Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
World Journal of Surgical Oncology
Published in: World Journal of Surgical Oncology 1/2019

Open Access 01-12-2019 | NSCLC | Research

Prognostic role of the advanced lung cancer inflammation index in cancer patients: a meta-analysis

Authors: Xin Hua, Jing Chen, Ying Wu, Jun Sha, Shuhua Han, Xiaoli Zhu

Published in: World Journal of Surgical Oncology | Issue 1/2019

Login to get access

Abstract

Background

Inflammation plays a critical role in the development and progression of cancers. The advanced lung cancer inflammation index (ALI) is thought to be able to reflect systemic inflammation better than current biomarkers. However, the prognostic significance of the ALI in various types of cancer remains unclear. Our meta-analysis aimed to comprehensively investigate the relationship between the ALI and oncologic outcomes to help physicians better assess the prognosis of cancer patients.

Methods

The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, and Wanfang databases were searched for relevant studies. Hazard ratios (HRs) with 95% confidence intervals (95% CIs) were calculated and pooled from the included studies. Furthermore, a sensitivity analysis was performed to evaluate the reliability of the articles. Finally, Begg’s test, Egger’s test, and the funnel plot were applied to assess the significance of publication bias.

Results

In total, 1736 patients from nine studies were included in our meta-analysis. The median cutoff value for the ALI was 23.2 (range, 15.5–37.66) in the analyzed studies. The meta-analysis showed that there was a statistically significant relationship between a low ALI and worse overall survival (OS) in various types of cancer (HR = 1.70, 95% CI = 1.41–1.99, P < 0.001). Moreover, results from subgroup meta-analysis showed that the ALI had a significant prognostic value in non-small cell lung cancer, small cell lung cancer, colorectal cancer, head and neck squamous cell carcinoma, and diffuse large B cell lymphoma (P < 0.05 for all).

