Correlation Analysis Of Systemic Immune-inflammation Index And FIGO Staging Of Patients With Ovarian Cancer

Objective:Systemic immune inflammation index(SII)constructed based on the counts of lymphocytes,platelets and neutrophils.This study analyzed the correlation between SII and FIGO staging of patients with ovarian cancer.To explore whether the high level of SII before surgery can help distinguish benign and malignant ovarian tumors.Does SII have value in predicting patients with advanced ovarian cancer?Methods:A collection of 348 patients with ovarian tumors in the Affiliated Hospital of Qinghai University from October 2017 to October 2020.These patients not only underwent initial surgical treatment,but were also diagnosed with pathology after surgery.Among these patients,there were 251 patients with malignant ovarian tumors and 97 patients with benign ovarian tumors.According to the 2014 edition of FIGO’s surgical pathological staging criteria,patients with ovarian cancer were divided into two groups: early group(n=90,FIGO stage Ⅰ～Ⅱ)and advanced group(n=161,FIGO stage Ⅲ～Ⅳ).The control group consisted of patients with benign ovarian tumors.Calculate SII=N×P/L,NLR=N/L,PLR=P/L from the neutrophil count,platelet count,and lymphocyte count obtained by the preoperative complete blood count test.Spearman rank correlation was used to test the correlation between preoperative high SII and FIGO staging in patients with ovarian cancer.Logistic regression analysis was used to determine whether preoperative SII is an independent factor affecting the FIGO staging of ovarian cancer patients.Draw receiver operating characteristic curve and analyze the value of SII in identifying benign and malignant ovarian tumors and predicting advanced ovarian cancer.Results:1.Compared with the benign ovarian tumor group,the malignant ovarian tumor group has higher SII,PLR,NLR,the number of menopausal cases,the number of cases with a serum CA125 level ≥35U/m L,platelet count,age,neutrophil count.and low lymphocyte count and hemoglobin.There are statistical differences(P<0.05).However,comparing the red blood cell counts of the two groups was not statistically significant(P>0.05).2.There were significant differences in neutrophil count,malignant ascites,histopathological type,serum CA125 level ≥ 35U/m L,SII and NLR among benign ovarian tumor group,early ovarian cancer group and advanced ovarian cancer group.However,compared with benign ovarian tumor group,there was no significant difference in lymphocyte count,platelet count,hemoglobin and PLR in early ovarian cancer group,but there were significant differences in the number of menopausal cases and age(P < 0.05).Compared with the early stage group,the hemoglobin and lymphocyte count decreased,while the platelet count and PLR increased in patients with advanced ovarian cancer,but there was no significant difference in the number of menopausal cases and age(P > 0.05).3.Spearman rank correlation suggests that SII,PLR,NLR,malignant ascites,and histopathological types of patients with ovarian cancer are all positively correlated with FIGO staging.Comparing the magnitude of these correlation coefficients(rs)shows that SII has a significant correlation with the FIGO staging of patients with ovarian cancer(rs = 0.518,P<0.01).4.Through univariate and multivariate binary logistic regression analysis,SII of ovarian cancer patients is an influencing factor of FIGO staging,but SII is not an independent influencing factor of FIGO staging of ovarian cancer patients(P>0.05,no statistical difference).But the histopathological type(OR = 2.143,P = 0.041),malignant ascites(OR = 0.150,P <0.001),PLR(OR = 1.008,P = 0.011)are independent factors influencing the FIGO staging of patients with ovarian cancer.5.Using receiver operating characteristic curves,we compared the value of SII,NLR,and PLR in identifying benign and malignant ovarian tumors and predicting the FIGO staging of patients with ovarian cancer as advanced.The area under the curve for SII to differentiate benign and malignant ovarian tumors is 0.810(95% CI:0.765～0.855,P<0.01).The area under the curve(AUC)of SII to differentiate benign and malignant ovarian tumors was 0.810(95% CI: 0.765～0.855,P<0.01).The area under the curve of SII predicting advanced ovarian cancer is 0.812(95% CI: 0.754～0.870,P<0.01).which was significantly better than the predictive value of NLR and PLR.Conclusions:1.The increase of SII in ovarian malignant tumors indicates the existence of immune inflammatory response.2.The increase of SII before surgery in patients with ovarian cancer has a significant positive correlation with FIGO staging.The preoperative increase of SII in patients with ovarian cancer is an influencing factor of FIGO staging,but SII is not an independent factor.3.Preoperative SII is significantly better than PLR and NLR in identifying benign and malignant ovarian tumors and predicting the FIGO staging of patients with ovarian cancer.When the preoperative SII>545.12,the ovarian tumor is more likely to be malignant.When the preoperative SII>621.84,the FIGO staging of patients with ovarian cancer is more likely to be advanced.The high preoperative SII helps predict the severity of ovarian cancer patients and guide individualized treatment.