Li Guanghua, Wang Zhao, Xu Jianbo, Wu Hui, Cai Shirong, He Yulong
Department of Gastrointestinal Surgery, First Affiliated Hospital of Sun Yat-sen University, 510080, Guangzhou, Guangdong Province, People's Republic of China.
BMC Cancer. 2016 Mar 25;16:249. doi: 10.1186/s12885-016-2276-3.
The prognostic value of lactate dehydrogenase levels in the prognosis of colorectal cancer patients has been assessed for years, although the results remain controversial and heterogeneous. Thus, we comprehensively reviewed the evidence from studies that evaluated lactate dehydrogenase levels in colorectal cancer patients to determine their effect.
The following databases were searched in September 2014 to identify studies that evaluated the prognostic value of lactate dehydrogenase levels in colorectal cancer: PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials. We extracted hazard ratios (HRs) and the associated 95% confidence intervals (CIs) from the identified studies, and performed random-effects model meta-analyses on the overall survival (OS) and progression-free survival (PFS). Thirty-two studies with a cumulative sample size of 8,261 patients were included in our analysis.
Our meta-analyses revealed that high levels of lactate dehydrogenase were associated with poor OS (HR, 1.75; 95% CI, 1.52-2.02) in colorectal cancer patients. However, this effect was not obvious in the OS of non-metastatic colorectal cancer patients (HR, 1.21; 95% CI, 0.79-1.86). The prognostic value of lactate dehydrogenase levels on PFS was also not confirmed (HR, 1.36; 95% CI, 0.98-1.87). Subgroup analyses revealed that the prognostic significance of lactate dehydrogenase was independent of study location, patient age, number of patients, metastasis, chemotherapy with anti-angiogenesis drugs, study type, or risk of bias.
Our results indicate that high lactate dehydrogenase levels are associated with poor OS among colorectal cancer patients, although these levels are not significant predictors of PFS.
多年来一直评估乳酸脱氢酶水平在结直肠癌患者预后中的价值，尽管结果仍存在争议且参差不齐。因此，我们全面回顾了评估结直肠癌患者乳酸脱氢酶水平的研究证据，以确定其影响。
2014年9月检索了以下数据库，以识别评估乳酸脱氢酶水平在结直肠癌中预后价值的研究：PubMed、EMBASE和Cochrane对照试验中央注册库。我们从纳入的研究中提取风险比（HRs）及相关的95%置信区间（CIs），并对总生存期（OS）和无进展生存期（PFS）进行随机效应模型荟萃分析。我们的分析纳入了32项研究，累计样本量为8261例患者。
我们的荟萃分析显示，结直肠癌患者中乳酸脱氢酶水平升高与较差的总生存期相关（HR，1.75；95%CI，1.52 - 2.02）。然而，在非转移性结直肠癌患者的总生存期方面，这种影响并不明显（HR，1.21；95%CI，0.79 - 1.86）。乳酸脱氢酶水平对无进展生存期的预后价值也未得到证实（HR，1.36；95%CI，0.98 - 1.87）。亚组分析显示，乳酸脱氢酶的预后意义与研究地点、患者年龄、患者数量、转移情况、抗血管生成药物化疗情况、研究类型或偏倚风险无关。
我们的结果表明，结直肠癌患者中乳酸脱氢酶水平升高与较差的总生存期相关，尽管这些水平不是无进展生存期的显著预测指标。
