Niu Zuo-Hu, Lin Li, Peng Hong-Ye, Zheng Xin-Zhuo, Wang Mi-Yuan, Sun Feng-Xia, Xu Chun-Jun
Department of Infections, Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China.
BMC Gastroenterol. 2025 Jan 24;25(1):34. doi: 10.1186/s12876-025-03635-2.
Digestive system carcinomas (DSC) constitute a significant proportion of solid tumors, with incidence rates rising steadily each year. The systemic inflammation response index (SIRI) has been identified as a potential prognostic marker for survival in various types DSC. This meta-analysis aimed to evaluate the prognostic value of SIRI in patients with DSC.
We conducted a comprehensive literature search of PubMed, Web of Science Core Collection, Embase, and Cochrane Library databases, searching for studies published from inception to May 30, 2023. Eligible studies included cohort studies that assessed the association between pre-treatment SIRI levels and DSC prognosis. We extracted and synthesized hazard ratios (HRs) and 95% confidence intervals (CIs) using STATA/SE 12.0, stratifying HRs based on univariable and multivariable analysis. Due to substantial heterogeneity, we applied a random-effect model for all pooled analyses. The primary outcome of interest was the overall survival (OS), while secondary outcomes included progression-free survival (PFS), disease-free survival (DFS), time to progression (TTP), and disease specific survival (DSS). Publication bias was evaluated using Begg's test and Egger's tests.
A total of 34 cohort studies encompassing 9628 participants were included in this meta-analysis. Notable heterogeneity was observedin the OS (I = 76.5%, p < 0.001) and PFS (I = 82.8%, p = 0.001) subgroups, whereas no significant heterogeneity was detected in the DFS, TTP, and DSS subgroups. Elevated SIRI was found to be significantly associated with shorter OS (HR = 1.98, 95% CI: 1.70-2.30, tau = 0.0966) and poorer PFS (HR = 2.36, 95% CI: 1.58-3.53, tau = 0.1319), DFS (HR = 1.80, 95% CI: 1.61-2.01, tau < 0.0001), TTP (HR = 2.03, 95% CI: 1.47-2.81, tau = 0.0232), and DSS (HR = 1.99, 95% CI: 1.46-2.72, tau < 0.0001). Furthermore, an increase in SIRI following treatment was linked to reduced OS, TTP, and DFS, while a decrease in SIRI post-treatment corresponded with improved OS, TTP, and DFS compared to baseline levels.
Elevated SIRI is associated with poorer clinical outcomes in patients with DSC. This index may serve as a valuable prognostic biomarker, offering a promising tool for predicting survival in DSC patients.
REGISTRATION NUMBER: CRD42023430962.
消化系统癌（DSC）在实体瘤中占相当大的比例，且发病率逐年稳步上升。全身炎症反应指数（SIRI）已被确定为各类DSC患者生存的潜在预后标志物。本荟萃分析旨在评估SIRI在DSC患者中的预后价值。
我们对PubMed、Web of Science核心合集、Embase和Cochrane图书馆数据库进行了全面的文献检索，检索从数据库建立至2023年5月30日发表的研究。符合条件的研究包括评估治疗前SIRI水平与DSC预后之间关联的队列研究。我们使用STATA/SE 12.0提取并综合危险比（HR）和95%置信区间（CI），根据单变量和多变量分析对HR进行分层。由于存在显著异质性，我们对所有汇总分析应用随机效应模型。主要关注的结局是总生存期（OS），次要结局包括无进展生存期（PFS）、无病生存期（DFS）、进展时间（TTP）和疾病特异性生存期（DSS）。使用Begg检验和Egger检验评估发表偏倚。
本荟萃分析共纳入34项队列研究，涉及9628名参与者。在OS（I² = 76.5%，p < 0.001）和PFS（I² = 82.8%，p = 0.001）亚组中观察到显著异质性，而在DFS、TTP和DSS亚组中未检测到显著异质性。发现SIRI升高与较短的OS（HR = 1.98，95% CI：1.70 - 2.30，tau = 0.0966）、较差的PFS（HR = 2.36，95% CI：1.58 - 3.53，tau = 0.1319）、DFS（HR = 1.80，95% CI：1.61 - 2.01，tau < 0.0001）、TTP（HR = 2.03，95% CI：1.
