Systemic immune-inflammation index (SII) has been suggested to be effective to reflect the inflammatory status and thus may be an underlying biomarker for prognosis prediction. This hypothesis has been demonstrated in meta-analyses on several cancer types. However, there was no study to confirm the prognostic roles of SII for gynecological and breast cancers, which was the goal of our study. PubMed, EMBASE, and Cochrane Library databases were searched to collect the articles exploring the associations of SII with prognostic outcomes [overall survival (OS), disease-free survival (DFS), progression-free survival (PFS), lymph node metastasis (LNM), and lymphovascular invasion (LVI)] in gynecological and breast cancers. The prognostic value of SII was estimated by hazard ratio (HR) or relative risk (RR) with 95% confidence interval (CI). Nine articles involving 2724 patients in 11 datasets were included. Meta-analysis showed that a high SII index was significantly associated with poor OS (HR = 2.12, 95% CI, 1.61–2.79, P < 0.001), DFS/PFS (HR = 2.28, 95% CI 1.52–3.41, P < 0.001) and an increased risk for LNM (RR = 1.34, 95% CI 1.20–1.50, P < 0.001) in patients with gynecological and breast cancers. Subgroup analysis confirmed the prognostic role of SII for OS was applicable to all cancer types, but the association with DFS/PFS and LNM was only significant for ovarian cancer and breast cancer, especially triple-negative breast cancer. No significant association was detected between SII and LVI. High SII may be a promising indicator for the prediction of poor prognosis in patients with gynecological and breast cancers, especially ovarian cancer and triple-negative breast cancer.

/pdf/prognostic-prediction-of-systemic-immune-inflammation-index-590i5de611.pdf

Prognostic prediction of systemic immune-inflammation index for patients with gynecological and breast cancers: a meta-analysis

Although previous studies have evaluated the prognostic role of the systemic immune-inflammation index (SII) in patients with breast cancer, the results were inconsistent. Therefore, in this context, we aimed to identify the prognostic and clinicopathological value of the SII in patients with breast cancer by performing a meta-analysis. A literature search was using PubMed, Web of Science, EMBASE, and Cochrane Library databases for relevant articles, from their inception to May 12, 2020. The prognostic value of the SII in breast cancer was assessed by pooling the hazard ratios (HRs) with 95% confidence intervals (CIs). The clinical outcomes included the overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), and distant metastasis-free survival (DMFS). The methodological quality of all the included studies was evaluated using the Newcastle–Ottawa quality assessment scale. The odds ratios (ORs) with 95% CIs were combined to evaluate the correlation between the SII and clinicopathological characteristics of patients with breast cancer. Publication bias was evaluated using the Begg funnel plot and the Egger linear regression test. All statistical analyses were performed using Stata software, version 12.0 (Stata Corporation, College Station, TX, USA). A p value of < 0.05 was considered statistically significant. Eight studies involving 2642 patients were included in the current meta-analysis. The combined data showed that patients with a high SII had worse OS (HR = 1.79, 95% CI 1.33–2.42, p < 0.001), poorer DFS/RFS (HR = 1.79, 95% CI 1.31–2.46, p < 0.001), and inferior DMFS (HR = 1.64, 95% CI 1.32–2.03, p < 0.001) than patients with a low SII. In addition, a high SII was correlated with the presence of lymph node metastasis (OR = 1.38, 95% CI 1.12–1.69, p = 0.002), higher T stage (OR = 1.49, 95% CI 1.17–1.89, p < 0.001), advanced TNM stage (OR = 1.37, 95% CI 1.07–1.77, p = 0.014), and higher histological grade (OR = 3.71, 95% CI 1.00–13.73, p = 0.049). However, there was no significant association between the SII and the pathological type (OR = 0.82, 95% CI 0.55–1.23, p = 0.345) or lymphatic invasion (OR = 1.30, 95% CI 0.82–2.08, p = 0.266). The results of our meta-analysis suggest that an elevated SII predicts poor survival outcomes and is associated with clinicopathological features that indicate tumor progression of breast cancer.

