BMC gastroenterology · 2026
Prognostic role of C-reactive protein-albumin-lymphocyte (CALLY) index in gastrointestinal malignancies: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод пока не подготовлен
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Rayyan Yaser, Odeh Nada, Theeb Laith, Alajlouni Yazeed Y, Alzoubi Mohammad, Al-Assaf Noor F, Jaber Layan A, AlHammouri Hashim M, Alzghoul Abdullah H, Khamaiseh Abdallah M, Hamdan Ayham S, Alhaj Ahmad M
Аннотация
INTRODUCTION: Gastrointestinal (GI) malignancies are a major cause of cancer-related morbidity and mortality. While prognostic tools such as TNM staging and serum biomarkers are widely used, they have limitations. The C-reactive protein-albumin-lymphocyte (CALLY) index, an integrated marker of inflammation, nutrition, and immunity, has emerged as a potential prognostic tool. However, its prognostic value across GI malignancies remains unclear. This systematic review aims to assess the prognostic significance of the CALLY index in GI malignancies, with a primary focus on survival outcomes and a secondary assessment of its association with postoperative complications.
METHODOLOGY: Relevant literature was screened through December 2024 to identify studies assessing the prognostic significance of the CALLY index in GI malignancies. Outcomes included overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), recurrence-free survival (RFS), recurrence rates, and postoperative complications. Eligible studies underwent qualitative synthesis, while meta-analysis was conducted for gastric cancer only. Relative risks (RRs) were pooled using a fixed- or random-effects model based on heterogeneity (I² > 50%). Subgroup analyses were performed based on CALLY cutoff values and TNM stage. Publication bias was assessed using funnel plots and Egger's test.
RESULTS: A total of 21 studies (8,600 patients) met inclusion criteria. Across all GI malignancies, higher CALLY values, regardless of cutoff variations (range: 0.369-6.96), were consistently associated with improved OS, CSS, DFS, and RFS, while lower values correlated with increased recurrence rates and higher postoperative complication rates. In gastric cancer, a higher CALLY index was associated with improved 5-year OS (RR = 0.81, p < 0.00001) and lower major postoperative complications (RR = 1.48, p = 0.02). Subgroup analysis suggested that a CALLY cutoff < 3 and TNM stage IV inclusion contributed to heterogeneity. No significant publication bias was detected.
CONCLUSION: The CALLY index appears to be a promising independent prognostic biomarker in GI malignancies, with higher values associated with improved survival and fewer postoperative complications. In gastric cancer specifically, meta-analysis confirms its predictive value for 5-year overall survival and major postoperative outcomes. Larger prospective studies are warranted to establish standardized cutoff points and to optimize its clinical utility across diverse patient populations.
METHODOLOGY: Relevant literature was screened through December 2024 to identify studies assessing the prognostic significance of the CALLY index in GI malignancies. Outcomes included overall survival (OS), cancer-specific survival (CSS), disease-free survival (DFS), recurrence-free survival (RFS), recurrence rates, and postoperative complications. Eligible studies underwent qualitative synthesis, while meta-analysis was conducted for gastric cancer only. Relative risks (RRs) were pooled using a fixed- or random-effects model based on heterogeneity (I² > 50%). Subgroup analyses were performed based on CALLY cutoff values and TNM stage. Publication bias was assessed using funnel plots and Egger's test.
RESULTS: A total of 21 studies (8,600 patients) met inclusion criteria. Across all GI malignancies, higher CALLY values, regardless of cutoff variations (range: 0.369-6.96), were consistently associated with improved OS, CSS, DFS, and RFS, while lower values correlated with increased recurrence rates and higher postoperative complication rates. In gastric cancer, a higher CALLY index was associated with improved 5-year OS (RR = 0.81, p < 0.00001) and lower major postoperative complications (RR = 1.48, p = 0.02). Subgroup analysis suggested that a CALLY cutoff < 3 and TNM stage IV inclusion contributed to heterogeneity. No significant publication bias was detected.
CONCLUSION: The CALLY index appears to be a promising independent prognostic biomarker in GI malignancies, with higher values associated with improved survival and fewer postoperative complications. In gastric cancer specifically, meta-analysis confirms its predictive value for 5-year overall survival and major postoperative outcomes. Larger prospective studies are warranted to establish standardized cutoff points and to optimize its clinical utility across diverse patient populations.