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Prognostic significance of the systemic inflammation response index in gastrointestinal malignancy patients: a pooled analysis of 10,091 participants

    Xian-Wen Liang‡

    Department of Hepatobiliary & Pancreatic Surgery, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan Province, 570311, China

    ,
    Bing Liu‡

    Department of Gastrointestinal Surgery, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, 570208, China

    ,
    Hai-Jing Yu‡

    Department of International Nursing School, Hainan Medical University, Haikou, Hainan Province, 570102, China

    ,
    Jia-Cheng Chen

    Department of Hepatobiliary & Pancreatic Surgery, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan Province, 570311, China

    ,
    Zhi Cao

    Department of Hepatobiliary & Pancreatic Surgery, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan Province, 570311, China

    ,
    Sheng-Zhong Wang

    *Author for correspondence:

    E-mail Address: shengzhong323@163.com

    Department of Gastrointestinal Surgery, Central South University Xiangya School of Medicine Affiliated Haikou Hospital, Haikou, 570208, China

    &
    Jin-Cai Wu

    **Author for correspondence:

    E-mail Address: wujincai021@126.com

    Department of Hepatobiliary & Pancreatic Surgery, Hainan General Hospital (Hainan Affiliated Hospital of Hainan Medical University), Haikou, Hainan Province, 570311, China

    Published Online:https://doi.org/10.2217/fon-2023-0545

    Background: We performed a meta-analysis to investigate the association of the systemic inflammation response index (SIRI) with long-term survival outcomes in patients with gastrointestinal malignancy. Methods: PubMed, Web of Science and Embase were searched for relevant studies evaluating the prognostic significance of the SIRI in gastrointestinal malignancies until May 2023. Results: 30 studies with 10,091 patients were included. The pooled results identified that patients in the high SIRI group had a worse overall survival and disease-free survival, which was observed across various tumor types, tumor stages and primary treatments. Conclusion: An elevated SIRI is negatively associated with worse survival outcomes of gastrointestinal malignancy patients and can be used as a risk stratification index for gastrointestinal malignancies.

    Papers of special note have been highlighted as: • of interest; •• of considerable interest

