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. 2024 Dec 5;24(1):1499.
doi: 10.1186/s12885-024-13261-y.

Negative association of C-reactive protein-albumin-lymphocyte index (CALLY index) with all-cause and cause-specific mortality in patients with cancer: results from NHANES 1999-2018

Di Zhu  1 , Ye-Ding Lin  1 , Yan-Zhu Yao  1 , Xiang-Jun Qi  1 , Kai Qian  2 , Li-Zhu Lin  3
Affiliations

Negative association of C-reactive protein-albumin-lymphocyte index (CALLY index) with all-cause and cause-specific mortality in patients with cancer: results from NHANES 1999-2018

Di Zhu et al. BMC Cancer. .

Abstract

Background: The CALLY index, which is derived from C-reactive protein (CRP) content, serum albumin level, and total lymphocyte count, reflects the immune, nutritional, and inflammatory status of the body. Lack of sufficient evidence on the correlation between the CALLY index and the prognosis of cancer patients with various cancer forms. This study seeks to elucidate the association between the CALLY index and mortality from all causes as well as specific causes in cancer patients within a U.S.

Methods: This investigation encompassed 3511 cancer-afflicted adults from the National Health and Nutritional Examination Surveys (NHANES) spanning 1999 to 2018. The CALLY index was measured at baseline only. The relationship between the CALLY index and mortality from both all causes and cancer specifically was examined using Cox proportional hazards models. Additionally, restricted cubic spline, piecewise linear regression, and various subgroup and sensitivity analyses were employed.

Results: Over a median follow-up of 103 months, 1,355 deaths occurred, and the incidence of all-cause mortality for these participants was 38.34%. Our findings indicate that an elevated CALLY index correlates with a diminished risk of all-cause mortality. Upon applying a natural logarithmic transformation to the CALLY index, the comprehensively adjusted model revealed that each one-unit increment in ln CALLY corresponded to a 18% decrease in all-cause mortality risk among cancer patients (HR = 0.82, 95% CI:0.79-0.86). Analyses of mortality due to cardiac and cancer-related causes yielded consistent results, which were robust across various subgroup and sensitivity analyses.

Conclusion: The CALLY index demonstrated a linear and negative association with all-cause mortality, as well as mortality caused by cancer and cardiac conditions, highlighting its significant prognostic value in patients with oncological conditions.

Keywords: CALLY index; Cancer; NHANES; Population-based study; Retrospective study.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. This study utilized publicly available data from the National Health and Nutrition Examination Survey (NHANES), which was approved by the National Center for Health Statistics Ethics Review Board. All participants provided informed consent at the time of data collection by NHANES. Consent for publication: Not applicable. This manuscript does not contain any individual person’s data in any form. Competing interests: The authors declare that no commercial or financial relationships that could be construed as potential conflicts of interest influenced the research conducted.

Figures

Fig. 1
Fig. 1
Flowchart for screening participants in the NHANES database
Fig. 2
Fig. 2
Kaplan-Meier survival analysis curves illustrating significant differences in all-cause mortality rates for adult cancer patients categorized by different ln CALLY quartile groups
Fig. 3
Fig. 3
Smoothed curve fitting with covariates adjusted for cancer patient follow-up data shows an approximately linear relationship between cancer patient mortality and CALLY index
See this image and copyright information in PMC

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