He Liying, Li Hui, Cai Jianye, Chen Liang, Yao Jia, Zhang Yingcai, Xu Wanfu, Geng Lanlan, Yang Min, Chen Peiyu, Zheng Jun, Yang Yang, Gong Sitang
Department of Gastroenterology, Guangzhou Women and Children's Medical Center, Guangzhou, China.
The First Affiliated Hospital of Jinan University, Guangzhou, China.
Cell Physiol Biochem. 2018;51(3):1237-1249. doi: 10.1159/000495500. Epub 2018 Nov 27.
BACKGROUND/AIMS: Increasing evidence indicates that the systemic inflammatory response plays a vital role in carcinogenesis. The Glasgow Prognostic Score or modified Glasgow Prognostic Score (GPS/mGPS) is a novel inflammatory indicator which consists of CRP and albumin. Here, we performed a meta-analysis to evaluate the prognostic value of the GPS/ mGPS in patients with colorectal cancer (CRC) and to assess its consistency in different CRC therapies.
The electronic databases PubMed, Embase, Scopus, Web of Science, and Cochrane Library were searched from inception through December 2017 for the association between the GPS/mGPS and clinical outcomes. Study characteristics and prognostic data were extracted from each relevant study. Overall survival (OS) and cancer-specific survival (CSS) were considered the primary outcomes, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. The quality of each study was pooled using the random-effects Mantel-Haenszel model. Finally, subgroup analyses were performed to detect the heterogeneity of different CRC treatments.
Thirty-four studies, with a combined total of 8834 patients, were eligible for this meta-analysis. Data on OS and CSS were available in 23 and 22 studies, respectively. By comparing the prognostic values of different levels of the GPS in CRC patients, the summary HRs for OS and CSS were 2.18 (95% CI 1.83-2.60) and 1.82 (95% CI 1.57-2.11), respectively. According to the different tumor stages, the subgroup analyses were stratified by different treatments, including curative or palliative therapy. The results robustly confirmed the prognostic role of the GPS/mGPS.
Our results suggest that the GPS/mGPS is a novel and effective prognostic indicator for the OS and CSS of patients with CRC.
背景/目的:越来越多的证据表明,全身炎症反应在癌症发生过程中起着至关重要的作用。格拉斯哥预后评分或改良格拉斯哥预后评分(GPS/mGPS)是一种新的炎症指标,由CRP和白蛋白组成。在此,我们进行了一项荟萃分析,以评估GPS/mGPS在结直肠癌(CRC)患者中的预后价值,并评估其在不同CRC治疗中的一致性。
检索电子数据库PubMed、Embase、Scopus、Web of Science和Cochrane图书馆,从数据库建立至2017年12月,以查找GPS/mGPS与临床结局之间的关联。从每项相关研究中提取研究特征和预后数据。总生存期(OS)和癌症特异性生存期(CSS)被视为主要结局,并计算风险比(HRs)和95%置信区间(CIs)。使用随机效应Mantel-Haenszel模型汇总每项研究的质量。最后,进行亚组分析以检测不同CRC治疗的异质性。
34项研究,共计8834例患者,符合本荟萃分析的条件。分别有23项和22项研究提供了OS和CSS的数据。通过比较CRC患者不同水平GPS的预后价值,OS和CSS的汇总HRs分别为2.18(95%CI 1.83-2.60)和1.82(95%CI 1.57-2.11)。根据不同的肿瘤分期,亚组分析按不同治疗方法分层,包括根治性或姑息性治疗。结果有力地证实了GPS/mGPS的预后作用。
我们的结果表明,GPS/mGPS是CRC患者OS和CSS的一种新的有效预后指标。