of diagnosis.Systemic immune-inflammation index (SIRI) was defined as (neutrophil count×monocytes count)/lymphocyte count. Pan-immune inflammation value (PIV) was calculated as follows: (neutrophil count × platelet count × monocyte count)/lymphocyte count.The optimal cut-off valuesweredetermined according to the receiver operating characteristic (ROC) curve. These values were 2.8 and 585 in limited stage SCLC and 1.33 and 497 in all-stage SCLC for SIRI and PIV, respectively.Overall survival (OS) was estimated withthe Kaplan-Meier method and compared with the log rank test. Multivariate analysis was estimated using the Cox regression model.
RESULTS
Of the 81 patients with SCLC,28 (34.6%) patients had LS-SCLC while 53 (65.4%) patients had extensive stage disease.In whole group, median SIRI was 2.37 (IQR, 0.34–18.59), while median PIVwas 634.80 (IQR, 61.57–8320). Although there was a numerical difference between survival in analysis performed in the patient group including all stages, statistical significance could not be achieved for both markers (p=0.20 for SIRI; p=0.058 for PIV).While statistical significance was found for OS and ECOG, SIRI, and PIV status in univariate analysis of patients with limited stage SCLC, no significant difference was found between the variables with multivariate analysis.
DISCUSSION AND CONCLUSION
Our findings show that SIRI and PIV may be promising predictors for prognosis in SCLC.