Abstract
OBJECTIVE: The aim of this study was to confirm the association of systemic immune-inflammation index (SII) with relapse and metastasis of cervical squamous cell carcinoma (CSCC) in patients over 50 years and older. METHODS: This retrospective study included 470 patients aged 50 years and older with CSCC who were treated at the Second Affiliated Hospital of Dalian Medical University between January 2020 and January 2023. The patients were divided into two groups according to median SII: high SII (n = 235) and low SII (n = 235). Univariate and multivariate logistic regression analysis, subgroup analysis, and receiver operating characteristic curve (ROC) analysis were used to explore the association of SII with relapse and metastasis. RESULTS: The total population was 470, of which 161 (34%) relapsed and 133 metastasized (28.3%). Compared with low SII, high SII group had higher probability of relapse and metastasis (P < 0.05). Multivariate logistic regression analysis showed that, after adjusting for all confounding factors, each additional standard deviation in SII increased the risk of relapse by 28.5%, and the risk of relapse was 1.568 times higher for high SII than for low SII (P < 0.05). In addition, each additional unit in log(10)SII and LnSII increased the risk of metastasis by 178.4% and 56%, respectively (P < 0.05). Moreover, in subgroups of patients aged 65 years or older, postmenopausal, with uterine fibroids, without HPV infection, without hypertension, without diabetes, and without undergoing radical cervical cancer, higher levels of SII remained significantly associated with an increased risk of metastasis (P < 0.05). In addition, ROC analysis indicated that SII had a certain predictive value for both relapse and metastasis (AUC = 0.599 and 0.617). CONCLUSION: Higher levels of SII are significantly associated with a higher risk of relapse and metastasis, indicating that SII may have important clinical value in the prognosis assessment of CSCC.