Longitudinal Trajectories of Hematologic Inflammatory Markers and Their Prognostic and Mediating Roles in
Jia-Ching Lin1, Chung-Feng Hwang1,2,3,4, Wei-Chih Chen1,3
1Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Objective.:
To examine the longitudinal trajectories of hematologic inflammatory markers and their prognostic and mediating roles in nasopharyngeal carcinoma (NPC).
Methods.:
This retrospective cohort study used group-based trajectory modeling (GBTM) on 1,867 NPC patients in Taiwan across three time points during radiotherapy.
Results.:
A high-inflammation systemic immune-inflammation index (SII), calculated from platelet, neutrophil, and lymphocyte counts on routine blood tests (platelet × neutrophil / lymphocyte), trajectory (3.4% of patients) independently predicted poorer overall survival (adjusted HR, 1.89) and greater odds of disease persistence (adjusted OR, 2.09). Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) trajectories were not significantly associated with outcomes. Disease persistence mediated 14.7% of the total survival effect of SII.
Conclusion.:
In this exploratory analysis, high-inflammation SII trajectories were associated with inferior survival and increased residual disease risk in NPC. However, as SII was not associated with recurrence and disease persistence explained only a small proportion of the survival association, the pathway linking SII to survival remains unclear and warrants prospective investigation.