背景:来自血细胞计数的预后评分作为癌症炎症压力的间接测量引起了人们的极大兴趣。最近开发的泛免疫炎症值(PIV),包括中性粒细胞的方程,血小板,单核细胞,和淋巴细胞水平,已经在几个队列中进行了评估,尽管随着肿瘤类型的变化,疾病阶段,截止日期,和治疗。因此,我们评估了癌症患者生存率和PIV之间的关系,进行系统评价和荟萃分析。方法:我们从Pubmed,Medline,和Embase数据库来过滤已发表的研究,直到2022年5月17日。荟萃分析是使用随机效应模型的通用逆方差方法进行的。结果:共纳入15项研究,包括4942例患者。在对15项研究的汇总分析中,与PIV水平较低的患者相比,PIV水平较高的患者死亡风险显著增加(HR:2.00,95%CI:1.51-2.64,p<0.001),进展或死亡风险增加(HR:1.80,95%CI:1.39-2.32,p<0.001).在几个临床场景中的分析是一致的,包括非转移性或转移性疾病,不同的截止值(500、400和300),以及靶向治疗或免疫疗法治疗(各p<0.001)。结论:现有证据表明,PIV可能是癌症的预后生物标志物。然而,在非转移性疾病患者或未接受免疫治疗或靶向治疗的患者中,需要进一步的研究来探索PIV作为预后生物标志物的前景.
Background: Prognostic scores derived from the blood count have garnered significant interest as an indirect measure of the inflammatory pressure in cancer. The recently developed pan-immune-inflammation value (PIV), an equation including the neutrophil, platelet, monocyte, and lymphocyte levels, has been evaluated in several cohorts, although with variations in the tumor types, disease stages, cut-offs, and treatments. Therefore, we evaluated the association between survival and PIV in cancer, performing a systematic
review and meta-analysis. Methods: We conducted a systematic
review from the Pubmed, Medline, and Embase databases to filter the published studies until 17 May 2022. The meta-analyses were performed with the generic inverse-variance method with a random-effects model. Results: Fifteen studies encompassing 4942 patients were included. In the pooled analysis of fifteen studies, the patients with higher PIV levels had significantly increased risk of death than those with lower PIV levels (HR: 2.00, 95% CI: 1.51−2.64, p < 0.001) and increased risk of progression or death (HR: 1.80, 95% CI: 1.39−2.32, p < 0.001). Analyses were consistent across several clinical scenarios, including non-metastatic or metastatic disease, different cut-offs (500, 400, and 300), and treatment with targeted therapy or immunotherapy (p < 0.001 for each). Conclusion: The available evidence demonstrates that PIV could be a prognostic biomarker in cancer. However, further research is needed to explore the promise of PIV as a prognostic biomarker in patients with non-metastatic disease or patients treated without immunotherapy or targeted therapy.