An investigation of systemic inflammation and clinical outcomes in patients with common solid tumours

Saeed, Randa (2026) An investigation of systemic inflammation and clinical outcomes in patients with common solid tumours. PhD thesis, University of Glasgow.

Abstract

Systemic inflammation is increasingly recognised as a key determinant of clinical outcomes in patients with solid tumours, influencing tumour progression, treatment response, and survival. This thesis evaluated the prevalence, prognostic value, and clinical utility of systemic inflammation–based markers and scores across common cancers, including non-small cell lung cancer (NSCLC), oesophagogastric (OGC), and colorectal cancer (CRC). A series of retrospective cohort studies and a systematic review/meta-analysis were conducted to assess markers, including the neutrophil-to-lymphocyte ratio (NLR), C-reactive protein (CRP), C-reactive protein/albumin ratio (CAR), and the modified Glasgow Prognostic Score (mGPS).

The findings demonstrate that systemic inflammation is common across these cancers but varies in magnitude by tumour type, stage, and host fitness, with advanced NSCLC showing the highest inflammatory response. CRP-based scores (CAR, mGPS) consistently provided more substantial prognostic value than ratios derived from differential white cell counts, par-ticularly in operable OG and CRC, where baseline inflammation was lower. In NSCLC, sys-temic inflammation was associated with nutritional decline, survival after immunotherapy, and prognosis independent of conventional clinicopathological factors. The meta-analysis further confirmed the predictive utility of inflammatory biomarkers in NSCLC patients re-ceiving immunotherapy.

Overall, this thesis highlights systemic inflammation as a clinically relevant prognostic factor across multiple solid tumours, with CRP-based measures emerging as the most sensitive and reliable indicators. These findings support the routine use of CRP in prognostication and pa-tient stratification and suggest its potential role as both an inclusion criterion and an outcome measure in future interventional studies of anti-inflammatory therapies in cancer.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
• Colleges/Schools: College of Medical Veterinary and Life Sciences
• Supervisor's Name: McMillan, Professor Donald and McSorley, Dr. Stephen
• Date of Award: 2026
• Depositing User: Theses Team
• Unique ID: glathesis:2026-85739
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 04 Feb 2026 10:13
• Last Modified: 04 Feb 2026 10:14
• Thesis DOI: 10.5525/gla.thesis.85739
• URI: https://theses.gla.ac.uk/id/eprint/85739

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