Predictive value of systemic immune-inflammation index in the high-grade subtypes components of small-sized lung adenocarcinoma

BoHua Wei ¹, Yi Zhang ², Kejian Shi ¹

⁰Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Beijing, China.

Journal of Cardiothoracic Surgery +

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February 2, 2024

View abstract on PubMed

Summary

A new model using the systemic immune-inflammation index (SII) can predict high-grade subtypes in small lung adenocarcinomas. This aids surgeons in selecting the best surgical approach for early-stage lung cancer patients.

Area Of Science

Oncology
Thoracic Surgery
Diagnostic Imaging

Background

Accurate subtyping of small lung adenocarcinomas (≤2 cm) is vital for surgical planning.
Micropapillary and solid components significantly influence treatment decisions.
Preoperative prediction of these subtypes remains a challenge.

Purpose Of The Study

To develop a simple, preoperative prediction method for micropapillary and solid components in small lung adenocarcinomas.
To identify preoperative indicators associated with high-grade subtypes.
To aid in optimizing surgical strategies for early-stage lung cancer.

Main Methods

Retrospective analysis of 341 patients with small lung adenocarcinoma.
Classification into S/MP5+ (≥5% solid or micropapillary components) and S/MP5- groups.
Multivariate logistic regression to identify independent predictors.
Nomogram construction and validation using calibration and ROC curves.

Main Results

Maximum diameter, consolidation tumor ratio (CTR), and systemic immune-inflammation index (SII) were independent predictors of S/MP5+.
The nomogram demonstrated good calibration and discrimination (AUC=0.893).
SII was a significant predictor (p<0.001).

Conclusions

A nomogram incorporating SII, maximum diameter, and CTR is a practical tool for preoperative prediction of high-grade subtypes in small lung adenocarcinoma.
This model can assist in determining optimal surgical procedures.
Preoperative assessment using SII improves surgical decision-making for lung adenocarcinoma.

Keywords:

Lung adenocarcinoma Micropapillary Nomogram Solid Systemic immune-inflammation index