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血液学标志物对鼻咽癌患者的预后意义:一项荟萃分析。

Prognostic Significance of Hematological Markers for Patients with Nasopharyngeal Carcinoma: A Meta-analysis.

作者信息

Yang Shanshan, Zhao Kun, Ding Xiao, Jiang Haiping, Lu Haijun

机构信息

Department of Oncology, the Affiliated Hospital of Qingdao University, Qingdao, Shandong Province, China.

Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China.

出版信息

J Cancer. 2019 Jun 2;10(11):2568-2577. doi: 10.7150/jca.26770. eCollection 2019.

Abstract

: Hematological parameters are considered to be associated with prognosis in various cancers. We designed a meta-analysis to evaluate the prognostic significance of hematological parameters, including the neutrophil-to-lymphocyte ratio (NLR), C-reactive protein/albumin ratio (CRP/ALB), lymphocyte-to-monocyte ratio (LMR), plasma fibrinogen level, Glasgow prognostic score (GPS), platelet-to-lymphocyte ratio (PLR) and high-density lipoprotein cholesterol (HDL-C) level, on clinical outcomes in nasopharyngeal carcinoma (NPC). : Relevant studies published prior to February 2018 were identified in the PubMed, Web of Science, EMBASE and Cochrane library databases. The primary outcome was overall survival (OS), and the secondary outcome was progression-free survival (PFS). The pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. : In total, 23 studies encompassing 23,417 patients were included in our meta-analysis. An elevated NLR was related to a poor OS (HR=1.46, 95% CI=1.30-1.63, <0.00001) and PFS (HR=1.67, 95% CI=1.36-2.07, <0.00001), and a high PLR was associated with a poor OS (HR=1.62, 95% CI=1.32-1.98, <0.00001). Additionally, a high LMR predicted a significantly favorable OS (HR=0.50, 95% CI: 0.43-0.58, <0.00001). CRP/ALB, the GPS, HDL-C and plasma fibrinogen levels were also related to OS and PFS. : Inflammation-based prognostic scoring systems considering inflammatory cells (lymphocytes, neutrophils, platelets and monocytes) and proteins (ALB, CRP and HDL-C) are essential prognostic factors.

摘要

血液学参数被认为与多种癌症的预后相关。我们设计了一项荟萃分析,以评估包括中性粒细胞与淋巴细胞比值(NLR)、C反应蛋白/白蛋白比值(CRP/ALB)、淋巴细胞与单核细胞比值(LMR)、血浆纤维蛋白原水平、格拉斯哥预后评分(GPS)、血小板与淋巴细胞比值(PLR)以及高密度脂蛋白胆固醇(HDL-C)水平在内的血液学参数对鼻咽癌(NPC)临床结局的预后意义。在PubMed、科学网、EMBASE和Cochrane图书馆数据库中检索2018年2月之前发表的相关研究。主要结局为总生存期(OS),次要结局为无进展生存期(PFS)。计算合并风险比(HRs)和95%置信区间(CIs)。我们的荟萃分析共纳入23项研究,涉及23417例患者。NLR升高与较差的OS(HR=1.46,95%CI=1.30 - 1.63,<0.00001)和PFS(HR=1.67,95%CI=1.36 - 2.07,<0.00001)相关,PLR升高与较差的OS(HR=1.62,95%CI=1.32 - 1.98,<0.00001)相关。此外,高LMR预示着显著良好的OS(HR=0.50,95%CI:0.43 - 0.58,<0.00001)。CRP/ALB、GPS、HDL-C和血浆纤维蛋白原水平也与OS和PFS相关。考虑炎症细胞(淋巴细胞、中性粒细胞、血小板和单核细胞)和蛋白质(ALB、CRP和HDL-C)的基于炎症的预后评分系统是重要的预后因素。

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