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Systemic Inflammation Response Index (SIRI), cancer stem cells and survival of localised gastric adenocarcinoma after curative resection

  • Original Article – Cancer Research
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

Abstract

Purpose

Systemic Inflammation Response Index (SIRI), based on peripheral neutrophil, monocyte, and lymphocyte counts, was recently developed and used as a marker to predict the survival of patients with malignant tumours. Cancer stem cells (CSCs) can contribute to gastric cancer progression and recurrence. It is not clear whether SIRI is associated with CSCs during gastric cancer development.

Methods

The SIRI was developed in a training cohort of 455 gastric cancer patients undergoing curative resection between 2007 and 2009, and validated in a validation cohort of 327 patients from 2010 to 2011. CD44 + CSCs were measured on tumour sections by immunohistochemical analysis.

Results

An optimal cut-off point for the SIRI of 0.82 divided the gastric cancer patients into a low SIRI group (SIRI < 0.82) and a high SIRI group (SIRI ≥ 0.82) in the training cohort. Compared with patients who had a SIRI < 0.82, patients who had a SIRI ≥ 0.82 had a shorter disease-free survival (DFS) (HR 2.529; 95% CI 1.922–3.326; p < 0.001) and shorter disease-special survival (DSS) (HR 2.692; 95% CI 2.022–3.585; p < 0.001) in the training cohort, comparable DFS and DSS findings were observed in the validation cohort, even for patients in pathological TNM stage of I subgroup. A SIRI ≥ 0.82 was significantly associated with older age, larger tumour, higher pathological TNM stage, lymphovascular invasion, and perineural invasion. Additionally, patients in the low SIRI group were prone to DFS and DSS benefits from postoperative adjuvant chemotherapy. Univariate and multivariate analyses revealed that SIRI was an independent predictor for DFS and DSS. Furthermore, gastric cancer patients with CD44 + CSCs scores had higher SIRI level (mean 1.198 vs. 0.835; p < 0.001). In patients with CD44 + CSCs, those with SIRI ≥ 0.82 had higher recurrence rates and shorter survival time than patients with SIRI < 0. 82.

Conclusions

SIRI was a useful prognostic indicator of poor outcomes in patients with gastric cancer and is a promising tool for gastric cancer treatment strategy decisions. The dismal outcomes in patients with high SIRI might be related to CSCs.

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Acknowledgements

We thank Xiuwen Lan, Hongyu Gao, and Zhiguo Li for their excellent technical assistance. We thank Li Chen, Wenpeng Wang, Shubin Song, and Yimin Wang for data collection and analysis. We thank Chunfeng Li and Hongfeng Zhang for fruitfull help.

Funding

This study was funded by 20122307110022.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Harbin Medical University Cancer Hospital, 150 HaPing Road, Harbin, 150081, China

    Sen Li, Xiuwen Lan, Hongyu Gao, Zhiguo Li, Li Chen, Shubin Song, Yimin Wang, Chunfeng Li, Hongfeng Zhang & Yingwei Xue

  2. Department of Gynecologic Oncology, Cancer Hospital Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China

    Wenpeng Wang

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  1. Sen Li
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  2. Xiuwen Lan
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  4. Zhiguo Li
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  5. Li Chen
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  7. Shubin Song
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  9. Chunfeng Li
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  11. Yingwei Xue
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Correspondence to Yingwei Xue.

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The author(s) declared no potential conflicts of interest.

Ethical approval

This study was approved by the Ethics Committee of Harbin Medical University Cancer Hospital. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Li, S., Lan, X., Gao, H. et al. Systemic Inflammation Response Index (SIRI), cancer stem cells and survival of localised gastric adenocarcinoma after curative resection. J Cancer Res Clin Oncol 143, 2455–2468 (2017). https://doi.org/10.1007/s00432-017-2506-3

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  • DOI: https://doi.org/10.1007/s00432-017-2506-3

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