Prognostic value and clinicopathological significance of pre-and post-treatment systemic immune-inflammation index in colorectal cancer patients: a meta-analysis.

IF 2.5 3区医学 Q3 ONCOLOGY World Journal of Surgical Oncology Pub Date : 2025-01-13 DOI:10.1186/s12957-025-03662-z

Yueting Tan, Bei'er Hu, Qian Li, Wen Cao

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Abstract

Background: In recent years, the association between systemic immune-inflammation index (SII) and the prognosis of patients with colorectal cancer (CRC) has remained a topic of considerable debate. To address this, the present study was carried out to investigate the prognostic significance of SII in CRC.

Methods: Databases including PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science were scrutinized up to March 27, 2024. The relationship between pre- and post-treatment SII levels and the prognosis of CRC was evaluated. Following literature screening, quality assessment, and extraction of outcome measures, a meta-analysis was conducted using Stata. Publication bias was assessed by funnel plots and Egger's test.

Results: A total of 27 studies were included in the analysis. Pooled results demonstrated that a high SII level was associated with poor overall survival (OS, HR = 1.78, 95% CI = 1.40-2.26), progression-free survival (PFS, HR = 1.80, 95% CI = 1.26-2.56), disease-free survival (DFS, HR = 1.91, 95% CI = 1.43-2.56), and recurrence-free survival (RFS, HR = 3.29, 95% CI = 1.58-6.88). Notably, the association between pre-treatment SII and OS, PFS, and DFS was stronger than that observed for post-treatment SII, indicating that treatment may attenuate the predictive valueof SII for survival outcomes. Additionally, elevated SII was correlated with poor tumor differentiation, tumor location in the rectum, and larger tumor size ≥ 5 cm.

Conclusion: Our meta-analysis suggested that a high SII is a predictor of poor prognosis in CRC patients. High SII levels were strongly correlated with inferior OS, PFS, DFS, and RFS. The relationship between SII and survival outcomes was attenuated post-treatment compared to pre-treatment. Additionally, elevated SII was correlated with clinicopathological factors in CRC patients. These findings suggest that SII can serve as an independent prognostic indicator for CRC.

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结直肠癌患者治疗前后全身免疫炎症指数的预后价值及临床病理意义：meta分析

背景：近年来，系统性免疫炎症指数（SII）与结直肠癌（CRC）患者预后之间的关系一直是一个颇有争议的话题。为了解决这个问题，本研究旨在探讨SII在结直肠癌中的预后意义。方法：截至2024年3月27日，对PubMed、Embase、Cochrane Central Register of Controlled Trials （Central）和Web of Science等数据库进行审查。评估治疗前后SII水平与结直肠癌预后的关系。在文献筛选、质量评估和结果测量提取之后，使用Stata进行meta分析。采用漏斗图和Egger检验评估发表偏倚。结果：共纳入27项研究。综合结果显示，高SII水平与较差的总生存期（OS, HR = 1.78, 95% CI = 1.40-2.26）、无进展生存期（PFS, HR = 1.80, 95% CI = 1.26-2.56）、无疾病生存期（DFS, HR = 1.91, 95% CI = 1.43-2.56）和无复发生存期（RFS, HR = 3.29, 95% CI = 1.58-6.88）相关。值得注意的是，治疗前SII与OS、PFS和DFS之间的相关性强于治疗后SII，这表明治疗可能会降低SII对生存结果的预测价值。此外，SII升高与肿瘤分化差、肿瘤位于直肠、肿瘤大小≥5 cm相关。结论：我们的荟萃分析表明，高SII是CRC患者预后不良的预测因子。高SII水平与较差的OS、PFS、DFS和RFS密切相关。与治疗前相比，治疗后SII与生存结果之间的关系减弱。此外，SII升高与结直肠癌患者的临床病理因素相关。这些发现提示SII可作为结直肠癌的独立预后指标。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

World Journal of Surgical Oncology ONCOLOGY-SURGERY

CiteScore

4.70

自引率

15.60%

发文量

362

审稿时长

3 months

期刊介绍： World Journal of Surgical Oncology publishes articles related to surgical oncology and its allied subjects, such as epidemiology, cancer research, biomarkers, prevention, pathology, radiology, cancer treatment, clinical trials, multimodality treatment and molecular biology. Emphasis is placed on original research articles. The journal also publishes significant clinical case reports, as well as balanced and timely reviews on selected topics. Oncology is a multidisciplinary super-speciality of which surgical oncology forms an integral component, especially with solid tumors. Surgical oncologists around the world are involved in research extending from detecting the mechanisms underlying the causation of cancer, to its treatment and prevention. The role of a surgical oncologist extends across the whole continuum of care. With continued developments in diagnosis and treatment, the role of a surgical oncologist is ever-changing. Hence, World Journal of Surgical Oncology aims to keep readers abreast with latest developments that will ultimately influence the work of surgical oncologists.