Department of Obstetrics and Gynecology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; College of Graduate Health Sciences, University of Tennessee Health Science Center, Memphis, TN, USA.
Department of Obstetrics and Gynecology, College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
Eur J Obstet Gynecol Reprod Biol. 2021 Sep;264:88-96. doi: 10.1016/j.ejogrb.2021.07.022. Epub 2021 Jul 14.
To meta-analytically examine the frequency and prognostic impact of preoperative leukocytosis in endometrial carcinoma (EC).
Five major databases were searched till 01-February-2021. Studies that evaluated the frequency of preoperative leukocytosis or its correlation with pathological and survival outcomes in EC patients were included. Data were pooled as mean differences (MD), odds ratios (OR), or hazard ratios (HR) with 95% confidence intervals.
Nine retrospective studies, with low risk of bias, were included. The pooled prevalence of preoperative leukocytosis was 11.2% (95% CI: 8.2-14.3). There was a significant correlation between preoperative leukocytosis and FIGO stage III-IV (OR = 2.10, 95% CI: 1.60-2.75), ≥50% myometrial invasion (OR = 1.32, 95% CI: 1.02-1.72), lymph node involvement (OR = 1.83, 95% CI: 1.29-2.59), cervical involvement (OR = 2.29, 95% CI: 1.68-3.13), adnexal involvement (OR = 2.17, 95% CI: 1.42-3.31), and tumor size (MD = 1.10 cm, 95% CI: 0.63-1.58). However, preoperative leukocytosis did not significantly correlate with tumor grade II-III, non-endometrioid histology, peritoneal cytology, and lympho-vascular space involvement (p > 0.05). Additionally, preoperative leukocytosis correlated with higher rates of death (OR = 2.85, 95% CI: 2.03-4.00), tumor recurrence (OR = 2.36, 95% CI: 1.21-4.61), and worse overall survival at univariate and multivariate analyses (HR = 2.90, 95% CI: 2.24-3.75 and HR = 2.16, 95% CI: 1.59-2.94, respectively). As for disease-free survival, preoperative leukocytosis emerged as an independent prognostic factor on univariate (HR = 1.27, 95% CI: 1.16-1.39) but not multivariate (HR = 1.08, 95% CI: 1.00-1.18) analyses.
Preoperative leukocytosis is common and correlates with poor pathological and survival outcomes in EC patients.
荟萃分析子宫内膜癌（EC）患者术前白细胞增多的频率及其对预后的影响。
检索截至 2021 年 2 月 1 日的 5 个主要数据库，纳入评估 EC 患者术前白细胞增多频率及其与病理和生存结局相关性的研究。数据以均数差（MD）、比值比（OR）或风险比（HR）及其 95%置信区间进行汇总。
纳入 9 项低偏倚风险的回顾性研究。术前白细胞增多的总患病率为 11.2%（95%CI：8.2-14.3）。术前白细胞增多与 FIGO 分期 III-IV （OR=2.10，95%CI：1.60-2.75）、≥50%肌层浸润（OR=1.32，95%CI：1.02-1.72）、淋巴结受累（OR=1.83，95%CI：1.29-2.59）、宫颈受累（OR=2.29，95%CI：1.68-3.13）、附件受累（OR=2.17，95%CI：1.42-3.31）和肿瘤大小（MD=1.10cm，95%CI：0.63-1.58）显著相关。然而，术前白细胞增多与肿瘤分级 II-III、非子宫内膜样组织学、腹膜细胞学和淋巴管血管空间受累无显著相关性（p>0.05）。此外，术前白细胞增多与死亡率（OR=2.85，95%CI：2.03-4.00）、肿瘤复发率（OR=2.36，95%CI：1.21-4.61）以及单因素和多因素分析中的总体生存较差相关（HR=2.90，95%CI：2.24-3.75 和 HR=2.16，95%CI：1.59-2.94）。对于无病生存率，术前白细胞增多是单因素（HR=1.27，95%CI：1.16-1.39）而不是多因素（HR=1.08，95%CI：1.00-1.18）分析中的独立预后因素。
术前白细胞增多在 EC 患者中较为常见，与不良的病理和生存结局相关。
