淋巴细胞与单核细胞比值对胃癌患者的临床病理和预后意义：一项荟萃分析。
Clinicopathological and prognostic significance of lymphocyte to monocyte ratio in patients with gastric cancer: A meta-analysis.
机构信息
Department of Breast Surgery, Thyroid Surgery, Pancreatic Surgery, Huangshi Central Hospital of Edong Healthcare Group, Hubei Polytechnic University, No. 141 Tianjin Road, Huangshi, Hubei, China.
Department of Breast Surgery, Thyroid Surgery, Pancreatic Surgery, Huangshi Central Hospital of Edong Healthcare Group, Hubei Polytechnic University, No. 141 Tianjin Road, Huangshi, Hubei, China.
出版信息
Int J Surg. 2018 Feb;50:67-71. doi: 10.1016/j.ijsu.2018.01.002. Epub 2018 Jan 9.
BACKGROUND
Recently, the lymphocyte-to-monocyte ratio (LMR) has been reported to be a prognostic factor in multiple malignancies. The current study was designed to assess the prognostic value of pretreatment LMR in gastric cancer (GC).
METHODS
MEDLINE, EMBASE, Cochrane, and CNKI databases were searched until April 2017. Eligible articles were defined as studies assessing the prognostic role of pretreatment LMR in GC. Pooled hazard ratios (HRs) for overall survival (OS), disease-free survival (DFS), and recurrence-free survival (RFS) were calculated using fixed-effects or random-effects models.
RESULTS
A total of six studies comprising 4908 patients were included in the study. Pooled results showed that low LMR was significantly associated with decreased OS (HR: 0.66, 95% confidence interval [CI]: 0.54-0.82, p < .001), but not with poor DFS/RFS (HR: 0.71, 95% CI: 0.38-1.32, p = .004). The unfavorable prognostic impact of low LMR on OS was observed in patients of different disease stages and cut-off values. Moreover, low LMR was significantly related to age (>median), gender (male), CEA (>5 ng/ml), tumor size (>3 cm), TNM stage (III-IV), lymph node metastasis, and distant metastasis.
CONCLUSIONS
Low pretreatment LMR may be a significant prognostic biomarker for poor OS in patients with GC.
背景
最近，淋巴细胞与单核细胞比值（LMR）已被报道为多种恶性肿瘤的预后因素。本研究旨在评估术前 LMR 在胃癌（GC）中的预后价值。
方法
检索 MEDLINE、EMBASE、Cochrane 和中国知网（CNKI）数据库，检索截至 2017 年 4 月。定义符合条件的文章为评估术前 LMR 在 GC 中预后作用的研究。使用固定效应或随机效应模型计算总生存期（OS）、无病生存期（DFS）和无复发生存期（RFS）的合并危险比（HR）。
结果
共有 6 项研究纳入 4908 例患者。汇总结果表明，低 LMR 与 OS 降低显著相关（HR：0.66，95%置信区间[CI]：0.54-0.82，p<0.001），但与较差的 DFS/RFS 无关（HR：0.71，95%CI：0.38-1.32，p=0.004）。在不同疾病分期和截断值的患者中，低 LMR 对 OS 的不利预后影响均可见。此外，低 LMR 与年龄（>中位值）、性别（男性）、CEA（>5ng/ml）、肿瘤大小（>3cm）、TNM 分期（III-IV）、淋巴结转移和远处转移显著相关。
结论
术前低 LMR 可能是 GC 患者 OS 不良的显著预后生物标志物。
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