/pdf/prognostic-value-of-the-systemic-immune-inflammation-index-42gllt56mo.pdf

Prognostic value of the systemic immune-inflammation index in patients with breast cancer: a meta-analysis.

To evaluate the association of systemic immune-inflammation index (SII) levels, neutrophil/lymphocyte ratio (NLR), and platelet/lymphocyte ratio (PLR) with severity of noninfectious uveitis. This retrospective study included 46 patients with noninfectious uveitis (uveitis group) and 46 age- and sex-matched healthy subjects (control group). The demographic and ocular findings, localization, and activity of uveitis were recorded at the time of onset evaluation. SII, NLR, and PLR levels of patients were compared between the groups. SII, NLR, and PLR levels were significantly higher in uveitis group when compared to control group (p < 0.001, p = 0.005, and p = 0.001, respectively). While SII and NLR were significantly higher in severe anterior uveitis than mild anterior uveitis (p = 0.006 and p = 0.021, respectively), only SII was significantly higher in severe posterior and panuveitis than mild ones (p = 0.038). SII, as a novel inflammation index, may be more significant tool than NLR and PLR in determining the severity of the uveitis. Furthermore, SII may be a potential useful index in clinical practice to follow-up and manage these patients by monitoring response to anti-inflammatory treatment modalities.

Evaluation of systemic immune-inflammation index level as a novel marker for severity of noninfectious uveitis

Thyroid nodule is a common and frequently occurring disease in the neck in recent years, and ultrasound has become the preferred imaging diagnosis method for thyroid nodule due to its advantages of noninvasive, nonradiation, real‐time, and repeatable. The thyroid imaging, reporting and data system (TI‐RADS) classification standard scores suspicious nodules that are difficult to determine benign and malignant as grade 4, and further pathological puncture is recommended clinically, which may lead to a large number of unnecessary biopsies and operations. Including conventional ultrasound, ACR TI‐RADS, shear wave elastography, super microvascular imaging, contrast enhanced ultrasound, “firefly,” artificial intelligence, and multimodal ultrasound imaging used in combination. In order to identify the most clinically significant malignant tumors when reducing invasive operations. This article reviews the application and research progress of multimodal ultrasound imaging in the diagnosis of TI‐RADS 4 thyroid nodules.

Multimodal ultrasound imaging: A method to improve the accuracy of diagnosing thyroid TI‐RADS 4 nodules

Objectives Triple-negative breast cancer (TNBC) is a highly aggressive subtype of breast cancer with a relatively poor prognosis. Neoadjuvant chemotherapy (NAC) is the main treatment method. Due to the heterogeneity of the tumor, the chemotherapy response of TNBC patients is significantly different. Inflammation is closely related to the occurrence and development of cancer. The systemic immune-inflammation index (SII) is an indicator that can comprehensively reflect the state of systemic inflammation. This study aims to explore the association between SII and the NAC efficacy as well as the prognosis in TNBC. Methods The data of TNBC patients who underwent NAC and systemic treatment in Xiangya Hospital of Central South University from January 2015 to June 2019 were collected. According to the inclusion and exclusion criteria, 231 TNBC patients were finally included. The pre-NAC SII was calculated according to the blood routine results of the patients at 1 week before chemotherapy, and the patients were divided into a pre-NAC low SII group (SII Results Before NAC, the differences in SII between groups with different ages and tumor sizes were significant (P=0.007 and P=0.002, respectively); after chemotherapy, there were no significant differences in SII between different ages, tumor sizes, histological grades, lymph node staging, and Ki-67 groups (all P>0.05). There were 115 patients with low SII before NAC, with a pathological complete response (pCR) rate of 15.7%; there were 116 patients with high SII before NAC, with a pCR rate of 6.0%. Patients with low SII before NAC had a higher pCR rate than patients with high SII before NAC, and the difference was statistically significant (P=0.019).There were 156 patients with lymph node staging pN0, with a pCR rate of 14.7%; and there were 75 patients with lymph node staging pN1-pN2, with a pCR rate of 2.7%. Patients with lymph node staging pN0 had a higher pCR rate than those with lymph node staging pN1-pN2, and the difference was significant (P=0.006). During the follow-up, 34 patients had local recurrence or distant metastasis. The Kaplan-Meier survival curve showed that the 3-year disease-free survival (DFS) rates for patients with low SII before NAC and high SII before NAC were 87.8% and 82.8%, respectively, and the former was significantly higher than the latter (P=0.005); the 3-year DFS rates for patients with tumor sizes of T1-T2 and T3 were 89.0% and 67.5%, respectively, and the former was significantly higher than the latter (P=0.001); the 3-year DFS rates for patients with lymph node staging of pN0 and pN1-pN2 were 87.8% and 82.8%, respectively, and the former was significantly higher than the latter (P=0.009). Cox analysis showed that SII before NAC and tumor size were independent influencing factors of patients' DFS (P=0.038, P=0.010, respectively). Conclusions SII has important clinical significance in predicting the efficacy and prognosis of NAC in TNBC patients, and it has the potential to be a biomarker.

