Association between pan-immune-inflammation value and prognosis in lung cancer patients: a systematic review and...

The prognostic role of pan-immune-inflammation value (PIV) in lung cancer remains unclear. This meta-analysis aimed to identify the relationship between PIV and prognosis in lung cancer.

Several databases were searched up to April 26, 2025. Endpoints included the overall survival (OS), progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), complete response rate (CRR), and pulmonary infection (PI). Hazard ratios (HRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were combined. Subgroup analysis by tumor type and treatment for OS and PFS was performed.

Eighteen studies involving 4,367 cases were included. Our results indicated that a high PIV was associated with poor OS (HR =2.38; 95% CI: 2.06-2.75; P<0.001) and PFS (HR =1.93; 95% CI: 1.67-2.23; P<0.001). Subgroup analysis by tumor type and treatment further identified the above findings. Furthermore, PIV was also related to the ORR (OR =0.56; 95% CI: 0.39-0.80; P=0.002), DCR (OR =0.61; 95% CI: 0.43-0.88; P=0.007), CRR (OR =0.42; 95% CI: 0.19-0.92; P=0.03), and risk of PI (OR =2.15; 95% CI: 1.02-4.51; P=0.044).

PIV may serve as a prognostic biomarker associated with survival outcomes in lung cancer, and patients with a high PIV tend to have a worse prognosis. However, PIV should be interpreted as a surrogate marker reflecting systemic inflammatory status rather than a causal determinant of disease progression.