Exploring the role of the systemic immune-inflammation index in colorectal cancer: A study on screening and prognostic assessment

Table 1 Basic information between colorectal cancer group and colorectal adenoma group, median (Q₂₅, Q₇₅) or n (%)

Variables	Total (n = 332)	Colorectal cancer group (n = 141)	Colorectal adenoma group (n = 191)	Statistic	P value
Age (year)	63.00 (54.00, 73.00)	72.00 (62.50, 78.00)	58.00 (51.00, 67.00)	Z = 8.843	< 0.001
Gender				χ2 = 0.365	0.546
Male	218 (65.66)	90 (63.83)	128 (67.02)
Female	114 (34.34)	51 (36.17)	63 (32.98)
Position of the lesion				χ2 = 24.141	< 0.001
Rectum	58 (17.47)	37 (26.24)	21 (10.99)
Left hemicolon	149 (44.88)	43 (30.50)	106 (55.50)
Right hemicolon	125 (37.65)	61 (43.26)	64 (33.51)
FIT				χ2 = 104.610	< 0.001
Negative	181 (54.52)	31 (21.99)	150 (78.53)
Positive	151 (45.48)	110 (78.01)	41 (21.47)
Fatty liver				χ2 = 30.521	< 0.001
No	280 (84.34)	137 (97.16)	143 (74.87)
Yes	52 (15.66)	4 (2.84)	48 (25.13)
CEA (ng/mL)	2.04 (1.16, 3.71)	3.57 (1.55, 11.53)	1.72 (0.93, 2.47)	Z = 7.128	< 0.001
Hb (g/L)	131.00 (117.00, 146.00)	116.00 (92.50, 130.50)	140.00 (129.50, 152.00)	Z = 10.261	< 0.001
TG (mmol/L)	1.28 (0.91, 1.86)	1.05 (0.82, 1.39)	1.46 (1.11, 2.26)	Z = 6.498	< 0.001
TC (mmol/L)	4.39 (3.80, 5.08)	3.99 (3.41, 4.78)	4.70 (4.12, 5.25)	Z = 5.846	< 0.001

FIT: Fecal immunochemical test; CEA: Carcinoembryonic antigen; Hb: Hemoglobin; TG: Triglyceride; TC: Total cholesterol.

Table 2 Comparison of systemic immune inflammatory index between colorectal cancer group and colorectal adenoma group, median (Q₂₅, Q₇₅)

Variables	Total (n = 332)	Colorectal cancer group (n = 141)	Colorectal adenoma group (n = 191)	Z value	P value
PLT (109/L)	208.50 (170.00, 260.00)	233.00 (183.00, 302.00)	197.00 (166.00, 239.00)	4.171	< 0.001
Neu (109/L)	3.80 (2.97, 4.95)	4.40 (3.40, 6.43)	3.44 (2.79, 4.32)	5.817	< 0.001
Lym (109/L)	1.67 (1.28, 2.18)	1.30 (0.92, 1.67)	1.98 (1.56, 2.34)	8.834	< 0.001
PLR	120.48 (91.57, 169.64)	173.20 (121.93, 267.07)	103.91 (85.18, 125.13)	9.832	< 0.001
NLR	2.12 (1.50, 3.45)	3.31 (2.11, 5.58)	1.73 (1.31, 2.30)	9.544	< 0.001
SII	436.25 (288.84, 725.97)	712.76 (435.87, 1586.92)	347.56 (256.05, 471.03)	9.450	< 0.001
CRP (mg/L)	2.51 (0.75, 6.27)	4.90 (2.09, 18.84)	1.15 (0.56, 4.75)	7.339	< 0.001
ALB (g/L)	42.90 (39.63, 45.80)	40.00 (36.95, 43.35)	44.00 (42.00, 47.20)	8.159	< 0.001

PLT: Platelet count; Neu: Neutrophil; Lym: Lymphocyte; PLR: Platelet-to-lymphocyte ratio; NLR: Neutrophil-to-lymphocyte ratio; SII: Systemic immune-inflammation index; CRP: C-reactive protein; ALB: Albumin.

