Histopathological Evaluation of Systemic Immune-Inflammation Index (SII) in Oral Squamous Cell Carcinoma
Aishwarya Karhale *
GDCH, Chh. Sambhajinagar, Maharashtra, India.
Vaishali Nandkhedkar
Department of Oral and Maxillofacial Pathology, GDCH, Chh. Sambhajinagar, Maharashtra, India.
Mandakini Mandale
Department of Oral and Maxillofacial Pathology, GDCH, Chh. Sambhajinagar, Maharashtra, India.
Jayanti G. Humbe
Department of Oral and Maxillofacial Pathology, GDCH, Chh. Sambhajinagar, Maharashtra, India.
Savita Wagh
Department of Oral and Maxillofacial Pathology, GDCH, Chh. Sambhajinagar, Maharashtra, India.
*Author to whom correspondence should be addressed.
Abstract
Introduction: Oral squamous cell carcinoma (OSCC) shows considerable biological heterogeneity in clinical behaviour and prognosis. Conventional histopathological grading remains important but may not fully reflect tumour aggressiveness or the systemic immune-inflammatory status of the host. The systemic immune-inflammation index (SII), derived from peripheral blood neutrophil, lymphocyte and platelet counts, may provide an adjunctive indicator of host inflammatory and immune response in OSCC.
Aim: This study evaluated SII in patients with OSCC and correlated SII values with histopathological grades.
Materials and Method: A total of 60 subjects were included, comprising 20 healthy controls and 40 histopathologically confirmed OSCC cases. Before treatment, 2 mL of venous blood was collected under aseptic conditions, and complete blood count analysis was performed using an automated haematology analyser. SII was calculated using the formula: platelet count × neutrophil count / lymphocyte count. Descriptive statistics were expressed as mean ± standard deviation. The independent Student’s t-test was used to compare SII values between healthy controls and OSCC patients, and one-way ANOVA with post hoc analysis was used to assess differences across histopathological grades. A p-value < 0.05 was considered statistically significant.
Results: The mean SII was significantly higher in OSCC patients (2195.98 ± 1165.98) than in healthy controls (429.87 ± 50.20) (p < 0.001). SII values increased progressively from well-differentiated to poorly differentiated OSCC, and this association was statistically significant (p < 0.05).
Conclusion: The findings suggest that SII is elevated in OSCC and shows a positive association with poorer histopathological differentiation. SII may serve as a simple, cost-effective adjunctive inflammatory biomarker for supporting histopathological assessment in OSCC.
Keywords: Oral squamous cell carcinoma, systemic immune-inflammation index, histopathological grading, tumour differentiation, immune-inflammatory response, inflammatory biomarker