Systemic immune-inflammatory index is associated with malignancy in Lung-RADS 4 lung nodules

Area of Science:

• Pulmonary Medicine
• Oncology
• Radiology

Background:

• Accurate risk stratification of pulmonary nodules detected by low-dose computed tomography (LDCT) is crucial.
• Lung CT Screening Reporting and Data System (Lung-RADS) 4 nodules represent a high-risk group requiring careful evaluation.
• The systemic immune-inflammatory index (SII) has emerged as a potential biomarker for various cancers.

Purpose of the Study:

• To investigate the association between the systemic immune-inflammatory index (SII) and malignancy in patients with Lung-RADS 4 nodules identified on LDCT.
• To determine if SII can aid in differentiating malignant from benign nodules within this high-risk category.

Main Methods:

• Retrospective review of 123 patients with Lung-RADS 4A/B/X nodules identified on LDCT.
• Exclusion of patients with incomplete blood counts, loss to follow-up, or non-cancerous nodule diagnoses (inflammatory, granulomas, metastases).
• Univariate, multivariable, and cut-point analyses to assess the correlation between SII and malignancy, adjusting for clinical factors.

Main Results:

• 63.4% of evaluated nodules were diagnosed as lung cancer.
• Patients with malignant nodules exhibited a significantly higher median SII compared to those with benign nodules (P=0.007).
• An SII cutoff of 561 demonstrated a 3.74-fold increased odds of malignancy (P=0.008).

Conclusions:

• An elevated SII is significantly associated with malignancy in non-inflammatory Lung-RADS 4 pulmonary nodules detected by LDCT.
• SII calculation can serve as a valuable adjunct tool for risk-stratification and prognostication of high-risk pulmonary nodules.
• Further research may integrate SII into clinical decision-making algorithms for pulmonary nodule management.