格拉斯哥预后评分在结直肠癌中的预后价值：对9839例患者的荟萃分析

Prognostic value of the Glasgow prognostic score in colorectal cancer: a meta-analysis of 9,839 patients.

作者信息

Lu Xin, Guo Wanying, Xu Wei, Zhang Xuelei, Shi Zhijie, Zheng Leizhen, Zhao Wenzhao

机构信息

Department of Gastrointestinal Surgery, The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, China,

Department of Breast Surgery, The First Affiliated Hospital and College of Clinical Medicine of Henan University of Science and Technology, Luoyang 471003, China.

出版信息

Cancer Manag Res. 2018 Dec 24;11:229-249. doi: 10.2147/CMAR.S185350. eCollection 2019.

PURPOSE

The aim of this study was to perform a systematic review and meta-analysis to evaluate the value of the Glasgow prognostic score (GPS) or modified Glasgow prognostic score (mGPS) in patients with colorectal cancer (CRC).

METHODS

A comprehensive medical literature search was performed using the online databases PubMed, Embase, Web of Science, and the Cochrane Library. After extracting basic characteristics and prognostic data from the included studies, overall survival (OS) and cancer-specific survival (CSS) were pooled as primary outcomes. Subgroup analyses were performed according to therapeutic strategies, models, cutoff values, regions, tumor, node, metastasis stages, sample size, and ages.

RESULTS

Forty-three independent cohorts from 41 studies with 9,839 CRC patients were included in the present study. Correlation between GPS or mGPS and OS was analyzed in 32 cohorts of 7,714 patients, and 23 independent cohorts of 5,375 patients focused on the correlation between GPS or mGPS and CSS. The overall outcomes showed that patients with elevated GPS or mGPS were associated with poor OS (HR: 2.20, 95% CI: 1.88-2.57, <0.001). Elevated GPS or mGPS also resulted in worse CSS (HR: 1.86, 95% CI: 1.59-2.17, <0.001). The results of the subgroup analyses confirmed the overall outcomes.

CONCLUSION

GPS or mGPS is an accurate prognostic predictor in patients with CRC. Patients with elevated pretreatment GPS or mGPS have a poor prognosis. Subgroup analyses confirmed the overall outcomes. Pretreatment GPS is a useful biomarker in the management of CRC.

目的

本研究旨在进行系统评价和荟萃分析，以评估格拉斯哥预后评分（GPS）或改良格拉斯哥预后评分（mGPS）在结直肠癌（CRC）患者中的价值。

方法

使用在线数据库PubMed、Embase、Web of Science和Cochrane图书馆进行全面的医学文献检索。从纳入的研究中提取基本特征和预后数据后，将总生存期（OS）和癌症特异性生存期（CSS）合并作为主要结局。根据治疗策略、模型、临界值、地区、肿瘤、淋巴结、转移分期、样本量和年龄进行亚组分析。

结果

本研究纳入了来自41项研究的43个独立队列，共9839例CRC患者。在7714例患者的32个队列中分析了GPS或mGPS与OS之间的相关性，在5375例患者的23个独立队列中关注GPS或mGPS与CSS之间的相关性。总体结果显示，GPS或mGPS升高的患者OS较差（HR：2.20，95%CI：1.88-2.57，<0.001）。GPS或mGPS升高也导致CSS更差（HR：1.86，95%CI：1.59-2.17，<0.001）。亚组分析结果证实了总体结果。