SKOR SYSTEMIC IMMUNE INFLAMMATION INDEX SEBAGAI PREDIKTOR METASTASIS TULANG PADA NON-SMALL CELL LUNG CANCER DI RSUD DR. MOEWARDI

Oleh :
Naelin Nikmah - S602208006 - Fak. Kedokteran

Introduction: Non-small cell lung cancer (NSCLC) is the leading cause of death from lung cancer due to distant metastasis, with bone metastasis being one of the most common sites. Between 30–66% of NSCLC patients experience bone metastasis during their disease. Bone metastasis is closely associated with skeletal-related events (SREs), which cause chronic bone pain and neurological disorders due to spinal cord compression, leading to a decline in performance status (PS) and quality of life. Early detection of bone metastasis is crucial to reduce morbidity, mortality, and optimize therapy. The systemic immune-inflammation index (SII) is an easily accessible, inexpensive, non-invasive inflammatory biomarker associated with poor NSCLC prognosis and an indicator of bone metastasis occurrence. This study aims to determine the relationship between pre-treatment SII scores in predicting bone metastasis occurrence in NSCLC patients.Methods: This study used a retrospective cohort design with data from 54 NSCLC patients at Dr. Moewardi Hospital, Surakarta, from 1 October 2022 to 30 September 2024. Receiver operating characteristic (ROC) curve analysis was performed to assess the sensitivity, specificity, accuracy, and area under the curve (AUC) of the SII score. Kaplan-Meier survival analysis and log-rank test were used to analyze the time to bone metastasis.Results: The pretreatment SII score demonstrated excellent diagnostic accuracy (AUC=0.957, p<0.001), with a cut-off point of 1036.23, sensitivity of 92.5%, specificity of 85.7%, and accuracy of 90.7%. Kaplan-Meier survival analysis showed that SII scores >1036.23 had a mean time to bone metastasis of 4.79 months (95% CI 4.00-5.59), which was faster than SII scores <1036.23 of 10.87 months (95% CI 9.57-12.16). The log-rank test showed a significant difference in bone metastasis survival between groups (p<0.001).Conclusion: The pre-treatment SII score is a strong predictor of bone metastasis in NSCLC and can be used for clinical risk stratification.Keywords: NSCLC, bone metastasis, SII