Li Mu-Xing, Bi Xin-Yu, Li Zhi-Yu, Huang Zhen, Han Yue, Zhou Jian-Guo, Zhao Jian-Jun, Zhang Ye-Fan, Zhao Hong, Cai Jian-Qiang
From the Department of Abdominal Surgical Oncology (M-XL, X-YB, Z-YL, ZH, J-GZ, J-JZ, Y-FZ, HZ, J-QC) and Department of Radiofrequency Ablation (YH), Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS and PUMC), Cancer Hospital, Beijing, People's Republic of China.
Medicine (Baltimore). 2015 Dec;94(49):e2133. doi: 10.1097/MD.0000000000002133.
Conflicting results about the prognostic value of Glasgow Prognostic Score (GPS) in hepatocellular carcinoma (HCC) patients have been reported. We searched the available articles and performed the meta-analysis to clarify the predictive value of GPS in HCC patients' outcome.A systematic literature search was conducted using PubMed (Medline), Embase, Cochrane Library, Web of Science, ChinaInfo, and Chinese National Knowledge Infrastructure for all years up to September 2015. Studies analyzing the relationship of GPS and survival outcome were identified. Hazard ratio (HR) with 95% confidence interval (CI) was calculated to assess the risk.A total of 10 studies were finally enrolled in the meta-analysis. The pooled estimates demonstrated a significant relationship between elevated GPS and inferior overall survival in patients with HCC (HR = 2.156, 95% CI: 1.696-2.740, P < 0.001). Patients with increased GPS had a tendency toward shorter progression-free survival (HR = 1.755, 95% CI: 0.943-3.265, P = 0.076). And elevated GPS was found to be significantly associated with advanced Child-Pugh class (odds ratio = 25.979, 95% CI: 6.159-109.573, P < 0.001). The publication bias analysis revealed that there was publication bias in the meta-analysis.Glasgow Prognostic Score may be an independent prognostic factor in patients with HCC. More well-designed studies with adequate follow-up duration are warranted.
关于格拉斯哥预后评分(GPS)在肝细胞癌(HCC)患者中的预后价值,已有相互矛盾的结果报道。我们检索了现有文章并进行荟萃分析,以阐明GPS对HCC患者预后的预测价值。利用PubMed(医学索引数据库)、Embase、Cochrane图书馆、科学网、中国资讯网和中国知网,对截至2015年9月的所有年份进行了系统的文献检索。确定了分析GPS与生存结果关系的研究。计算了具有95%置信区间(CI)的风险比(HR)以评估风险。
最终共有10项研究纳入荟萃分析。汇总估计表明,HCC患者中GPS升高与总体生存率较差之间存在显著关系(HR = 2.156,95% CI:1.696 - 2.740,P < 0.001)。GPS升高的患者无进展生存期有缩短趋势(HR = 1.755,95% CI:0.943 - 3.265,P = 0.076)。并且发现GPS升高与Child-Pugh分级晚期显著相关(优势比 = 25.979,95% CI:6.159 - 109.573,P < 0.001)。发表偏倚分析显示荟萃分析中存在发表偏倚。
格拉斯哥预后评分可能是HCC患者的一个独立预后因素。需要更多设计良好且随访时间足够的研究。