Systemic Inflammatory Response and Prognostic Scoring in Cancer
Summary
The systemic inflammatory response (SIR) is increasingly recognised as a hallmark of cancer progression and host–tumour interaction. Tumour cells and the tumour microenvironment can trigger a cascade of cytokine release, acute-phase protein synthesis and haematological alterations, reflecting a dysregulated immune state. Quantitative scoring systems have emerged to translate these laboratory changes into prognostic tools. Chief among these is the modified Glasgow Prognostic Score (mGPS), which integrates elevations in C-reactive protein and reductions in serum albumin to stratify risk. Additional indices, such as the neutrophil–lymphocyte ratio (NLR) and platelet–lymphocyte ratio (PLR), capture shifts in innate versus adaptive immunity. High-sensitivity variants of these scores offer refined discrimination in early-stage disease. Collectively, inflammation-based prognostic scores provide cost-effective, reproducible metrics that complement traditional staging systems, inform treatment intensity and may guide novel immunomodulatory strategies.
Research from Nature Portfolio
Recent studies have demonstrated the predictive value of postoperative mGPS in patients with locally advanced rectal cancer undergoing neoadjuvant chemoradiotherapy. Assessment of mGPS following chemoradiotherapy identified a high-risk group with markedly reduced five-year disease-free survival, confirming mGPS as an independent determinant of outcome beyond tumour stage. This work underlines the dynamic nature of systemic inflammation and its potential to refine postoperative risk stratification. In a foundational meta-analysis, investigators systematically reviewed inflammation-based prognostic scores across a broad spectrum of operable cancers. Elevated NLR, PLR, lymphocyte–monocyte ratio and mGPS were consistently associated with poorer overall and cancer-specific survival, supporting the routine incorporation of these measures into preoperative and postoperative assessments.
Systemic Inflammatory Response and Prognostic Scoring in Cancer publication trend
The graph below shows the total number of articles in systemic inflammatory response and prognostic scoring in cancer across all publications each year (not limited to Nature Index journals).
Technical terms
Systemic inflammatory response (SIR): Body-wide activation of immune and acute-phase pathways triggered by tumour-derived and host-derived mediators.
Modified Glasgow Prognostic Score (mGPS): A cumulative index based on C-reactive protein and albumin levels, used to stratify cancer prognosis.
Neutrophil–lymphocyte ratio (NLR): The quotient of circulating neutrophil count to lymphocyte count, reflecting innate versus adaptive immune balance.
C-reactive protein (CRP): An acute-phase protein synthesised by hepatocytes in response to interleukin-6 and other proinflammatory cytokines.
Albumin: A serum protein whose concentration decreases in systemic inflammation and malnutrition, integral to several prognostic algorithms.
References
- The modified Glasgow prognostic score is a reliable predictor of oncological outcomes in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy. Scientific Reports (2023).
- The role of the systemic inflammatory response in predicting outcomes in patients with operable cancer: Systematic review and meta-analysis. Scientific Reports (2017).
- Evaluation of the inflammation-based modified Glasgow Prognostic Score (mGPS) as a prognostic and predictive biomarker in patients with metastatic colorectal cancer receiving first-line chemotherapy: a post hoc analysis of the randomized phase III XELAVIRI trial (AIO KRK0110). ESMO Open (2024).
- Prognostic Biomarkers of Systemic Inflammation in Non-Small Cell Lung Cancer: A Narrative Review of Challenges and Opportunities. Cancers (2024).
- Utility of High-Sensitivity Modified Glasgow Prognostic Score in Cancer Prognosis: A Systemic Review and Meta-Analysis. International Journal of Molecular Sciences (2023).
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