Ye Qingjian, Wu Zhixi, Xia Tingting, Liu Dong, Yang Yuebo, Tang Hong
Department of Gynecology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong 510630, P.R. China.
Department of Obstetrics and Gynecology, Dongguan People's Hospital (Affiliated Dongguan Hospital, Southern Medical University), Dongguan, Guangdong 523000, P.R. China.
Exp Ther Med. 2020 Jan;19(1):359-366. doi: 10.3892/etm.2019.8205. Epub 2019 Nov 18.
The aim of the present meta-analysis study was to determine the association between pre-treatment thrombocytosis and prognosis of patients with endometrial cancer. Articles published prior to December 2018 containing information on platelet count and endometrial cancer were searched in the PubMed, Embase and the Cochrane Library databases. A platelet count of ≥350 or >400×10/l was considered to indicate thrombocytosis. Hazard ratios (HRs) with 95% CI were calculated using a random- or fixed-effects model to assess the strength of the associations. A Funnel plot and Egger's test were used to evaluate the publication bias and sensitivity analyses were performed to estimate the robustness of the present results by using Stata 13.0 software. A pooled analysis of 11 studies that met the inclusion criteria was performed, involving a total of 2,590 patients with endometrial cancer. The overall survival (OS), progression-free survival (PFS) and disease-free survival (DFS) time of patients with endometrial cancer who exhibited pre-treatment thrombocytosis were shorter than those in patients without pre-treatment thrombocytosis (OS, HR=2.25, 95% CI=1.26-4.00; PFS, HR=2.60, 95% CI=1.23-5.50; DFS, HR=2.23, 95% CI=1.45-3.42). However, pre-treatment thrombocytosis was not associated with disease-specific survival time in patients with endometrial cancer (HR=2.17, 95% CI=0.51-9.27; P=0.296). Subgroup analysis indicated that pre-treatment thrombocytosis was not associated with OS time in patients of Asian and European ethnicity. Furthermore, pre-treatment thrombocytosis (platelet count >400×10/l) was an independent predictor of OS, PFS and DFS regardless of the clinical stage.
本荟萃分析研究的目的是确定子宫内膜癌患者治疗前血小板增多症与预后之间的关联。在PubMed、Embase和Cochrane图书馆数据库中检索了2018年12月之前发表的包含血小板计数和子宫内膜癌信息的文章。血小板计数≥350或>400×10⁹/L被认为表明存在血小板增多症。使用随机或固定效应模型计算95%置信区间的风险比(HRs),以评估关联强度。采用漏斗图和Egger检验评估发表偏倚,并使用Stata 13.0软件进行敏感性分析以估计本研究结果的稳健性。对符合纳入标准的11项研究进行了汇总分析,共纳入2590例子宫内膜癌患者。治疗前出现血小板增多症的子宫内膜癌患者的总生存期(OS)、无进展生存期(PFS)和无病生存期(DFS)均短于未出现治疗前血小板增多症的患者(OS,HR=2.25,95%CI=1.26 - 4.00;PFS,HR=2.60,95%CI=1.23 - 5.50;DFS,HR=2.23,95%CI=1.45 - 3.42)。然而,治疗前血小板增多症与子宫内膜癌患者的疾病特异性生存期无关(HR=2.17,95%CI=0.51 - 9.27;P=0.296)。亚组分析表明,治疗前血小板增多症与亚洲和欧洲种族患者的OS时间无关。此外,无论临床分期如何,治疗前血小板增多症(血小板计数>400×10⁹/L)都是OS、PFS和DFS的独立预测因素。