Association between systemic immune-inflammation index and neoadjuvant chemotherapy efficacy as well as prognosis in triple-negative breast cancer.

Background Thyroid nodules are a common thyroid disorder. The aim of the present study was to observe the application value of ultrasonic shear wave elastography (SWE) and contrast-enhanced ultrasound (CEUS) in the differential diagnosis of patients with benign and malignant thyroid lesions. Methods Eighty-two patients with thyroid nodules (96 thyroid nodules) at our hospital were enrolled. All patients underwent ultrasonic SWE and CEUS examination. With surgical pathology as the gold standard, the Young's modulus, CEUS imaging features, and quantitative parameters were compared between the benign and malignant groups. The diagnostic efficiency of SWE, CEUS, and their combination was analyzed by receiver-operating characteristic curve (ROC). Results The average of the Young's modulus in the malignant group was significantly higher than that of the benign group (P 0.05). The curve sharpness in the benign group was significantly lower than that of the malignant group (P<0.05). ROC analysis found that the diagnostic sensitivity and specificity of SWE, CEUS, and their combination were 90.1% and 81.6%, 67.8% and 75.4%, and 97.3% and 71.5%, respectively. Conclusions Compared with CEUS, the sensitivity and specificity of SWE were relatively higher in the differential diagnosis of benign and malignant thyroid lesions, and a combination of both can improve the diagnostic sensitivity of SWE alone to a certain extent.

/pdf/application-of-ultrasonic-shear-wave-elastography-and-1ekuv9eqva.pdf

Application of ultrasonic shear wave elastography and contrast-enhanced ultrasound in the differential diagnosis of patients with benign and malignant thyroid lesions.

The Correlation between Traditional Ultrasound Features and the Expression of Estrogen Receptor, Progesterone Receptor, Human Epidermal Growth Factor Receptor-2, and Ki-67 in Breast Carcinoma