Conclusions

These results showed that a low ALI was associated with poor OS in various types of cancer, and the ALI could act as an effective prognostic biomarker in cancer patients.
Appendix
Available only for authorised users
Literature
1.
Rebecca L, Siegel MPH, Kimberly D, Ahmedin J. Cancer statistics, 2019. CA Cancer J Clin. 2019;69(1):7–34.CrossRef
2.
Ferlay J, Colombet M, Soerjomataram I, Mathers C, Parkin DM, Piñeros M, Znaor A, Bray F. Estimating the global cancer incidence and mortality in 2018: GLOBOCAN sources and methods. Int J Cancer. 2019;144(8):1941–53.PubMedCrossRef
3.
Piao J, Zhu L, Sun J, Li N, Dong B, Yang Y, Chen L. High expression of CDK1 and BUB1 predicts poor prognosis of pancreatic ductal adenocarcinoma. Gene. 2019;701:15–22.PubMedCrossRef
4.
Zhang Y, Chen B, Wang L, Wang R, Yang X. Systemic immune-inflammation index is a promising noninvasive marker to predict survival of lung cancer: a meta-analysis. Medicine (Baltimore). 2019;98(3):13788.CrossRef
5.
Abbas M, Habib M, Naveed M, Karthik K, Dhama K, Shi M, Dingding C. The relevance of gastric cancer biomarkers in prognosis and pre- and post- chemotherapy in clinical practice. Biomed Pharmacother. 2017;95:1082–90.PubMedCrossRef
6.
Elinav E, Nowarski R, Thaiss CA, Hu B, Jin C, Flavell RA. Inflammation-induced cancer: crosstalk between tumours, immune cells and microorganisms. Nat Rev Cancer. 2013;13:759–71.CrossRefPubMed
7.
8.
Diakos CI, Charles KA, McMillan DC, Clarke SJ. Cancer-related inflammation and treatment effectiveness. Lancet Oncol. 2014;15(11):493–503.CrossRef
9.
10.
Minardi D, Scartozzi M, Montesi L, Santoni M, Burattini L, Bianconi M, Lacetera V, Milanese G, Cascinu S, Muzzonigro G. Neutrophil-to-lymphocyte ratio may be associated with the outcome in patients with prostate cancer. Springerplus. 2015;4:255.PubMedPubMedCentralCrossRef
11.
Tang H, Lu W, Li B, Li C, Xu Y, Dong J. Prognostic significance of neutrophil-to-lymphocyte ratio in biliary tract cancers: a systematic review and meta-analysis. Oncotarget. 2017;8(22):36857–68.PubMedPubMedCentralCrossRef
12.
Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454(7203):436–44.CrossRefPubMed
13.
Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet. 2001;357(9255):539–45.PubMedCrossRef
14.
Wang Z, Zhan P, Lv Y. Prognostic role of pretreatment neutrophil-to-lymphocyte ratio in non-small cell lung cancer patients treated with systemic therapy: a meta-analysis. Transl Lung Cancer Res. 2019;8(3):214–26.PubMedPubMedCentralCrossRef
15.
16.
17.
McMillan DC. Systemic inflammation, nutritional status and survival in patients with cancer. Curr Opin Clin Nutr Metab Care. 2009;12(3):223–6.PubMedCrossRef
18.
Cole CL, Kleckner IR, Jatoi A, Schwarz EM, Dunne RF. The role of systemic inflammation in cancer-associated muscle wasting and rationale for exercise as a therapeutic intervention. JCSM Clin Rep. 2018;3(2):e00065.PubMedPubMedCentral
19.
Kim EY, Kim YS, Seo JY, Park I, Ahn HK, Jeong YM, Kim JH, Kim N. The relationship between sarcopenia and systemic inflammatory response for cancer cachexia in small cell lung cancer. PLoS One. 2016;11(8):161125.
20.
Kim EY, Kim YS, Park I, Ahn HK, Cho EK, Jeong YM. Prognostic significance of CT-determined sarcopenia in patients with small-cell lung cancer. J Thorac Oncol. 2015;10(12):1795–9.PubMedCrossRef
21.
Min KK, Chul JH, Soo L. Differences among skeletal muscle mass indices derived from height-, weight-, and body mass index-adjusted models in assessing sarcopenia. Korean J Intern Med. 2016;31(4):643–50.CrossRef
22.
Oki S, Toiyama Y, Okugawa Y, Shimura T, Okigami M, Yasuda H, Fujikawa H, Okita Y, Yoshiyama S, Hiro J, Kobayashi M, Ohi M, Araki T, Inoue Y, Mohri Y, Kusunoki M. Clinical burden of preoperative albumin-globulin ratio in esophageal cancer patients. Am J Surg. 2017;214(5):891–8.PubMedCrossRef
23.
Yamashita K, Ushiku H, Katada N, Hosodaa K, Moriyaa H, Mienoa H, Kikuchia S, Hoshib K, Watanabea M. Reduced preoperative serum albumin and absence of peritoneal dissemination may be predictive factors for long-term survival with advanced gastric cancer with positive cytology test. Eur J Surg Oncol. 2015;41:1324–32.PubMedCrossRef
24.
Lai CC, You JF, Yeh CY, Chen JS, Tang R, Wang JY, Chin CC. Low preoperative serum albumin in colon cancer: a risk factor for poor outcome. Int J Color Dis. 2011;26(4):473–81.CrossRef
25.
