R0胃癌根治术后中性粒细胞与淋巴细胞比值（NLR）预后意义的系统评价与Meta分析
Systematic Review and Meta-Analysis of the Prognostic Significance of Neutrophil-Lymphocyte Ratio (NLR) After R0 Gastrectomy for Cancer.
作者信息
Mellor Katie L, Powell Arfon G M T, Lewis Wyn G
机构信息
Wales Post Graduate Medical and Dental Education Deanery School of Surgery, Cardiff University, Cardiff, CF14 4XW, UK.
Division of Cancer and Genetics, Cardiff University, University Hospital of Wales, Heath Park, Cardiff, UK.
出版信息
J Gastrointest Cancer. 2018 Sep;49(3):237-244. doi: 10.1007/s12029-018-0127-y.
PURPOSE
A meta-analysis was performed to evaluate the prognostic value of neutrophil-lymphocyte ratio (NLR) in patients undergoing potentially curative gastrectomy for cancer (GC).
METHODS
Thomson Reuters Web of Science, Ovid MEDLINE(R) and PUBMED databases were searched for relevant articles using search terms neutrophil-lymphocyte ratio (NLR), GC and survival. Articles reporting overall survival (OS), cancer-specific survival and disease-free survival (DFS), in patients undergoing R0 gastrectomy, were studied.
RESULTS
Articles numbering 365 were identified during the preliminary search, and 10 containing 4164 patients were included in the final review. Most patients were > 60 years of age, male (67%) and 2239 (53.8%) had pT3 disease. The number of NLR dichotomization thresholds reported numbered 7, with 2.00 and 3.00 (n = 2) the most common. NLR was associated with poor survival in eight studies with hazard ratios ranging from 1.54 (95% confidence interval (CI) 1.26-1.89) to 2.99 (1.99-4.49). Pooled odds ratio (OR) for OS was 2.31 (1.40-3.83, p = 0.001) and for DFS 2.72 (1.14-6.54, p = 0.020). Four studies presented T-stage data, OR 1.62 (1.33-1.96, p < 0.001).
CONCLUSION
NLR is an important prognostic indicator associated with both OS and DFS after R0 resection of GC, but the critical level is equivocal.
目的
进行一项荟萃分析，以评估中性粒细胞与淋巴细胞比值（NLR）在接受潜在根治性胃癌切除术（GC）患者中的预后价值。
方法
使用检索词中性粒细胞与淋巴细胞比值（NLR）、GC和生存情况，在汤森路透科学网、Ovid MEDLINE(R)和PUBMED数据库中检索相关文章。研究对接受R0胃切除术患者的总生存期（OS）、癌症特异性生存期和无病生存期（DFS）进行报道的文章。
结果
在初步检索中识别出365篇文章，最终纳入10篇文章，共4164例患者。大多数患者年龄>60岁，男性占67%，2239例（53.8%）有pT3期疾病。报道的NLR二分法阈值有7个，最常见的是2.00和3.00（n = 2）。八项研究中NLR与不良生存相关，风险比范围为1.54（95%置信区间（CI）1.26 - 1.89）至2.99（1.99 - 4.49）。OS的合并比值比（OR）为2.31（1.40 - 3.83，p = 0.001），DFS的合并比值比为2.72（1.14 - 6.54，p = 0.020）。四项研究提供了T分期数据，OR为1.62（1.33 - 1.96，p < 0.001）。
结论
NLR是GC行R0切除术后与OS和DFS均相关的重要预后指标，但临界水平尚不明确。
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