| Objective:To investigate the relationship between systemic immune-inflammation index(SII)and prognosis of patients with pancreatic cancer.In this study,systematic evaluation and meta-analysis were used to study the relationship between SII and the prognosis of patients with pancreatic cancer,in order to provide data support for improving the clinical prognosis and individualized treatment of these patients.Methods:PubMed,EMBASE,Web of Science,MEDLINE,Cochrane Library,CNKI,Chinese Biomedical Database,Wanfang Medical And VIP database were searched to collect published studies on the relationship between SII and prognosis of pancreatic cancer patients.The retrieval time is from the database construction to August 1,2021.Two researchers independently screened literatures,extracted data,and evaluated the quality of the included studies.Stata 12.0 software was used for data analysis.Results:A total of 11 literatures(including 12 retrospective cohort studies)were included,with a total sample size of 3857 patients.The results of meta-analysis of the relationship between SII and different outcome indicators of patients are as follows:In terms of the association between SII levels and overall survival(OS)in patients with pancreatic cancer,10 studies involving 3223 patients showed that higher SII levels were associated with shorter OS[HR=1.57,95%CI(1.31,1.87),P<0.001].Four studies involving 1270 patients examined the relationship between SII levels and Recurrence-free survival(RFS)/progression-free survival(PFS)/Disease-free survival(DFS),showed that higher SII levels were associated with shorter RFS/PFS/DFS[HR=1.26,95%CI(1.13,1.40),P<0.001].Subgroup analysis of the relationship between SII level and OS was conducted from the aspects of SII critical value,sample size,country,treatment method and study time.The results showed that higher SII level among all subgroups was still associated with shortened OS in patients with pancreatic cancer.In addition,after subgroup analysis,the heterogeneity among all groups decreased compared to the previous,except for the SII critical value less than 600 and the Chinese regional study subgroup which had higher heterogeneity.The relationship between SII level and clinicopathological characteristics of pancreatic cancer patients was analyzed,and it was found that compared with low SII group,CA19-9 was higher in high SII group[OR=2.00,95%CI(1.31,3.07),P=0.001],and there was a positive correlation between SII level and TBIL level in pancreatic cancer patients[OR-2.11,95%CI(1.33,3.34),P=0.001],SII level was higher in patients with pancreatic head tumor[OR=1.42,95%CI(1.17,1.71),P=0.000].There was no correlation between SII level and gender,age,tumor stage,tumor differentiation,TNM stage,whether there was pancreatitis or diabetes.Conclusion:Based on current evidence,high level of SII may be an independent risk factor for poor prognosis in patients with pancreatic cancer.However,due to the limitation of research quantity and quality,the above conclusions need to be verified by more high-quality studies. |
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