Table 3 Single factor binary logistic regression analysis of systemic immune inflammation index

Variables	β	SE	Wald	P value	OR (95%CI)
Age	-0.096	0.012	59.262	< 0.001	0.908 (0.886-0.931)
Gender
Male					Reference
Female	-0.141	0.233	0.365	0.546	0.869 (0.550-1.372)
Position of the lesion
Rectum					Reference
Left hemicolon	1.469	0.328	20.095	< 0.001	4.343 (2.285-8.255)
Right hemicolon	0.614	0.327	3.539	0.060	1.849 (0.975-3.506)
FIT
Negative					Reference
Positive	-2.564	0.269	90.764	< 0.001	0.077 (0.045-0.131)
Fatty liver
No					Reference
Yes	2.442	0.534	20.916	< 0.001	11.497 (4.037-32.740)
CEA	-0.369	0.068	29.168	< 0.001	0.691 (0.605-0.791)
PLT	-0.008	0.002	23.562	< 0.001	0.992 (0.989-0.995)
Neu	-0.389	0.070	31.103	< 0.001	0.677 (0.591-0.777)
Lym	1.810	0.240	56.971	< 0.001	6.109 (3.819-9.775)
PLR	-0.024	0.003	55.659	< 0.001	0.976 (0.970-0.983)
NLR	-0.671	0.104	41.786	< 0.001	0.511 (0.417-0.627)
SII	-0.003	0.000	42.177	< 0.001	0.997 (0.996-0.998)
ALB	0.226	0.031	51.568	< 0.001	1.253 (1.178-1.333)
TG	1.074	0.197	29.566	< 0.001	2.926 (1.987-4.309)
TC	0.619	0.123	25.330	< 0.001	1.858 (1.460-2.364)
CRP	-0.081	0.016	24.199	< 0.001	0.922 (0.893-0.953)

OR: Odds ratio; 95%CI: 95% confidence interval; FIT: Fecal immunochemical test; CEA: Carcinoembryonic antigen; PLT: Platelet count; Neu: Neutrophil; Lym: Lymphocyte; PLR: Platelet-to-lymphocyte ratio; NLR: Neutrophil-to-lymphocyte ratio; SII: Systemic immune-inflammation index; TG: Triglyceride; TC: Total cholesterol; CRP: C-reactive protein; ALB: Albumin.

Table 4 Differential diagnosis of area under curve and diagnostic efficacy of colorectal cancer

	AUC (95%CI)	P value	Sensitivity	Specificity	Youden index	Cut-off value
CRP	0.738 (0.683, 0.793)	< 0.001	0.796	0.601	0.397	1.675
PLR	0.811 (0.760, 0.862)	< 0.001	0.657	0.904	0.561	148.3891
NLR	0.802 (0.753, 0.851)	< 0.001	0.650	0.819	0.469	2.4854
SII	0.801 (0.751, 0.850)	< 0.001	0.723	0.761	0.484	480.3264

AUC: Area under the curve; 95%CI: 95% confidence interval; PLR: Platelet-to-lymphocyte ratio; NLR: Neutrophil-to-lymphocyte ratio; SII: Systemic immune-inflammation index; CRP: C-reactive protein.

Table 5 The relationship between preoperative systemic immune-inflammation index and postoperative pathological characteristics of colorectal cancer, n (%)

Variables	Total (n = 91)	SII low value group (n = 31)	SII high value group (n = 60)	χ2 value	P value
Position of the lesion				3.199	0.202
Rectum	25 (27.47)	11 (35.48)	14 (23.33)
Left hemicolon	25 (27.47)	10 (32.26)	15 (25.00)
Right hemicolon	41 (45.05)	10 (32.26)	31 (51.67)
Lesion size (cm)				0.691	0.406
≤ 3	19 (20.88)	8 (25.81)	11 (18.33)
> 3	72 (79.12)	23 (74.19)	49 (81.67)
Pathological differentiation degree				-	0.736
Poorly differentiated adenocarcinoma	22 (24.18)	6 (19.35)	16 (26.67)
Moderately differentiated adenocarcinoma	64 (70.33)	23 (74.19)	41 (68.33)
Well differentiated adenocarcinoma	5 (5.49)	2 (6.45)	3 (5.00)
T				6.910	0.009
T1-2	23 (25.27)	13 (41.94)	10 (16.67)
T3-4	68 (74.73)	18 (58.06)	50 (83.33)
N				4.919	0.027
N0	53 (58.24)	23 (74.19)	30 (50.00)
N1-2	38 (41.76)	8 (25.81)	30 (50.00)
Cut edge				-	0.546
Negative	89 (97.80)	31 (100.00)	58 (96.67)
Positive	2 (2.20)	0 (0.00)	2 (3.33)
Vascular nerve infiltration				4.251	0.039
No	51 (56.04)	22 (70.97)	29 (48.33)
Yes	40 (43.96)	9 (29.03)	31 (51.67)

SII: Systemic immune-inflammation index.

