ObjectiveTo investigate the relationship between peripheral blood inflammatory markers and the development of retinopathy of prematurity (ROP) in extremely low birth weight infants (ELBWI), and to preliminarily evaluate their predictive value for ROP. MethodsA retrospective clinical study. A total of 191 ELBWI who were born at The Affiliated Hospital of Qingdao University and admitted to the neonatal intensive care unit between January 2018 and December 2023 were enrolled. According to the presence or absence of inflammation-related diseases (necrotizing enterocolitis, bronchopulmonary dysplasia, neonatal sepsis), infants were divided into an inflammation-related disease group (144 cases) and a non-inflammation-related disease group (47 cases). Clinical data and peripheral blood inflammatory markers at 7, 14, and 28 days after birth, including white blood cell count (WBC), C-reactive protein (CRP) level, neutrophil-to-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII) that were compared between the two groups, as well as between infants with and without ROP within the inflammation-related disease group. Logistic regression analysis was used to identify variables associated with the occurrence of ROP. A receiver operating characteristic (ROC) curve was constructed to assess the predictive performance of the combined model, and decision curve analysis (DCA) was applied to evaluate its potential clinical utility. ResultsAmong the 191 infants included, 80 cases were diagnosed with ROP (41.9%, 80/191). The incidence of ROP was 68/144 (47.22%) in the inflammation-related disease group and 12/47 (25.53%) in the non-inflammation-related disease group, with a statistically significant difference between the two groups (χ2=6.849, P=0.010). In the inflammation-related disease group, compared with infants without ROP, those with ROP had lower birth weight (Z=?2.591) and gestational age (Z=?2.942), a lower proportion of cesarean delivery (χ2=5.846), longer durations of invasive and noninvasive mechanical ventilation (Z=?2.500, ?2.057), and a higher incidence of patent ductus arteriosus (χ2=4.598) (P＜0.05). Levels of inflammatory markers were significantly higher in the ROP group, including WBC and SII at 7 days (Z=?2.85, ?2.565), SII at 14 days (Z=?2.531), and WBC, NLR, and SII at 28 days after birth (Z=?2.385, ?3.051, ?2.719; P＜0.05). In contrast, CRP levels at 7, 14, and 28 days did not differ significantly between ROP and non-ROP infants (Z=?1.550, ?0.796, ?0.132; P＞0.05). Multivariate logistic regression analysis showed that decreased birth weight [95% confidence interval (CI) 0.990-0.998] and increased WBC at 7 days (95%CI 1.004-1.129) and SII at 28 days (95%CI 1.001-1.006) after birth were independent related factors for the occurrence of ROP (P＜0.05). ROC curve analysis indicated that the area under the curve for predicting ROP by combining birth weight, WBC at 7 days after birth, and SII at 28 days was 0.71, with a sensitivity of 91% and a specificity of 44%. DCA shows that when the risk threshold is 31% to 98%, this combined prediction model has a positive net clinical benefit. In the non-inflammation-related disease group, only birth weight was negatively correlated with the occurrence of ROP (95%CI 0.975-0.996, P=0.005). ConclusionsIn ELBWI patients with inflammation-related diseases, the levels of peripheral blood WBC and SII are associated with the occurrence of ROP. The combination of birth weight and inflammatory indicators at specific time points has certain predictive value for ROP.
Objective To explore the association between the preoperative systemic immune-inflammation index (SII) and prognosis in non-small cell lung cancer (NSCLC) patients. Methods A comprehensive literature survey was performed on PubMed, Web of Science, EMbase, The Cochrane Library, Wanfang, and CNKI databases to search the related studies from inception to December 2021. The hazard ratio (HR) and 95% confidence interval (CI) were combined to evaluate the correlation of the preoperative SII with overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS) in NSCLC patients. Results A total of 11 studies involving 9 180 patients were eventually included. The combined analysis showed that high SII levels were significantly associated with worse OS (HR=1.61, 95%CI 1.36-1.90, P<0.001), DFS (HR=1.50, 95%CI 1.34-1.68, P<0.001), and RFS (HR=1.17, 95%CI 1.04-1.33, P<0.001). Subgroup analyses also further verified the above results. Conclusion Preoperative SII is a powerful prognostic biomarker for predicting outcome in patients with operable NSCLC and contribute to prognosis evaluation and treatment strategy formulation. However, more well-designed and prospective studies are warranted to verify our findings.
ObjectiveTo preliminary investigate the association between systemic inflammatory biomarkers such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and diabetic retinopathy (DR). MethodsA cross-sectional study. A total of 5 999 patients diagnosed with diabetes in the NHANES database during the survey periods from 1999 to 2018 were included in the study. They were divided into the DR group (1 331 cases) and the non-DR group (4 668 cases) based on the presence or absence of DR. Demographic and laboratory data (including complete blood count, blood glucose, and lipid profiles) were collected, and NLR, PLR, and SII were calculated. The survey weights were used to handle the complex sampling design. After adjusting for confounding factors such as C-reactive protein, a weighted multivariate logistic regression model was applied to analyze the association between the logarithmically transformed and quartile-categorized NLR, PLR, SII and DR, and the odds ratio (OR) and its 95% confidence interval (CI) were calculated. Restricted cubic spline (RCS) was used to analyze the dose-response relationship, and subgroup analysis and interaction tests were conducted through Bonferroni correction. ResultsAfter multivariate adjustment, logistic regression analysis showed in the fully adjusted model with log transformation, neither SII (OR=1.160, 95%CI 0.756-1.780), NLR (OR=0.834, 95%CI 0.669-1.040), nor PLR (OR=1.360, 95%CI 0.859-2.154) showed statistically significant linear associations with DR (P＞0.05). RCS analysis indicated that SII showed no statistically significant overall association with DR (Poverall=0.062), but a non-linear relationship was observed (Pnon-linear=0.045). There was a significant non-linear dose-response relationship between PLR and DR (Poverall=0.011, Pnon-linear=0.009); and there was also a significant non-linear dose-response relationship between NLR and DR (Poverall=0.017, Pnon-linear=0.035). Subgroup analysis revealed that the absence of significant associations between SII, NLR, PLR and DR remained stable across different subgroups. ConclusionBased on a large sample cross-sectional study using the NHANES database, no independent linear association is found between PLR, NLR or SII and DR, and the results remain consistent across various subgroups.