<p>Clinical significance of systemic immune-inflammation index (SII) and C-reactive protein-to-albumin ratio (CAR) in patients with esophageal cancer: a meta-analysis</p>

Abstract

Background: Numerous studies have reported that systemic immune-inflammation index (SII) and C-reactive protein-to-albumin ratio (CAR) correlate with tumor progression and prognosis in various types of human cancer. The aim of this study is to systematically investigate the clinical significance of SII and CAR in esophageal cancer (EC). Methods: We searched a number of databases for articles reporting the effect of pretreatment SII and CAR on the survival of EC patients. Review Manager 5.3 and STATA/SE 14.1 were applied in this meta-analysis. The multivariable-adjusted hazard ratio (HR) was used for calculating the relationship between SII and CAR and overall survival (OS), and the odds ratio (OR) was applied for the clinical pathology. Results: Five original studies for SII and seven original datasets for CAR were included for analysis. Increased SII showed a significant association with shorter OS in EC patients after surgery (HR: 1.34, 95% CI: 1.15–1.53, P <0.001) and high CAR indicated worse long-term OS in EC (HR: 1.60, 95% CI: 1.29–1.90, P <0.001). Different subgroup analyses were also confirmed the prognostic roles in EC patients. Furthermore, the adverse impacts of elevated SII and CAR on tumor progression were revealed in the infiltration depth, lymph node metastasis, and clinical stage. Conclusions: Both pretreatment SII and CAR might be promising predictors of cancer survival and tumor progression in EC. Further studies are warranted to verify the clinical usefulness in patients with EC.

Prognostic prediction of systemic immune-inflammation index for patients with gynecological and breast cancers: a meta-analysis

“…Thus, SII may be effective to reflect the inflammatory status which is an important mechanism for the development of cancers and may be an underlying biomarker for prognosis prediction. This hypothesis had been demonstrated in meta-analyses on lung cancer [23,24], esophageal cancer [25], gastrointestinal cancers [26], hepatocellular carcinoma [27], and several other cancer types [28,29]. All these meta-analyses showed that increased SII predicted poor prognostic outcomes for patients with cancers.…”

Predictive value of C-reactive protein to albumin ratio as a biomarker for initial and repeated intravenous immunoglobulin resistance in a large cohort of Kawasaki disease patients: a prospective cohort study

“…However, both previous studies [29,30] and ours [31] documented that the predictive values of serum CRP and ALB as a single marker for initial IVIG resistance were not ideal. Notably, CAR as a ratio of CRP to ALB initially proposed by Fairclough [48], has been widely demonstrated to be more valuable and accurate than either CRP or ALB alone, providing a variable capable of merging information in the prediction of the systemic inflammatory state and prognosis in adverse cardiovascular events, cancers, inflammatory bowel disease, arteritis and critically ill septic patients [32][33][34][35][36][37][38][39][40][48][49][50][51]. In almost previous studies, CAR performed better predictive ability than either CRP or ALB alone, nonetheless, Cagdas et al found that CAR had better predictive accuracy than CRP but was not superior to ALB [52].…”

Prognostic Value of Pretreatment Systemic Immune-Inflammation Index in Gastric Cancer: A Meta-Analysis

“…Examples include neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), lymphocyte-monocyte ratio (LMR), and systemic immune-inflammation index (SII) (8)(9)(10)(11)(12)(13). SII, which is calculated as platelet count × neutrophil count/lymphocyte count, has been recently shown to have a powerful prognostic value in several tumors including lung cancer (14), esophageal cancer (15), colorectal cancer (16), and hepatocellular carcinoma (17). Previous studies have also investigated the prognostic impact of SII on GC, but the results have been inconsistent (12,13,(18)(19)(20)(21)(22)(23).…”