    References

    • 1. Sung H, Ferlay J, Siegel RL et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J. Clin. 71(3), 209–249 (2021).
    • 2. Arnold M, Abnet CC, Neale RE et al. Global burden of 5 major types of gastrointestinal cancer. Gastroenterology 159(1), 335–349 (2020).
    • 3. Chen F, Xie C, Ren K, Xu X. Prognostic value of the Naples Prognostic Score in patients with gastrointestinal cancers: a meta-analysis. Nutr. Cancer 75(7), 1–11 (2023).
    • 4. Atasever Akkas E, Erdis E, Yucel B. Prognostic value of the systemic immune-inflammation index, systemic inflammation response index, and prognostic nutritional index in head and neck cancer. Eur. Arch. Otorhinolaryngol. 280(8), 3821–3830 (2023).
    • 5. Pang H, Zhang W, Liang X et al. Prognostic score system using preoperative inflammatory, nutritional and tumor markers to predict prognosis for gastric cancer: a two-center cohort study. Adv. Ther. 38(9), 4917–4934 (2021).
    • 6. Zhao X, Zhou Y, Liu B et al. Preoperative neutrophil–lymphocyte ratio (NLR)–binding fibrinogen–albumin ratio (FAR) is superior to platelet–lymphocyte ratio (PLR)–binding fibrinogen–albumin ratio (FAR) and lymphocyte–monocyte (LMR)–binding fibrinogen–albumin ratio (FAR) as predictors of survival in surgical patients with colorectal adenocarcinoma. Med. Sci. Monit. 29, e939442 (2023).
    • 7. Liu S, Li Z, Guo W, Fan Y. Predictive value of the neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and monocyte-to-lymphocyte ratio esophageal stricture after endoscopic submucosal dissection of early esophageal cancer. Med. Sci. Monit. 29, e940041 (2023).
    • 8. Li B, Zhou P, Liu Y et al. Platelet-to-lymphocyte ratio in advanced cancer: review and meta-analysis. Clin. Chim. Acta 483, 48–56 (2018).
    • 9. Chen L, Chen Y, Zhang L et al. In gastric cancer patients receiving neoadjuvant chemotherapy systemic inflammation response index is a useful prognostic indicator. Pathol. Oncol. Res. 27, 1609811 (2021).
    • 10. Chu Y, Liu Y, Jiang Y et al. Prognosis and complications of patients with primary gastrointestinal diffuse large B-cell lymphoma: development and validation of the systemic inflammation response index-covered score. Cancer Med. 12(8), 9570–9582 (2023). • Recent retrospective study exploring the prognostic value of the systemic inflammation response index (SIRI) in gastrointestinal malignancy.
    • 11. Cao Y, Zheng X, Hu Y et al. Levels of systemic inflammation response index are correlated with tumor-associated bacteria in colorectal cancer. Cell Death Dis. 14(1), 69 (2023). •• Reported a superior prognostic predictability of the SIRI when compared with other simple biomarkers, such as neutrophil-to-lymphocyte, monocyte-to-lymphocyte and platelet-to-lymphocyte ratios.
    • 12. Chen Y, Jin M, Shao Y, Xu G. Prognostic value of the systemic inflammation response index in patients with adenocarcinoma of the oesophagogastric junction: a propensity score-matched analysis. Dis. Markers 2019, 4659048 (2019).
    • 13. Qi Q, Zhuang L, Shen Y et al. A novel systemic inflammation response index (SIRI) for predicting the survival of patients with pancreatic cancer after chemotherapy. Cancer 122(14), 2158–2167 (2016). •• The first study that developed the novel inflammatory biomarker SIRI.
    • 14. Zheng Y, Chen Y, Chen J et al. Combination of systemic inflammation response index and platelet-to-lymphocyte ratio as a novel prognostic marker of upper tract urothelial carcinoma after radical nephroureterectomy. Front. Oncol. 9, 914 (2019).
    • 15. Hu M, Xu Q, Yang S et al. Pretreatment systemic inflammation response index (SIRI) is an independent predictor of survival in unresectable stage III non-small cell lung cancer treated with chemoradiotherapy: a two-center retrospective study. Ann. Transl. Med. 8(20), 1310 (2020).
    • 16. Valero C, Pardo L, Sansa A et al. Prognostic capacity of systemic inflammation response index (SIRI) in patients with head and neck squamous cell carcinoma. Head Neck 42(2), 336–343 (2020).
    • 17. Page MJ, McKenzie JE, Bossuyt PM et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 372, n71 (2021).
    • 18. Lin Y, Liu Z, Qiu Y et al. Clinical significance of plasma D-dimer and fibrinogen in digestive cancer: a systematic review and meta-analysis. Eur. J. Surg. Oncol. 44(10), 1494–1503 (2018). • Guideline for literature quality assessment.
