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C反应蛋白、白蛋白和淋巴细胞指数在预测胃肠道恶性肿瘤患者生存率中的价值：一项系统评价和荟萃分析

Value of CRP, albumin, and lymphocyte index in predicting survival of patients with gastrointestinal malignancies: a systematic review and meta-analysis.

作者信息

Li Hui, Mo Zhaozhao, Tong Guojun

机构信息

Department of Anorectal Surgery, Huzhou Central Hospital, Affiliated Central Hospital of HuZhou University, Huzhou, Zhejiang, China.

出版信息

Front Oncol. 2025 Jul 16;15:1592794. doi: 10.3389/fonc.2025.1592794. eCollection 2025.

DOI:10.3389/fonc.2025.1592794
PMID:40740873
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12307156/
Abstract

BACKGROUND

We conducted this systematic review to present high-quality evidence on the prognostic ability of CRP, albumin, and lymphocyte (CALLY) index for gastrointestinal (GI) malignancies.

METHODS

PubMed, Embase, Scopus, Web of Science, and Wanfang databases were searched till 15 January 2025 for studies reporting the prognostic ability of CALLY for all GI malignancies. Hazard ratios (HR) were pooled in a random-effect model for overall survival (OS) and progression-free survival (PFS).

RESULTS

18 studies were included. CALLY index was found to be a significant predictor of poor OS (HR: 1.89 95% CI: 1.720, 2.077 I = 12%) and PFS (HR: 1.617 95% CI: 1.444, 1.809 I = 1%) in GI malignancies. Low CALLY was a significant predictor of OS in pancreatic cancer (HR: 1.772 95% CI: 1.279, 2.456), cholangiocarcinoma (HR: 2.07 95% CI: 1.106, 3.875), colorectal liver metastasis (HR: 1.67 95% CI: 1.032, 2.702), gastric cancer (HR: 1.884 95% CI: 1.606, 2.210 I = 15%), colorectal cancer (HR: 2.284 95% CI: 1.737, 3.004 I = 0%), hepatocellular cancer (HR: 1.649 95% CI: 1.308, 2.079 I = 0%), and esophageal cancer (HR: 2.133 95% CI: 1.607, 2.831 I = 62%). Likewise, low CALLY was associated with worse PFS in pancreatic cancer (HR: 1.289 95% CI: 1.006, 1.652), esophageal cancer (HR: 2.171 95% CI: 1.543, 3.056 I = 0%), hepatocellular cancer (HR: 1.468 95% CI: 1.195, 1.801 I = 0%), gastric cancer (HR: 1.904 95% CI: 1.539, 2.356 I = 0%) and cholangiocarcinoma (HR: 2.13 95% CI: 1.163, 3.902). Random-effect meta-regression using sample size, age, male gender, TNM stage III/IV, lymph node metastasis, CALLY cut-off, low CALLY percentage, and follow-up as moderators were non-significant.

CONCLUSIONS

CALLY can be a simple and easy-to-use prognostic marker for GI malignancies. Further research is needed to decipher its role in specific GI malignancies and improve the quality of evidence.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/prospero/, identifier CRD42025636999.

摘要

背景

我们进行了这项系统评价，以提供关于C反应蛋白（CRP）、白蛋白和淋巴细胞（CALLY）指数对胃肠道（GI）恶性肿瘤预后评估能力的高质量证据。

方法

检索了PubMed、Embase、Scopus、Web of Science和万方数据库，直至2025年1月15日，以查找报告CALLY对所有GI恶性肿瘤预后评估能力的研究。采用随机效应模型汇总总生存期（OS）和无进展生存期（PFS）的风险比（HR）。

结果

纳入18项研究。发现CALLY指数是GI恶性肿瘤患者OS不良（HR：1.89，95%CI：1.720，2.077，I=12%）和PFS不良（HR：1.617，95%CI：1.444，1.809，I=1%）的显著预测指标。低CALLY是胰腺癌（HR：1.772，95%CI：1.279，2.456）、胆管癌（HR：2.07，95%CI：1.106，3.875）、结直肠癌肝转移（HR：1.67，95%CI：1.032，2.702）、胃癌（HR：1.884，95%CI：1.606，2.210，I=15%）、结直肠癌（HR：2.284，95%CI：1.737，3.004，I=0%）、肝细胞癌（HR：1.649，95%CI：1.308，2.079，I=0%）和食管癌（HR：2.133，95%CI：1.607，2.831，I=62%）患者OS的显著预测指标。同样，低CALLY与胰腺癌（HR：1.289，95%CI：1.006，1.652）、食管癌（HR：2.171，95%CI：1.543，3.056，I=0%）、肝细胞癌（HR：1.468，95%CI：1.195，1.801，I=0%）、胃癌（HR：1.904，95%CI：1.539，2.356，I=0%）和胆管癌（HR：2.13，95%CI：1.163，3.902）患者较差的PFS相关。以样本量、年龄、男性、TNM III/IV期、淋巴结转移、CALLY临界值、低CALLY百分比和随访作为调节因素的随机效应meta回归无显著性差异。

结论

CALLY可作为GI恶性肿瘤一种简单易用的预后标志物。需要进一步研究以阐明其在特定GI恶性肿瘤中的作用并提高证据质量。

系统评价注册

https://www.crd.york.ac.uk/prospero/，标识符CRD42025636999。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b5d/12307156/32f41c345fb5/fonc-15-1592794-g007.jpg
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