Table 6 The relationship between preoperative systemic immune inflammatory index and postoperative survival of colorectal cancer patients, n (%)

Variables	Total (n = 91)	Survival (n = 83)	Death (n = 8)	χ2 value	P value
Gender				0.000	1.000
Male	56 (61.54)	51 (61.45)	5 (62.50)
Female	35 (38.46)	32 (38.55)	3 (37.50)
Age (year)				1.681	0.195
≤ 60	23 (25.27)	23 (27.71)	0 (0.00)
> 60	68 (74.73)	60 (72.29)	8 (100.00)
Position of the lesion				-	0.583
Rectum	25 (27.47)	24 (28.92)	1 (12.50)
Left hemicolon	25 (27.47)	23 (27.71)	2 (25.00)
Right hemicolon	41 (45.05)	36 (43.37)	5 (62.50)
Lesion size (cm)				0.024	0.877
≤ 3	19 (20.88)	18 (21.69)	1 (12.50)
> 3	72 (79.12)	65 (78.31)	7 (87.50)
Pathological differentiation degree				-	0.497
Poorly differentiated adenocarcinoma	22 (24.18)	20 (24.10)	2 (25.00)
Moderately differentiated adenocarcinoma	64 (70.33)	59 (71.08)	5 (62.50)
Well differentiated adenocarcinoma	5 (5.49)	4 (4.82)	1 (12.50)
T				0.000	1.000
T1-2	23 (25.27)	21 (25.30)	2 (25.00)
T3-4	68 (74.73)	62 (74.70)	6 (75.00)
N				0.014	0.905
N0	53 (58.24)	49 (59.04)	4 (50.00)
N1-2	38 (41.76)	34 (40.96)	4 (50.00)
Cut edge				-	1.000
Negative	89 (97.80)	81 (97.59)	8 (100.00)
Positive	2 (2.20)	2 (2.41)	0 (0.00)
Vascular nerve infiltration				0.000	0.990
No	51 (56.04)	46 (55.42)	5 (62.50)
Yes	40 (43.96)	37 (44.58)	3 (37.50)
Postoperative liver metastasis				-	0.037
No	87 (95.60)	81 (97.59)	6 (75.00)
Yes	4 (4.40)	2 (2.41)	2 (25.00)
PLT				0.001	0.975
Low value	63 (69.23)	58 (69.88)	5 (62.50)
High value	28 (30.77)	25 (30.12)	3 (37.50)
Neu				1.802	0.179
Low value	49 (53.85)	47 (56.63)	2 (25.00)
High value	42 (46.15)	36 (43.37)	6 (75.00)
Lym				-	1.000
Low value	1 (1.10)	1 (1.20)	0 (0.00)
High value	90 (98.90)	82 (98.80)	8 (100.00)
PLR				2.869	0.090
Low value	54 (59.34)	52 (62.65)	2 (25.00)
High value	37 (40.66)	31 (37.35)	6 (75.00)
NLR				3.216	0.073
Low value	32 (35.16)	32 (38.55)	0 (0.00)
High value	59 (64.84)	51 (61.45)	8 (100.00)
SII				1.681	0.195
Low value	23 (25.27)	23 (27.71)	0 (0.00)
High value	68 (74.73)	60 (72.29)	8 (100.00)
CRP				0.571	0.450
Low value	72 (79.12)	67 (80.72)	5 (62.50)
High value	19 (20.88)	16 (19.28)	3 (37.50)

PLT: Platelet count; Neu: Neutrophil; Lym: Lymphocyte; PLR: Platelet-to-lymphocyte ratio; NLR: Neutrophil-to-lymphocyte ratio; SII: Systemic immune-inflammation index; CRP: C-reactive protein.