Jafri SH, Shi R, Mills G. Advance lung cancer inflammation index (ALI) at diagnosis is a prognostic marker in patients with metastatic non-small cell lung cancer (NSCLC): a retrospective review. BMC Cancer. 2013;13:158.PubMedPubMedCentralCrossRef
26.
Tierney JF, Stewart LA, Ghersi D, Burdett S, Sydes MR. Practical methods for incorporating summary time-to-event data into meta-analysis. Trials. 2007;8:16.PubMedPubMedCentralCrossRef
27.
Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010;25(9):603–5.PubMedCrossRef
28.
Asimit J, Day-Williams A, Zgaga L, Rudan I, Boraska V, Zeggini E. An evaluation of different meta-analysis approaches in the presence of allelic heterogeneity. Eur J Hum Genet. 2012;20(6):709–12.PubMedPubMedCentralCrossRef
29.
He X, Zhou T, Yang Y, Hong S, Zhan J, Hu Z, Fang W, Qin T, Ma Y, Zhao Y, Cheng Z, Huang Y, Zhao H, Yang G, Zhang L. Advanced lung cancer inflammation index, a new prognostic score, predicts outcome in patients with small-cell lung cancer. Clin Lung Cancer. 2015;16(6):165–71.CrossRef
30.
Kim EY, Kim N, Kim YS, Seo JY, Park I, Ahn HK, Jeong YM, Kim JH. Prognostic significance of modified advanced lung cancer inflammation index (ALI) in patients with small cell lung cancer_ comparison with original ALI. PLoS One. 2016;11(10):164056.
31.
Park YH, Yi HG, Lee MH, Kim CS, Lim JH. Prognostic value of the pretreatment advanced lung cancer inflammation index (ALI) in diffuse large b cell lymphoma patients treated with R-CHOP chemotherapy. Acta Haematol. 2017;137(2):76–85.PubMedCrossRef
32.
Bacha S, Sghaier A, Habibech S, Cheikhrouhou S, Racil H, Chaouch N, Chabbou A, Megdiche ML. Advanced lung cancer inflammation index: a prognostic score in patients with metastatic non-small cell lung cancer. Tunis Med. 2017;95(11):976–81.PubMed
33.
34.
Tomita M, Ayabe T, Maeda R, Nakamura K. Comparison of inflammation-based prognostic scores in patients undergoing curative resection for non-small cell lung cancer. World J Oncol. 2018;9(3):85–90.PubMedPubMedCentralCrossRef
35.
Shibutani M, Maeda K, Nagahara H, Fukuoka T, Matsutani S, Kimura K, Amano R, Hirakawa K, Ohira M. The prognostic significance of the advanced lung cancer inflammation index in patients with unresectable metastatic colorectal cancer: a retrospective study. BMC Cancer. 2019;19(1):241.PubMedPubMedCentralCrossRef
36.
37.
38.
Semeniuk-Wojtaś A, Lubas A, Stec R, Syryło T, Niemczyk S, Szczylik C. Neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and C-reactive protein as new and simple prognostic factors in patients with metastatic renal cell cancer treated with tyrosine kinase inhibitors: a systemic review and meta-analysis. Clin Genitourin Cancer. 2018;16(3):685–93.CrossRef
39.
Li W, Luo X, Liu Z, Chen Y, Li Z. Prognostic value of C-reactive protein levels in patients with bone neoplasms: a meta-analysis. PLoS One. 2018;13(4):195769.
40.
Yang X, Liu H, He M, Liu M, Zhou G, Gong P, Ma J, Wang Q, Xiong W, Ren Z, Li X, Zhang X. Prognostic value of pretreatment C-reactive protein/albumin ratio in nasopharyngeal carcinoma: a meta-analysis of published literature. Medicine (Baltimore). 2018;97(30):11574.CrossRef
41.
Szor DJ, Dias AR, Pereira MA, Ramos MFKP, Zilberstein B, Cecconello I, Júnior RU. Prognostic role of neutrophil/lymphocyte ratio in resected gastric cancer: a systematic review and meta-analysis. Clinics (Sao Paulo). 2018;73:360.CrossRef
42.
Chua W, Charles KA, Baracos VE, Clarke SJ. Neutrophil/lymphocyte ratio predicts chemotherapy outcomes in patients with advanced colorectal cancer. Br J Cancer. 2011;104(8):1288–95.PubMedPubMedCentralCrossRef
43.
Kishi Y, Kopetz S, Chun YS, Palavecino M, Abdalla EK, Vauthey JN. Blood neutrophil-to-lymphocyte ratio predicts survival in patients with colorectal liver metastases treated with systemic chemotherapy. Ann Surg Oncol. 2009;16(3):614–22.PubMedCrossRef
44.
Raungkaewmanee S, Tangjitgamol S, Manusirivithaya S, Srijaipracharoen S, Thavaramara T. Platelet to lymphocyte ratio as a prognostic factor for epithelial ovarian cancer. J Gynecol Oncol. 2012;23(4):265–73.PubMedPubMedCentralCrossRef
45.
Smith RA, Bosonnet L, Raraty M, Sutton R, Neoptolemos JP, Campbell F, Ghaneh P. Preoperative platelet-lymphocyte ratio is an independent significant prognostic marker in resected pancreatic ductal adenocarcinoma. Am J Surg. 2009;197(4):466–72.PubMedCrossRef
46.
Lu X, Guo W, Xu W, Zhang X, Shi Z, Zheng L, Zhao W. Prognostic value of the Glasgow prognostic score in colorectal cancer: a meta-analysis of 9,839 patients. Cancer Manag Res. 2018;11:229–49.PubMedPubMedCentralCrossRef
