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

Frontiers in oncology 2025 Vol.15() p. 1592794

Li H, Mo Z, Tong G

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[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.

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  • HR 1.89
  • 연구 설계 systematic review

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BibTeX ↓ RIS ↓
APA Li H, Mo Z, Tong G (2025). Value of CRP, albumin, and lymphocyte index in predicting survival of patients with gastrointestinal malignancies: a systematic review and meta-analysis.. Frontiers in oncology, 15, 1592794. https://doi.org/10.3389/fonc.2025.1592794
MLA Li H, et al.. "Value of CRP, albumin, and lymphocyte index in predicting survival of patients with gastrointestinal malignancies: a systematic review and meta-analysis.." Frontiers in oncology, vol. 15, 2025, pp. 1592794.
PMID 40740873

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.

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