Background The sonographic appearance in intrahepatic space-occupying lesions under the background of fatty liver is atypical. This study aimed to explore the value of contrast-enhanced ultrasonography (CEUS) in the differential diagnosis of intrahepatic space-occupying lesions under the background of fatty liver. Methods Twenty-one patients with intrahepatic space-occupying lesions under the background of fatty liver who were treated in our hospital from January 2017 to September 2020 and met the inclusion/ exclusion criteria were enrolled in this study. The clinical and imaging data, size, location, shape, and other characteristics of the lesions were analyzed. The accuracy of conventional ultrasound and contrast-enhanced ultrasound in diagnosing intrahepatic space-occupying lesions under the background of fatty liver were compared. Results The 21 patients had moderate to severe fatty liver, including 11 cases with malignant lesions (52.38%) and 10 cases with benign lesions (47.62%). The accuracy of CEUS (90.48%) was significantly higher than that of conventional ultrasound (61.90%) in diagnosing intrahepatic space-occupying lesions under the background of fatty liver. A total of 33 lesions were detected in 21 patients, which were hypoechoic. Liver abscesses mainly showed ring-shaped enhancement in the arterial phase and low enhancement in the portal phase, with abscess necrosis in the center and no significant enhancement. Liver cyst lesions showed no significant enhancement in the arterial, portal, and delayed phases. The three stages of focal fat loss were synchronized and simultaneously enhanced with surrounding fatty liver tissues. The area under the diagnostic curve of conventional ultrasound and CEUS was 0.668 and 0.809, respectively, and the area under the curve of CEUS detection was the largest (P Conclusions CEUS can effectively improve the diagnostic accuracy of intrahepatic space-occupying lesions under the background of fatty liver, and is an effective means to differentially diagnose intrahepatic space-occupying lesions under the background of fatty liver.

/pdf/contrast-enhanced-ultrasound-and-its-differential-diagnosis-1c9xfhvpy2.pdf

Contrast-enhanced ultrasound and its differential diagnosis in 21 patients with intrahepatic space-occupying lesions under the background of fatty liver

Introduction This research was conducted to explore the relationship between the systemic immune-inflammation index (SII) and breast imaging-reporting and data system (BI-RADS) classification using ultrasonography and the survival of patients with triple-negative breast cancer (TNBC) in a cohort of Chinese. Methods A total of 215 TNBC patients treated at our hospital between November 2008 and March 2016 were enrolled in this study. We used the log-rank test and Kaplan-Meier curves to assess the overall survival (OS) and disease-free survival (DFS) differences between groups. The prognostic role of SII and other clinicopathological characteristics in TNBC patients were identified using the Cox regression model. Results Patients with low and high SII had median OS of 60.9 and 40.3 months, respectively, (HR=3.78, 95% CI: 2.16-4.15, P<0.001); while the median DFS was 22.4 months and 14.4 months for TNBC patients with low and high SII, respectively (HR =3.16, 95% CI: 1.82-4.02, P<0.001). For patients with grade 5 ultrasonographic BI-RADS classification, the median DFS and OS were 41.2 and 16.5 months, respectively, whereas, it was 57.7 and 21.3 months, respectively, for those with BI-RADS grades 3-4 (P<0.01). According to multivariable analyses, increased SII was a risk factor that independently predicted poor OS (HR =2.96, 95% CI: 2.18-3.98, P<0.001) and DFS (HR = 2.85, 95% CI: 1.62-3.81, P=0.005). In addition, tumor stage, BI-RADS, and histological grade also independently predicted poor OS (P=0.002, <0.001, 0.004). Conclusion Pretreatment SII and BI-RADS 5 were independent indicators for prognosis in TNBC patients. It is imperative to conduct prospective studies to evaluate the potential role of SII in patient selection, treatment guidance, and design of clinical trials.

https://www.dovepress.com/getfile.php?fileID=47582

Systemic immune-inflammation index and ultrasonographic classification of breast imaging-reporting and data system predict outcomes of triple-negative breast cancer

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Papers

Application of ultrasonic shear wave elastography and contrast-enhanced ultrasound in the differential diagnosis of patients with benign and malignant thyroid lesions.

The Correlation between Traditional Ultrasound Features and the Expression of Estrogen Receptor, Progesterone Receptor, Human Epidermal Growth Factor Receptor-2, and Ki-67 in Breast Carcinoma

Contrast-enhanced ultrasound and its differential diagnosis in 21 patients with intrahepatic space-occupying lesions under the background of fatty liver

Systemic immune-inflammation index and ultrasonographic classification of breast imaging-reporting and data system predict outcomes of triple-negative breast cancer