Bi Guoshu, Yao Guangyu, Bian Yunyi, Xue Liang, Zhang Yi, Lu Tao, Fan Hong
Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.
Ann Thorac Cardiovasc Surg. 2020 Feb 20;26(1):1-12. doi: 10.5761/atcs.ra.19-00170. Epub 2019 Oct 5.
To quantitatively evaluate the effect of preexisting diabetes mellitus (DM) on the outcomes of patients with non-small-cell lung cancer (NSCLC).
Observational studies comparing the prognosis of NSCLC patients with and without diabetes were identified from PubMed, EMBASE, and The Cochrane Central Register of Controlled Trials (CENTRAL). We searched for studies that published in English from inception to March 30, 2019, using search terms related to diabetes and NSCLC. Pooled hazard ratio (HR) and 95% confidence interval (CI) were calculated by a random-effect model and subgroup analyses were performed.
In all, 17 of 1475 identified studies were finally included in the meta-analysis. The result revealed that preexisting diabetes had a significantly negative impact on the overall survival (OS) of patients with NSCLC (HR: 1.31, 95% CI: 1.12-1.54), especially in patients undergoing surgical treatment (HR: 1.46, 95% CI: 1.02-2.09) in comparison with those receiving only non-surgical treatment (HR: 1.33, 95% CI: 0.87-2.03). In addition, preexisting diabetes was more likely to be associated with a worse prognosis among Asian NSCLC patients than Western patients. Sensitivity analysis indicated that the main result was robust, and no evidence of publication bias was found.
Preexisting DM has a negative impact on diabetic NSCLC patients' prognosis.
定量评估糖尿病（DM）对非小细胞肺癌（NSCLC）患者预后的影响。
从PubMed、EMBASE和Cochrane对照试验中央注册库（CENTRAL）中检索比较有糖尿病和无糖尿病NSCLC患者预后的观察性研究。我们使用与糖尿病和NSCLC相关的检索词，检索了从创刊到2019年3月30日以英文发表的研究。采用随机效应模型计算合并风险比（HR）和95%置信区间（CI），并进行亚组分析。
总共1475项已识别研究中的17项最终纳入荟萃分析。结果显示，糖尿病对NSCLC患者的总生存期（OS）有显著负面影响（HR：1.31，95%CI：1.12 - 1.54），尤其是与仅接受非手术治疗的患者相比（HR：1.33，95%CI：0.87 - 2.03），接受手术治疗的患者（HR：1.46，95%CI：1.02 - 2.09）。此外，与西方患者相比，亚洲NSCLC患者中糖尿病更可能与更差的预后相关。敏感性分析表明主要结果稳健，未发现发表偏倚的证据。
糖尿病对糖尿病合并NSCLC患者的预后有负面影响。
