结直肠癌患者治疗前血小板增多症的不良预后意义：一项Meta分析

Poor Prognosis Significance of Pretreatment Thrombocytosis in Patients with Colorectal Cancer: a Meta-Analysis.

作者信息

Zhao Jian-Meng, Wang Yong-Hong, Yao Nan, Wei Kong-Kong, Jiang Lei, Hanif Shahbaz, Wang Zi-Xia

机构信息

The First Clinical Medical College of Lanzhou University, Lanzhou, China E-mail :

出版信息

Asian Pac J Cancer Prev. 2016;17(9):4295-4300.

PMID:27797233

Abstract

BACKGROUND

Recently, several studies have reported that elevated platelet counts may be associated with the poor prognosis of colorectal cancer. However, conclusions remain controversial. This meta-analysis was therefore designed to analyze and evaluate the prognostic role of preoperative or pretreatment thrombocytosis in patients with colorectal cancer.

MATERIALS AND METHODS

We searched PubMed, EMBASE, the Cochrane Library and Web of Science to March 29th, 2015. The citation lists of included studies were also hand-searched to identify further relevant trials. To investigate the association between thrombocytosis and prognosis of colorectal cancer, the 1-year, 3-year and 5-year survival of each studies were obtained. The odds ratio (OR) with its 95% confidence interval (CI) was used to evaluate the relation of overall survival (OS) between thrombocytosis and normal platelet counts (PLT). Likewise, disease free survival (DFS) was obtained and evaluated. The analysis was performed and assessed using Review Manager 5.2.

RESULTS

A total of 14 studies (N=5,566 participants, 11 including 4,468 for OS, 6 including 1,533 for DFS) were included in this meta-analysis, of which seven (N=3810) defined thrombocytosis as a platelet count ≥ 400?109L, and 375 (9.8%) patients exhibited pretreatment thrombocytosis. Thrombocytosis have a close relationship with the poor OS of colorectal cancer compared with normal PLT, with the pooled ORs of 1-year, 3-year and 5-year survival being 0.41 [95% CI 0.34-0.51; P<0.001], 0.28 [95% CI 0.21-0.38; P<0.001] and 0.26 [95% CI 0.20-0.34; P<0.001], respectively. For DFS, the same results were showed as the pooled ORs of 1-year, 3-year and 5-year survival respectively being 0.34 [95% CI 0.24-0.50; P<0.001], 0.31 [95% CI 0.23-0.43; P<0.001] and 0.25 [95% CI 0.18-0.34; P<0.001].

CONCLUSIONS

This meta-analysis indicated that thrombocytosis may predict poor prognosis for patients with colorectal cancer, and platelet counts may be a cost-effective and noninvasive marker.

摘要

背景

最近，多项研究报告称血小板计数升高可能与结直肠癌的不良预后相关。然而，结论仍存在争议。因此，本荟萃分析旨在分析和评估术前或预处理时血小板增多症在结直肠癌患者中的预后作用。

材料与方法

我们检索了截至2015年3月29日的PubMed、EMBASE、Cochrane图书馆和科学网。还对纳入研究的参考文献列表进行了手工检索，以确定更多相关试验。为了研究血小板增多症与结直肠癌预后之间的关联，获取了每项研究的1年、3年和5年生存率。采用比值比（OR）及其95%置信区间（CI）来评估血小板增多症与正常血小板计数（PLT）之间总生存期（OS）的关系。同样，获取并评估无病生存期（DFS）。使用Review Manager 5.2进行分析和评估。

结果

本荟萃分析共纳入14项研究（N = 5566名参与者，其中11项包括4468名用于OS分析，6项包括1533名用于DFS分析），其中7项研究（N = 3810）将血小板增多症定义为血小板计数≥400×10⁹/L，375名（9.8%）患者表现出预处理时血小板增多症。与正常PLT相比，血小板增多症与结直肠癌的不良OS密切相关，1年、3年和5年生存率的合并OR分别为0.41 [95%CI 0.34 - 0.51；P < 0.001]、0.28 [95%CI 0.21 - 0.38；P < 0.001]和0.26 [95%CI 0.20 - 0.34；P < 0.001]。对于DFS，结果相同，1年、3年和5年生存率的合并OR分别为0.34 [95%CI 0.24 - 0.50；P < 0.001]、0.31 [95%CI 0.23 - 0.43；P < 0.001]和0.25 [95%CI 0.18 - 0.34；P < 0.001]。