Rezazadeh Mohammad, Kamyabi Amirreza, Pisheh Ramtin Ghamkhari, Noroozie Sahar, Amiri Bahareh Shateri, Negahi Alireza, Radkhah Hanieh
Student Research Committee, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Department of Internal Medicine, School of Medicine, Hazrat-E Rasool General Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran.
BMC Gastroenterol. 2025 Mar 3;25(1):127. doi: 10.1186/s12876-025-03681-w.
Colorectal cancer (CRC) ranks as the third most prevalent cancer globally and the second leading cause of cancer-related mortality. This study investigates the diagnostic value of peripheral blood inflammatory indices, including the Cancer-Inflammation Prognostic Index (CIPI), Systemic Inflammation Response Index (SIRI), Hemoglobin-Albumin-Lymphocyte-Platelet (HALP) index, Neutrophil-to-Lymphocyte Ratio (NLR), and Platelet-to-Lymphocyte Ratio (PLR), in the early diagnosis of clinicopathological characteristics of CRC.
This retrospective observational study involved 224 patients with CRC aged over 45, admitted to Rasoul-Akram Hospital from September 2019 to 2023, undergoing elective CRC surgery. Key demographic and clinicopathological data were collected alongside blood samples to derive inflammatory indices. Univariate and multivariate analyses were applied to determine metastasis and stage predictors. A receiver operating characteristic (ROC) analysis was performed to evaluate the SIRI diagnostic value in differentiating tumors with and without metastasis and the CIPI diagnostic value in differentiating tumors with high and low stage.
The study identified a significant association between elevated SIRI levels and metastasis in univariate analysis (OR = 2.79, CI = 1.12-6.94). Multivariate analysis shows CIPI is associated with advanced tumor stages (OR = 1.97, CI = 1.14-3.38). According to the ROC curve, the optimal cut-off value of SIRI and CIPI was 1.376 (sensitivity 52.6%, specificity 60.8%, AUC = 61.5%) for diagnosing the metastasis and 7.114 (sensitivity 59.8%, specificity 57%, AUC = 57.9%) for diagnosing the tumor stage, respectively.
The findings show that a higher SIRI value is associated with a higher chance of metastasis and a higher CIPI value is associated with a higher chance of advanced stages. Furthermore, the study advocates for the integration of these inflammatory indices into clinical practice to facilitate personalized treatment strategies and early diagnosis, enhancing the prognosis and survival in CRC.
结直肠癌（CRC）是全球第三大常见癌症，也是癌症相关死亡的第二大主要原因。本研究调查外周血炎症指标，包括癌症-炎症预后指数（CIPI）、全身炎症反应指数（SIRI）、血红蛋白-白蛋白-淋巴细胞-血小板（HALP）指数、中性粒细胞与淋巴细胞比值（NLR）以及血小板与淋巴细胞比值（PLR），在结直肠癌临床病理特征早期诊断中的价值。
这项回顾性观察研究纳入了2019年9月至2023年期间入住拉苏勒-阿克拉姆医院、年龄超过45岁、接受择期结直肠癌手术的224例结直肠癌患者。收集关键的人口统计学和临床病理数据以及血样以得出炎症指标。应用单因素和多因素分析来确定转移和分期预测因素。进行受试者工作特征（ROC）分析，以评估SIRI在区分有无转移肿瘤方面的诊断价值以及CIPI在区分高分期和低分期肿瘤方面的诊断价值。
该研究在单因素分析中发现SIRI水平升高与转移之间存在显著关联（OR = 2.79，CI = 1.12 - 6.94）。多因素分析显示CIPI与肿瘤晚期相关（OR = 1.97，CI = 1.14 - 3.38）。根据ROC曲线，SIRI诊断转移的最佳截断值为1.376（敏感性52.6%，特异性60.8%，AUC = 61.5%），CIPI诊断肿瘤分期的最佳截断值为7.114（敏感性59.8%，特异性57%，AUC = 57.9%）。
研究结果表明，较高的SIRI值与较高的转移几率相关，较高的CIPI值与较高的晚期几率相关。此外，该研究主张将这些炎症指标整合到临床实践中，以促进个性化治疗策略和早期诊断，改善结直肠癌的预后和生存率。
