Abstract:

Objective To investigate the clinical characteristics and auxiliary value of the systemic inflammatory response index (SIRI), the monocyte-to-lymphocyte ratio (MLR), the neutrophil-to-lymphocyte ratio (NLR), and other hematological inflammatory markers in patients with silicosis and to explore their utility in distinguishing disease staging.

Methods A total of 182 silicosis patients hospitalized at the Guangdong Provincial Institute of Occupational Disease Prevention and Treatment between 2021 and 2024 were enrolled as the study group, while 126 healthy individuals undergoing routine physical examinations during the same period served as the controls. Complete blood count results were retrospectively reviewed, novel inflammatory indices were calculated, and statistical analyses were performed using R version 4.4.3.

Results Median levels of the novel inflammatory indices, including SIRI, AISI, NLR, and MLR, were significantly elevated in patients with stages I, Ⅱ, and Ⅲ silicosis compared with healthy controls (all P<0.05). Compared with patients at stage I, patients at stage III exhibited significantly higher median levels of SIRI, SII, AISI, NLR, MLR, and PLR (all P<0.05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) values of MLR, SIRI, and NLR were 0.733, 0.727, and 0.683, respectively, in distinguishing silicosis patients from healthy controls, superior to those of conventional hematological parameters. In differentiating healthy controls from silicosis patients at stage I, MLR (AUC = 0.672) and SIRI (AUC = 0.669) remained superior to absolute monocyte and neutrophil counts. In distinguishing the silicosis patients at stage I from those at stage Ⅲ, MLR (AUC = 0.640) and SIRI (AUC = 0.632) outperformed monocyte percentage and NLR. A logistic regression model combining MLR, SIRI, and NLR yielded an AUC of 0.739 for differentiating healthy controls from silicosis patients, slightly higher than MLR alone (0.733). However, in other subgroup comparisons, the AUC values of the combined model (0.671, 0.635) were close to MLR alone (0.672, 0.640).

Conclusions MLR and SIRI demonstrated relatively high sensitivity in distinguishing healthy individuals from silicosis patients and in differentiating different disease stages, with diagnostic performance superior to traditional hematological parameters. These inflammatory indices may serve as auxiliary markers for disease monitoring and clinical assessment in silicosis.