Preoperative Systemic Inflammation Response Index is Associated with Stage I Non-Seminoma Testicular Germ Cell Tumors: A Retrospective Pilot Study

INTRODUCTION: Testicular cancer accounts for 1% of all male neoplasms and 95% of cases are testicular germ cell tumors (TGCT). There are studies investigating the relationship between hematological inflammatory markers and testicular cancer. We aimed for the 1st time to investigate whether there is an association between Systemic Inflammation Response Index (SIRI) and clinical Stage 1 TGCT.
METHODS: A total of 60 patients who underwent radical inguinal orchiectomy because of testicular mass between June 2019 and December 2020 were included. Age, preoperative serum alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), lactate dehydrogenase (LDH) levels and whole blood cell counts, tumor stage, and tumor size of the patients were recorded. Pre-operative neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), Systemic Immune Inflammation Index, and SIRI were compared to preoperative serum AFP, hCG, and LDH levels between seminoma (n=27) and non-seminoma (n=33) TGCT groups.
RESULTS: No statistically significant difference was found between two groups in terms of tumor size, LDH level and tumor side, NLR, PLR, and Systemic Immune Inflammation Index (p>0.05). SIRI, serum AFP, and HCG levels were significantly higher in non-seminoma group (p=0.006, p=0.001, and p=0.005, respectively). In multivariate analysis, it was determined SIRI over 0.985 is associated with non-seminoma TGCT pathology (OR=5.662, 95% CI=1.284–24.966, p=0.022).
DISCUSSION AND CONCLUSION: In this pilot study, it was revealed that pre-operative SIRI is associated with non-seminoma TGCT. We believe it is important to explore the utility of SIRI in the differential diagnosis of TGCT in further studies.