Prognostic significance of complete blood cell count-derived inflammatory biomarkers in patients with small cell carcinoma of the cervix.

Abstract

e17521 Background: Inflammatory markers derived from complete blood cell count have previously been considered prognostic indicators for various diseases, but little is known about their relationship with small cell carcinoma of the cervix (SCCC). This study aims to evaluate the prognostic significance of inflammatory biomarkers in patients with SCCC. Methods: Between 2004 and 2024, 158 patients with SCCC were enrolled. Kaplan-Meier analysis, propensity score matching, and Cox regression analyses were used to assess treatment outcomes and risk factors. A prognostic nomogram was constructed using multivariate Cox analysis and was evaluated by receiver operating characteristic curve. The optimal cut-off values for continuous variables were determined using Cox regression, selecting thresholds that best differentiate survival outcomes. Results: Both univariable and multivariable Cox regression analyses showed that age, FIGO 2018 stage, surgery, Neutrophil-to-lymphocyte ratio (NLR), Platelet-to-lymphocyte ratio (PLR), and Systemic-inflammatory-response index (SIRI) are significant predictors of progression-free survival (PFS) in patients. A prognostic nomogram was established and evaluated, with an area under the curve (AUC) of 0.81 (95% confidence interval [CI] 0.73–0.88). Moreover, the PFS of patients with a high NLR (>2.11) was significantly poorer than that of patients with a low NLR. After propensity score matching, the protective effect of a low NLR was observed among patients with SCCC (p=0.0063). Conclusions: A robust prognostic nomogram for predicting the prognosis of patients with SCCC was developed, which can accurately predict PFS. Additionally, NLR is a promising predictor of PFS in patients with SCCC. Cox proportional hazard model of the all clinical characteristics on progression-free survival using univariable and multivariable analysis. Univariate analysis Multivariate analysis Characteristic HR 95% CI p-value HR 95% CI p-value Age 1.02 1.00, 1.04 0.019 1.03 1.01, 1.05 0.009 Tumor size 0.32 ≤4cm — — >4cm 1.25 0.80, 1.94 FIGO 2018 stage <0.001 0.001 I — — — — II 1.90 0.67, 5.37 1.13 0.37, 3.50 III 2.90 1.01, 8.28 1.41 0.44, 4.52 IV 11.3 3.79, 33.4 4.56 1.29, 16.0 Neoadjuvant therapy 0.019 0.96 No — — — — Yes 0.56 0.34, 0.93 0.98 0.49, 1.98 Surgery <0.001 0.082 No — — — — Yes 0.36 0.23, 0.57 0.55 0.28, 1.09 Radiation therapy 0.90 No — — Yes 0.97 0.63, 1.50 NLR 1.33 1.12, 1.57 0.002 0.63 0.40, 0.99 0.040 dNLR 0.18 0.00, 8.77 0.39 PLR 1.01 1.00, 1.01 <0.001 1.01 1.00, 1.01 0.004 MLR 26.0 5.02, 135 <0.001 3.83 0.12, 118 0.45 SII 1.00 1.00, 1.00 0.001 1.00 1.00, 1.00 0.72 SIRI 1.35 1.16, 1.57 0.001 1.61 0.98, 2.67 0.084 NLR: neutrophil-to-lymphocyte ratio, dNLR: derived neutrophil-to-lymphocyte ratio, PLR: Platelet-to-lymphocyte ratio, MLR: Monocyte-to-lymphocyte ratio, SII: Systemic-immune-inflammation index, SIRI: Systemic-inflammatory-response index.