47.
Liu Y, He X, Pan J, Chen S, Wang L. Prognostic role of Glasgow prognostic score in patients with colorectal cancer: evidence from population studies. Sci Rep. 2017;7(1):6144.PubMedPubMedCentralCrossRef
48.
Yang R, Chang Q, Meng X, Gao N, Wang W. Prognostic value of systemic immune-inflammation index in cancer: a meta-analysis. J Cancer. 2018;9(18):3295–302.PubMedPubMedCentralCrossRef
49.
Zhong JH, Huang DH, Chen ZY. Prognostic role of systemic immune-inflammation index in solid tumors: a systematic review and meta-analysis. Oncotarget. 2017;8(43):75381–8.PubMedPubMedCentral
50.
Millan DC, Watson WS, O'Gorman P, Preston T, Scott HR, McArdle CS. Albumin concentrations are primarily determined by the body cell mass and the systemic inflammatory response in cancer patients with weight loss. Nutr Cancer. 2001;39:210–3.CrossRef
51.
Don BR, Kaysen G. Serum albumin: relationship to inflammation and nutrition. Semin Dial. 2004;17(6):432–7.
52.
Scott HR, McMillan DC, Forrest LM. The systemic inflammatory response, weight loss, performance status and survival in patients with inoperable non-small cell lung cancer. BJC. 2002;87:264–7.PubMedCrossRefPubMedCentral
53.
Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J. 2010;9:69.PubMedPubMedCentralCrossRef
54.
Han J, Zhou Y, Zheng Y, Wang M, Cui J, Chen P, Yu J. Positive effect of higher adult body mass index on overall survival of digestive system cancers except pancreatic cancer: a systematic review and meta-analysis. Biomed Res Int. 2017;2017:1049602.
55.
Ozyurek BA, Ozdemirel TS, Ozden SB, Erdoğan Y, Ozmen O, Kaplan B, Kaplan T. Does advanced lung inflammation index (ALI) have prognostic significance in metastatic non-small cell lung cancer? Clin Respir J. 2018;12(6):2013–9.PubMedCrossRef
56.
Tomita M, Ayabe T, Nakamura K. The advanced lung cancer inflammation index is an independent prognostic factor after surgical resection in patients with non-small-cell lung cancer. Interact Cardiovasc Thorac Surg. 2018;26(2):288–92.PubMedCrossRef
57.
Feng JF, Huang Y, Chen QX. A new inflammation index is useful for patients with esophageal squamous cell carcinoma. Onco Targets Ther. 2014;7:1811–185.PubMedPubMedCentralCrossRef
58.
Vano YA, Oudard S, By MA, Têtu P, Thibault C, Aboudagga H, Scotté F, Elaidi R. Optimal cut-off for neutrophil-to-lymphocyte ratio: fact or fantasy? A prospective cohort study in metastatic cancer patients. PLoS One. 2018;13(4):195042.CrossRef
59.
Ikeda S, Yoshioka H, Ikeo S, Morita M, Sone N, Niwa T, Nishiyama A, Yokoyama T, Sekine A, Ogura T, Ishida T. Serum albumin level as a potential marker for deciding chemotherapy or best supportive care in elderly, advanced non-small cell lung cancer patients with poor performance status. BMC Cancer. 2017;17:797.PubMedPubMedCentralCrossRef
60.
Greenlee H, Unger JM, LeBlanc M, Ramsey S, Hershman DL. Association between body mass index (BMI) and cancer survival in a pooled analysis of 22 clinical trials. Cancer Epidemiol Biomark Prev. 2017;26(1):21–9.CrossRef
Metadata
Title
Prognostic role of the advanced lung cancer inflammation index in cancer patients: a meta-analysis
Authors
Xin Hua
Jing Chen
Ying Wu
Jun Sha
Shuhua Han
Xiaoli Zhu
Publication date
01-12-2019
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2019
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/s12957-019-1725-2

Other articles of this Issue 1/2019

World Journal of Surgical Oncology 1/2019 Go to the issue

Research

Association of pre-surgery to pre-radiotherapy lymphocyte counts ratio with disease-free survival in rectal cancer patients receiving neoadjuvant concurrent chemoradiotherapy

Research

Combined hepatocellular-cholangiocarcinoma: a population level analysis of incidence and mortality trends

Research

Analysis of patients scheduled for neoadjuvant therapy followed by surgery for esophageal cancer, who never made it to esophagectomy

Research

Risk factors for delayed perineal wound healing and its impact on prolonged hospital stay after abdominoperineal resection

Research

Relationship between S100A4 protein expression and pre-operative serum CA19.9 levels in pancreatic carcinoma and its prognostic significance

Research

Development and validation of a prognostic nomogram for predicting early recurrence after curative resection of stage II/III gastric cancer