附件评估的化疗反应评分（CRS）对卵巢高级别浆液性癌的预后价值：一项系统评价和荟萃分析

Prognostic Value of Chemotherapy Response Score (CRS) Assessed on the Adnexa in Ovarian High-Grade Serous Carcinoma: A Systematic Review and Meta-Analysis.

作者信息

Santoro Angela, Travaglino Antonio, Inzani Frediano, Straccia Patrizia, Arciuolo Damiano, Valente Michele, D'Alessandris Nicoletta, Scaglione Giulia, Angelico Giuseppe, Piermattei Alessia, Cianfrini Federica, Raffone Antonio, Zannoni Gian Franco

机构信息

Unità di Ginecopatologia e Patologia Mammaria, Dipartimento Scienze della Salute della Donna, del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Roma, Italy.

Division of Gynaecology and Human Reproduction Physiopathology, Department of Medical and Surgical Sciences (DIMEC), IRCCS Azienda Ospedaliero-Univeristaria di Bologna, S. Orsola Hospital, University of Bologna, Via Massarenti 13, 40138 Bologna, Italy.

出版信息

Diagnostics (Basel). 2022 Mar 4;12(3):633. doi: 10.3390/diagnostics12030633.

Background: chemotherapy response score (CRS) is widely used to assess the response of ovarian high-grade serous carcinoma (HGSC) to chemotherapy and is based on pathological examination of omental specimens. We aimed to assess the prognostic value of CRS assessed on the uterine adnexa. Methods: a systematic review and meta-analysis were performed by searching three electronic databases from 2015 inception to September 2021. We included all studies reporting either hazard ratio (HR) with 95% confidence interval (CI) for progression-free survival (PFS) or primary PFS data, for both adnexal and omental CRS in HGSC. HRs with 95% CI were extracted and pooled by using a significant p-value < 0.05. Statistical heterogeneity was assessed by using Higgins’ I2. Results: six studies with 691 HGSC patients were included. Adnexal CRS3 vs. CRS1-2 significantly stratified PFS, with a HR of 0.572 (0.447−0.733; p < 0.001). Omental CRS3 vs. CRS1-2 significantly stratified PFS with a similar HR (HR = 0.542; 95% CI 0.444−0.662; p < 0.001). Statistical heterogeneity was 0% in both analyses. Conclusions: adnexal CRS significantly stratifies PFS in HGSC and might be used when omental CRS is not assessable.

背景

化疗反应评分（CRS）广泛用于评估卵巢高级别浆液性癌（HGSC）对化疗的反应，且基于大网膜标本的病理检查。我们旨在评估子宫附件评估的CRS的预后价值。方法：通过检索2015年开始至2021年9月的三个电子数据库进行系统评价和荟萃分析。我们纳入了所有报告HGSC中附件和大网膜CRS的无进展生存期（PFS）的风险比（HR）及95%置信区间（CI）或原发性PFS数据的研究。采用显著p值<0.05提取并汇总95%CI的HR。使用希金斯I²评估统计异质性。结果：纳入了6项研究，共691例HGSC患者。附件CRS3与CRS1 - 2显著分层PFS，HR为0.572（0.447 - 0.733；p < 0.001）。大网膜CRS3与CRS1 - 2显著分层PFS，HR相似（HR = 0.542；95%CI 0.444 - 0.662；p < 0.001）。两项分析中的统计异质性均为0%。结论：附件CRS在HGSC中显著分层PFS，当大网膜CRS不可评估时可使用。