预后营养指数在肝细胞癌患者中的预后价值：一项观察性研究的荟萃分析。
The prognostic value of prognostic nutritional index in hepatocellular carcinoma patients: A meta-analysis of observational studies.
机构信息
Department of SICU. Affiliated Children 's Hospital of Zhengzhou University, Henan Children's Hospital, Zhengzhou, Henan Province, China.
General Surgery, Affiliated Tumor Hospital of Zhengzhou University, Henan Provincial Cancer Hospital, Zhengzhou, Henan Province, China.
出版信息
PLoS One. 2018 Oct 12;13(10):e0202987. doi: 10.1371/journal.pone.0202987. eCollection 2018.
BACKGROUND AND AIMS
The clinical value of the prognostic nutritional index (PNI) in hepatocellular carcinoma (HCC) has been investigated in previous studies, but the results remain controversial. Here we present a meta-analysis to systematically review the association between PNI and HCC prognosis.
METHOD
PubMed, EMBASE, Web of Science databases were systematically searched to identify relevant studies. Data were abstracted independently by two reviewers. A meta-analysis was performed to determine the prognostic and clinic-pathological values of PNI in HCC patients. Odds ratios (ORs) and 95% confidence intervals (CIs) were extracted to estimate the association of PNI with survival and clinic-pathological characteristics, respectively.
RESULTS
A total of eleven studies involving 3165 patients were analyzed. The pooled results indicated that low PNI is a significant predictor of poor 1-year, 3-year, 5-year OS (OR, 2.91, 4.05, 3.65; 95%CI, 2.30 to 3.70, 3.27 to 5.03,2.96-4.50; P = 0.14,0.22,0.11 respectively) and disease-free survival (DFS) (OR,2.35, 2.57, 2.75; 95%CI, 1.71 to 3.23, 1.89 to 3.49,2.01 to 3.75; P = 0.39,0.04,0.11, respectively). Moreover, PNI is significantly associated with serum AFP, tumor recurrence, tumor size and TNM stages in HCC patients. However, PNI is not significantly associated with tumor number and the incidence of cirrhosis in HCC patients.
CONCLUSIONS
PNI is an independent predictive indicator of survival and associated with serum AFP, tumor recurrence, tumor size and TNM stages in HCC patients.
背景与目的
先前的研究已经探讨了预后营养指数（PNI）在肝细胞癌（HCC）中的临床价值，但结果仍存在争议。在这里，我们进行了一项荟萃分析，以系统地回顾 PNI 与 HCC 预后之间的关系。
方法
系统地检索了 PubMed、EMBASE 和 Web of Science 数据库，以确定相关研究。由两位评审员独立提取数据。进行荟萃分析以确定 PNI 在 HCC 患者中的预后和临床病理价值。提取优势比（OR）和 95%置信区间（CI），以分别估计 PNI 与生存和临床病理特征的相关性。
结果
共分析了 11 项涉及 3165 名患者的研究。汇总结果表明，低 PNI 是预测 1 年、3 年和 5 年总生存期（OS）（OR，2.91、4.05、3.65；95%CI，2.30 至 3.70、3.27 至 5.03、2.96-4.50；P = 0.14、0.22、0.11）和无病生存期（DFS）（OR，2.35、2.57、2.75；95%CI，1.71 至 3.23、1.89 至 3.49、2.01 至 3.75；P = 0.39、0.04、0.11）差的显著预测因子。此外，PNI 与 HCC 患者的血清 AFP、肿瘤复发、肿瘤大小和 TNM 分期显著相关。然而，PNI 与 HCC 患者的肿瘤数量和肝硬化发生率无显著相关性。
结论
PNI 是生存的独立预测指标，与 HCC 患者的血清 AFP、肿瘤复发、肿瘤大小和 TNM 分期相关。
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