The prognostic value of systemic inflammation response index in digestive system carcinomas: a systematic review and meta-analysis

Abstract Background 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...

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Main Authors: Zuo-hu Niu, Li Lin, Hong-ye Peng, Xin-zhuo Zheng, Mi-yuan Wang, Feng-xia Sun, Chun-jun Xu
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Gastroenterology
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Online Access:https://doi.org/10.1186/s12876-025-03635-2
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author Zuo-hu Niu
Li Lin
Hong-ye Peng
Xin-zhuo Zheng
Mi-yuan Wang
Feng-xia Sun
Chun-jun Xu
author_facet Zuo-hu Niu
Li Lin
Hong-ye Peng
Xin-zhuo Zheng
Mi-yuan Wang
Feng-xia Sun
Chun-jun Xu
author_sort Zuo-hu Niu
collection DOAJ
description Abstract Background 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. Methods 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. Results A total of 34 cohort studies encompassing 9628 participants were included in this meta-analysis. Notable heterogeneity was observedin the OS (I 2 = 76.5%, p < 0.001) and PFS (I 2 = 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, tau2 = 0.0966) and poorer PFS (HR = 2.36, 95% CI: 1.58–3.53, tau2 = 0.1319), DFS (HR = 1.80, 95% CI: 1.61–2.01, tau2 < 0.0001), TTP (HR = 2.03, 95% CI: 1.47–2.81, tau2 = 0.0232), and DSS (HR = 1.99, 95% CI: 1.46–2.72, tau2 < 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. Conclusions 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. PROSPERO: registration number CRD42023430962
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spelling doaj-art-babda6e517ec42aa80e89479db659c2e2025-01-26T12:36:24ZengBMCBMC Gastroenterology1471-230X2025-01-0125111610.1186/s12876-025-03635-2The prognostic value of systemic inflammation response index in digestive system carcinomas: a systematic review and meta-analysisZuo-hu Niu0Li Lin1Hong-ye Peng2Xin-zhuo Zheng3Mi-yuan Wang4Feng-xia Sun5Chun-jun Xu6Department of Infections, Beijing Hospital of Traditional Chinese Medicine, Capital Medical UniversityBeijing Hospital of Traditional Chinese Medicine, Capital Medical UniversityGraduate School, Beijing University of Chinese MedicineGraduate School, Beijing University of Chinese MedicineSchool of Management, Beijing University of Chinese medicineDepartment of Infections, Beijing Hospital of Traditional Chinese Medicine, Capital Medical UniversityDepartment of Infections, Beijing Hospital of Traditional Chinese Medicine, Capital Medical UniversityAbstract Background 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. Methods 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. Results A total of 34 cohort studies encompassing 9628 participants were included in this meta-analysis. Notable heterogeneity was observedin the OS (I 2 = 76.5%, p < 0.001) and PFS (I 2 = 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, tau2 = 0.0966) and poorer PFS (HR = 2.36, 95% CI: 1.58–3.53, tau2 = 0.1319), DFS (HR = 1.80, 95% CI: 1.61–2.01, tau2 < 0.0001), TTP (HR = 2.03, 95% CI: 1.47–2.81, tau2 = 0.0232), and DSS (HR = 1.99, 95% CI: 1.46–2.72, tau2 < 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. Conclusions 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. PROSPERO: registration number CRD42023430962https://doi.org/10.1186/s12876-025-03635-2GastroenterologyOncologyPrognosis
spellingShingle Zuo-hu Niu
Li Lin
Hong-ye Peng
Xin-zhuo Zheng
Mi-yuan Wang
Feng-xia Sun
Chun-jun Xu
The prognostic value of systemic inflammation response index in digestive system carcinomas: a systematic review and meta-analysis
BMC Gastroenterology
Gastroenterology
Oncology
Prognosis
title The prognostic value of systemic inflammation response index in digestive system carcinomas: a systematic review and meta-analysis
title_full The prognostic value of systemic inflammation response index in digestive system carcinomas: a systematic review and meta-analysis
title_fullStr The prognostic value of systemic inflammation response index in digestive system carcinomas: a systematic review and meta-analysis
title_full_unstemmed The prognostic value of systemic inflammation response index in digestive system carcinomas: a systematic review and meta-analysis
title_short The prognostic value of systemic inflammation response index in digestive system carcinomas: a systematic review and meta-analysis
title_sort prognostic value of systemic inflammation response index in digestive system carcinomas a systematic review and meta analysis
topic Gastroenterology
Oncology
Prognosis
url https://doi.org/10.1186/s12876-025-03635-2
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