Long Yu, Wang Ting, Gao Qian, Zhou Chengya
Department of Medical Oncology, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.
Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Oncotarget. 2016 Dec 6;7(49):81849-81861. doi: 10.18632/oncotarget.13248.
The prognostic effect of pretreatment elevated platelet count remains controversial in colorectal cancer patients. We conducted this meta-analysis to evaluate the prognostic impact of it in these patients.
PubMed, EMBASE and Cochrane Library were searched and studies on the prognostic significance of pretreatment elevated platelet count in colorectal patients were identified. We performed the meta-analysis, using overall survival and disease-free survival as outcomes and presenting data with hazard ratio and its 95% confidence interval. Heterogeneity among studies and publication bias were also evaluated.
Thirty studies were included in the meta-analysis. Compared with normal platelet count, pretreatment elevated platelet count was associated with poorer overall survival (Hazard ratio = 1.837, 95% confidence interval, 1.497 to 2.255, p = 0.000) and poorer disease-free survival (Hazard ratio = 1.635, 95% confidence interval, 1.237 to 2.160, p = 0.001) in patients with colorectal cancer. In subgroup analyses, pretreatment elevated platelet count was also associated with poorer overall survival and disease-free survival in most subgroups.
Pretreatment elevated platelet count was an independent prognostic factor of overall survival and disease-free survival in colorectal cancer patients. Large-scale prospective studies and a validation study are warranted.
在结直肠癌患者中,治疗前血小板计数升高的预后影响仍存在争议。我们进行了这项荟萃分析,以评估其对这些患者的预后影响。
检索了PubMed、EMBASE和Cochrane图书馆,确定了关于结直肠癌患者治疗前血小板计数升高的预后意义的研究。我们进行了荟萃分析,以总生存期和无病生存期作为结局指标,并以风险比及其95%置信区间呈现数据。还评估了研究之间的异质性和发表偏倚。
荟萃分析纳入了30项研究。与正常血小板计数相比,结直肠癌患者治疗前血小板计数升高与较差的总生存期(风险比=1.837,95%置信区间为1.497至2.255,p=0.000)和较差的无病生存期(风险比=1.635,95%置信区间为1.237至2.160,p=0.001)相关。在亚组分析中,治疗前血小板计数升高在大多数亚组中也与较差的总生存期和无病生存期相关。
治疗前血小板计数升高是结直肠癌患者总生存期和无病生存期的独立预后因素。有必要进行大规模前瞻性研究和验证研究。