Prognostic and clinicopathological significance of systemic immune-inflammation index in colorectal cancer: a meta-analysis
Prognostic and clinicopathological significance of systemic immune-inflammation index in colorectal cancer: a meta-analysis
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DOI：
10.1177/1758835920937425
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发表时间：
2020-07-01
影响因子：
4.9
通讯作者：
Fan, Ruitai
中科院分区：
文献类型：
--
作者：
Dong, Meilian;Shi, Yonggang;Fan, Ruitai
背景资料：以前关于全身免疫炎症指数（SII）的研究，基于血小板，中性粒细胞和淋巴细胞计数，作为结直肠癌（CRC）患者的预后标志物，结果不一致。本研究的目的是评估SII在CRCviameta分析中的预后和临床病理作用。研究方法：对PubMed、Web of Science、Embase和科克伦图书馆数据库进行了全面的文献调查，以纳入截至2020年4月6日发表的研究。计算合并的风险比（HR）和比值比（OR）及其95%置信区间（CI），以估计结直肠癌中SII的预后和临床病理价值。结果：2016年至2019年期间发表的12项研究被纳入我们的荟萃分析。综合分析显示，高水平的SII与结直肠癌患者的总生存率（OS; HR = 1.61，95%CI = 1.21- 2.13，p = 0.001）和无进展生存率（HR = 1.74，95%CI = 1.26- 2.39，p = 0.001）显著相关。此外，升高的SII也与肿瘤分化差相关（OR = 1.60，95%CI = 1.27- 2.02，p < 0.001），有远处转移（OR = 2.27，95%CI = 1.10- 4.67，p = 0.026）、ECOG PS 1-2（OR = 1.98，95%CI = 1.39- 2.84，p < 0.001）和肿瘤大小> 5 cm（OR = 1.49，95%CI = 1.18- 1.88，p = 0.001）。然而，高SII与CRC患者的性别、肿瘤位置、淋巴结转移或年龄无显著相关性。结论：我们的荟萃分析表明，高水平的SII水平预测结直肠癌预后不良。此外，SII升高还与临床因素相关，提示该病恶性程度较高。
Background: Previous studies on the systemic immune-inflammation index (SII), which is based on platelet, neutrophil and lymphocyte counts, as a prognostic marker in patients with colorectal cancer (CRC) yielded inconsistent results. The aim of this study was to evaluate the prognostic and clinicopathological role of SII in CRCviameta-analysis. Methods: A comprehensive literature survey was performed on PubMed, Web of Science, Embase and the Cochrane Library databases to include studies published up to 6 April 2020. Pooled hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were computed to estimate the prognostic and clinicopathological value of SII in CRC. Results: A total of 12 studies published between 2016 and 2019 were included in our meta-analysis. The combined analysis showed that high SII levels were significantly associated with worse overall survival (OS; HR = 1.61, 95% CI = 1.21-2.13,p = 0.001) and progression-free survival (HR = 1.74, 95% CI = 1.26-2.39,p = 0.001) in CRC. Moreover, elevated SII was also correlated with poor tumor differentiation (OR = 1.60, 95% CI = 1.27-2.02,p < 0.001), presence of distant metastasis (OR = 2.27, 95% CI = 1.10-4.67,p = 0.026), ECOG PS of 1-2 (OR = 1.98, 95% CI = 1.39-2.84,p < 0.001) and tumor size > 5 cm (OR = 1.49, 95% CI = 1.18-1.88,p = 0.001). However, high SII was not significantly associated with sex, tumor location, lymph node metastasis, or age in patients with CRC. Conclusion: Our meta-analysis indicated that high SII levels predicted poor prognosis in CRC. In addition, an elevated SII was also associated with clinical factors, implying higher malignancy of the disease.