    • 19. Pang HY, Yan MH, Chen LH et al. Detection of asymptomatic recurrence following curative surgery improves survival in patients with gastric cancer: a systematic review and meta-analysis. Front. Oncol. 12, 1011683 (2022).
    • 20. Yang XC, Liu H, Liu DC et al. Prognostic value of pan-immune-inflammation value in colorectal cancer patients: a systematic review and meta-analysis. Front. Oncol. 12, 1036890 (2022).
    • 21. Tierney JF, Stewart LA, Ghersi D et al. Practical methods for incorporating summary time-to-event data into meta-analysis. Trials 8, 16 (2007). • Guideline for incorporating summary survival data into meta-analysis.
    • 22. Cui S, Cao S, Chen Q et al. Preoperative systemic inflammatory response index predicts the prognosis of patients with hepatocellular carcinoma after liver transplantation. Front. Immunol. 14, 1118053 (2023).
    • 23. Gao W, Zhang F, Ma T, Hao J. High preoperative fibrinogen and systemic inflammation response index (F-SIRI) predict unfavorable survival of resectable gastric cancer patients. J. Gastric Cancer 20(2), 202–211 (2020).
    • 24. Geng Y, Zhu D, Wu C et al. A novel systemic inflammation response index (SIRI) for predicting postoperative survival of patients with esophageal squamous cell carcinoma. Int. Immunopharmacol. 65, 503–510 (2018).
    • 25. Jin B, Hu W, Su S et al. The prognostic value of systemic inflammation response index in cholangiocarcinoma patients. Cancer Manag. Res. 13, 6263–6277 (2021).
    • 26. Kamposioras K, Papaxoinis G, Dawood M et al. Markers of tumor inflammation as prognostic factors for overall survival in patients with advanced pancreatic cancer receiving first-line FOLFIRINOX chemotherapy. Acta Oncol. 61(5), 583–590 (2022).
    • 27. Kim JS, Choi M, Kim SH et al. Systemic inflammation response index correlates with survival and predicts oncological outcome of resected pancreatic cancer following neoadjuvant chemotherapy. Pancreatology 22(7), 987–993 (2022).
    • 28. Li Q, Zhang R, Fu JL et al. The prognostic value of preoperative peripheral blood inflammatory biomarkers for intrahepatic cholangiocarcinoma after radical resection. Zhonghua Zhong Liu Za Zhi 44(11), 1194–1201 (2022).
    • 29. Li S, Lan X, Gao H et al. Systemic inflammation response index (SIRI), cancer stem cells and survival of localised gastric adenocarcinoma after curative resection. J. Cancer Res. Clin. Oncol. 143(12), 2455–2468 (2017).
    • 30. Li S, Xu H, Wang W et al. The systemic inflammation response index predicts survival and recurrence in patients with resectable pancreatic ductal adenocarcinoma. Cancer Manag. Res. 11, 3327–3337 (2019).
    • 31. Li W, Peng QW, Lin Y et al. A model to predict the recurrence of middle–high risk gastrointestinal stromal tumors based on preoperative fibrinogen and peripheral blood inflammatory indexes. Zhonghua Wei Chang Wai Ke Za Zhi 23(9), 896–903 (2020).
    • 32. Liu Z, Ge H, Miao Z et al. Dynamic changes in the systemic inflammation response index predict the outcome of resectable gastric cancer patients. Front. Oncol. 11, 577043 (2021).
    • 33. Pacheco-Barcia V, Mondéjar Solís R, France T et al. A systemic inflammation response index (SIRI) correlates with survival and predicts oncological outcome for mFOLFIRINOX therapy in metastatic pancreatic cancer. Pancreatology 20(2), 254–264 (2020).
    • 34. Qi WX, Wang X, Li C et al. Pretreatment absolute lymphocyte count is an independent predictor for survival outcomes for esophageal squamous cell carcinoma patients treated with neoadjuvant chemoradiotherapy and pembrolizumab: an analysis from a prospective cohort. Thorac. Cancer 14(17), 1556–1566 (2023).
    • 35. Sun L, Hu W, Liu M et al. High systemic inflammation response index (SIRI) indicates poor outcome in gallbladder cancer patients with surgical resection: a single institution experience in China. Cancer Res. Treat. 52(4), 1199–1210 (2020).
    • 36. Topkan E, Selek U, Pehlivan B et al. The prognostic significance of novel pancreas cancer prognostic index in unresectable locally advanced pancreas cancers treated with definitive concurrent chemoradiotherapy. J. Inflamm. Res. 14, 4433–4444 (2021).
