移植前中性粒细胞与淋巴细胞比值作为肝癌肝移植后新的预后预测因子：系统评价和荟萃分析。

The pretransplant neutrophil-lymphocyte ratio as a new prognostic predictor after liver transplantation for hepatocellular cancer: a systematic review and meta-analysis.

机构信息

Department of General Surgery, Qinghai Provincial People's Hospital, Xi'ning 810000, China.

Department of Clinical Medicine, The Clinical Medical College of Qinghai University, Xi'ning 810000, China.

出版信息

Biomark Med. 2018 Feb;12(2):189-199. doi: 10.2217/bmm-2017-0307. Epub 2018 Jan 12.

DOI:10.2217/bmm-2017-0307

PMID:29327595

Abstract

AIM

Recently, many reports showed that the pretransplant neutrophil-lymphocyte ratio (NLR) may be correlated with the prognosis of patients undergoing liver transplantation (LT) for hepatocellular cancer (HCC). However, their results still remained controversial. Thus we performed a meta-analysis of 13 studies to estimate the prognostic value of pretransplant NLR.

METHODS

Databases including PubMed, Embase, Cochrane Library and Web of Science were searched to September 2017. Hazard ratio (HR) or odds ratio (OR) with its 95% CI was used to evaluate the association between elevated NLR and the prognosis or clinical features of liver cancer patients.

RESULTS

A total of 13 studies including 1936 patients were included in this meta-analysis. Elevated pretransplant NLR had a close association with the overall survival (HR: 2.22; 95% CI: 1.34-3.68), recurrence-free survival (HR: 3.77; 95% CI: 2.01-7.06) and disease-free survival (HR: 2.51; 95% CI: 1.22-5.15) of patients undergoing LT for HCC, respectively. In addition, elevated NLR was associated with the presence of vascular invasion (OR: 2.39; 95% CI: 1.20-4.77) and Milan criteria (OR: 0.26; 95% CI: 0.17-0.40).

CONCLUSION

The results of this meta-analysis showed that elevated pretransplant NLR may be used as a new prognostic predictor after LT for HCC.

摘要

目的

最近，许多报告表明，移植前中性粒细胞-淋巴细胞比值（NLR）可能与接受肝细胞癌（HCC）肝移植（LT）的患者的预后相关。然而，他们的结果仍然存在争议。因此，我们进行了一项荟萃分析，纳入了 13 项研究来评估移植前 NLR 的预后价值。

方法

检索了包括 PubMed、Embase、Cochrane 图书馆和 Web of Science 在内的数据库，检索时间截至 2017 年 9 月。采用风险比（HR）或比值比（OR）及其 95%置信区间（CI）来评估 NLR 升高与肝癌患者预后或临床特征之间的关系。

结果

共有 13 项研究，共纳入 1936 例患者纳入本荟萃分析。移植前 NLR 升高与患者的总生存（HR：2.22；95%CI：1.34-3.68）、无复发生存（HR：3.77；95%CI：2.01-7.06）和无病生存（HR：2.51；95%CI：1.22-5.15）密切相关。此外，NLR 升高与血管侵犯（OR：2.39；95%CI：1.20-4.77）和米兰标准（OR：0.26；95%CI：0.17-0.40）相关。