Zhang Chenglong,Wang Xiaoyu,Niu Huizhong,et al.Prognostic value of systemic immune-inflammation index plus International Neuroblastoma Risk Group stratification in neuroblastoma[J].Journal of Clinical Pediatric Surgery,,():256-262.[doi:10.3760/cma.j.cn101785-20250104]
Prognostic value of systemic immune-inflammation index plus International Neuroblastoma Risk Group stratification in neuroblastoma
- Keywords:
- Neuroblastoma; Immunity; Humoral; Inflammation Mediators; Risk Assessment; Child
- Abstract:
- Objective Neuroblastoma (NB) is a common solid tumor in children.While survival rates for low/intermediate-risk cohorts have improved,the prognosis for high-risk individuals remains poor.Previous studies have demonstrated that systemic inflammatory markers play an important role in assessing tumor prognosis.This study was intended to evaluate the prognostic value of Systemic Immune-Inflammation Index (SII) in NB children and explore the potential role of combining SII with International Neuroblastoma Risk Group (INRG) stratification in improving prognostic prediction.Methods For this retrospective study,166 NB children were recruited from Hebei Childrens Hospital between January 2013 and November 2024.All of them underwent radical tumor resection.And complete preoperative blood component data and follow-up records were available.Preoperative blood parameters,including neutrophil,lymphocyte and platelet counts,were employed for calculating SII.Receiver operating characteristic (ROC) curve analysis was performed for assessing the relationship between SII and both mortality and disease progression.Kaplan-Meier survival analysis was utilized for validating its prognostic value.And univariate and multivariate Cox regression analyses were conducted for further evaluating its prognostic role.Results The area under the ROC curve (AUC) of SII for predicting mortality and disease progression was 0.89 and 0.82,respectively.The high-SII group (n=67) had a 5-year overall survival (OS) rate of 54.91% and it was significantly lower than that of low-SII group (95.31%,P<0.001).The 5-year event-free survival (EFS) rate was 41.32% in high-SII group and it was also significantly lower than that of low-SII group (90.37%,P<0.001).Cox regression analysis revealed that high SII was an independent risk factor for shortened OS (HR=19.70,P<0.001) and it was significantly associated with an elevated risk of disease progression (HR=4.66,P<0.01).When combining SII and INRG stratification,hazard ratio for OS spiked to 36.19 in high-risk group (P<0.001),demonstrating better predictive performance than either indicator alone.Conclusions The new prognostic indicator "SII+INRG stratification" effectively predicts the risk of mortality and recurrence,providing support for personalized treatment strategies in NB children.
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Memo
收稿日期:2025-1-11。
基金项目:河北省卫生健康委员会医学科学研究项目计划(20220039)
通讯作者:耿建磊,Email:genglei653@163.com