    • 37. Wang SB, Chen JY, Xu C et al. Evaluation of systemic inflammatory and nutritional indexes in locally advanced gastric cancer treated with adjuvant chemoradiotherapy after D2 dissection. Front. Oncol. 12, 1040495 (2022).
    • 38. Wang TC, An TZ, Li JX, Pang PF. Systemic inflammation response index is a prognostic risk factor in patients with hepatocellular carcinoma undergoing TACE. Risk Manag. Healthc. Policy 14, 2589–2600 (2021).
    • 39. Wu Y, Tu C, Shao C. Inflammatory indexes in preoperative blood routine to predict early recurrence of hepatocellular carcinoma after curative hepatectomy. BMC Surg. 21(1), 178 (2021).
    • 40. Xin Y, Zhang X, Li Y et al. A systemic inflammation response index (SIRI)-based nomogram for predicting the recurrence of early stage hepatocellular carcinoma after radiofrequency ablation. Cardiovasc. Intervent. Radiol. 45(1), 43–53 (2022).
    • 41. Xu L, Yu S, Zhuang L et al. Systemic inflammation response index (SIRI) predicts prognosis in hepatocellular carcinoma patients. Oncotarget 8(21), 34954–34960 (2017).
    • 42. Yan K, Wei W, Shen W et al. Combining the systemic inflammation response index and prognostic nutritional index to predict the prognosis of locally advanced elderly esophageal squamous cell carcinoma patients undergoing definitive radiotherapy. J. Gastrointest. Oncol. 13(1), 13–25 (2022).
    • 43. Yazici H, Yegen SC. Is systemic inflammatory response index (SIRI) a reliable tool for prognosis of gastric cancer patients without neoadjuvant therapy? Cureus 15(3), e36597 (2023).
    • 44. Ying HQ, Liao YC, Sun F et al. The role of cancer-elicited inflammatory biomarkers in predicting early recurrence within stage II–III colorectal cancer patients after curable resection. J. Inflamm. Res. 14, 115–129 (2021).
    • 45. Zhang J, Ding Y, Wang W et al. Combining the fibrinogen/albumin ratio and systemic inflammation response index predicts survival in resectable gastric cancer. Gastroenterol. Res. Pract. 2020, 3207345 (2020).
    • 46. Zhao M, Duan X, Mi L et al. Prognosis of hepatocellular carcinoma and its association with immune cells using systemic inflammatory response index. Future Oncol. 18(18), 2269–2288 (2022).
    • 47. Zhou Q, Su S, You W et al. Systemic inflammation response index as a prognostic marker in cancer patients: a systematic review and meta-analysis of 38 cohorts. Dose Response 19(4), 15593258211064744 (2021).
    • 48. Khandia R, Munjal A. Interplay between inflammation and cancer. Adv. Protein Chem. Struct. Biol. 119, 199–245 (2020).
    • 49. Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature 454(7203), 436–444 (2008). •• Study exploring the relationship between inflammation and cancer.
    • 50. Tian BW, Yang YF, Yang CC et al. Systemic immune-inflammation index predicts prognosis of cancer immunotherapy: systemic review and meta-analysis. Immunotherapy 14(18), 1481–1496 (2022).
    • 51. Ocana A, Nieto-Jiménez C, Pandiella A, Templeton AJ. Neutrophils in cancer: prognostic role and therapeutic strategies. Mol. Cancer 16(1), 137 (2017).
    • 52. Xiong S, Dong L, Cheng L. Neutrophils in cancer carcinogenesis and metastasis. J. Hematol. Oncol. 14(1), 173 (2021).
    • 53. Jaillon S, Ponzetta A, Di Mitri D et al. Neutrophil diversity and plasticity in tumour progression and therapy. Nat. Rev. Cancer 20(9), 485–503 (2020).
    • 54. Mantovani A, Schioppa T, Porta C et al. Role of tumor-associated macrophages in tumor progression and invasion. Cancer Metastasis Rev 25(3), 315–322 (2006).
    • 55. Huang C, Li Z, Li N et al. Interleukin 35 expression correlates with microvessel density in pancreatic ductal adenocarcinoma, recruits monocytes, and promotes growth and angiogenesis of xenograft tumors in mice. Gastroenterology 154(3), 675–688 (2018).
    • 56. Ugel S, Canè S, De Sanctis F, Bronte V. Monocytes in the tumor microenvironment. Annu. Rev. Pathol. 16, 93–122 (2021).
    • 57. Gonzalez H, Hagerling C, Werb Z. Roles of the immune system in cancer: from tumor initiation to metastatic progression. Genes Dev. 32(19–20), 1267–1284 (2018).
    • 58. Wu ES, Oduyebo T, Cobb LP et al. Lymphopenia and its association with survival in patients with locally advanced cervical cancer. Gynecol. Oncol. 140(1), 76–82 (2016).