School of Basic Medicine and Clinical Pharmacy, China Pharmaceutical University, Nanjing, 210009, China.
Department of Pharmacy, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China.
Int J Clin Oncol. 2022 Jul;27(7):1127-1138. doi: 10.1007/s10147-022-02181-1. Epub 2022 May 23.
The prognostic value of myosteatosis has been widely investigated in lung cancer, yet conclusions remain controversial. The purpose of this meta-analysis was to illuminate this issue. Medline, Embase, Cochrane Library and Web of Science Core Collection online databases were systematically searched from inception to 24 September 2021. Newcastle-Ottawa Scale tool was applied to evaluate the quality of included studies. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) for overall survival (OS) and progression-free survival (PFS) were used to examine prognostic value of myosteatosis. Subgroup analysis and sensitivity analysis were conducted to assess heterogeneity and stability of results. A total of 484 articles were screened from which 9 eligible studies involving 1667 patients were enrolled in this meta-analysis. Lung cancer patients with myosteatosis had significantly worse OS than patients without myosteatosis (HR 1.10, 95% CI 1.05-1.16, P < 0.001), both in six multivariate analysis (HR 1.46, 95% CI 1.16-1.85, P = 0.001) and in three univariate analysis (HR 1.08, 95% CI 1.03-1.14, P = 0.003). Pooled data from five studies using multivariate survival analysis also showed that patients with myosteatosis had a statistically significant unfavorable PFS (HR = 1.27, 95% CI 1.00-1.62, P = 0.049). Sensitivity analysis showed the result for OS was stable. But for PFS, the result was not robust. Myosteatosis might serve as an independent indicator of unfavorable survival outcomes for OS and PFS in lung cancer patients. Further studies are needed to confirm our results.
肌内脂肪含量在肺癌中的预后价值已被广泛研究，但结论仍存在争议。本荟萃分析旨在阐明这一问题。系统检索了 Medline、Embase、Cochrane Library 和 Web of Science Core Collection 在线数据库，检索时间从建库至 2021 年 9 月 24 日。采用 Newcastle-Ottawa Scale 量表评估纳入研究的质量。使用合并的风险比（HR）及其 95%置信区间（CI）来评估肌内脂肪含量对总生存期（OS）和无进展生存期（PFS）的预后价值。进行亚组分析和敏感性分析，以评估结果的异质性和稳定性。从 484 篇文章中筛选出 9 项符合条件的研究，共纳入 1667 例患者进行荟萃分析。有肌内脂肪含量的肺癌患者的 OS 明显差于无肌内脂肪含量的患者（HR 1.10，95%CI 1.05-1.16，P<0.001），在 6 项多变量分析（HR 1.46，95%CI 1.16-1.85，P=0.001）和 3 项单变量分析（HR 1.08，95%CI 1.03-1.14，P=0.003）中均如此。使用多变量生存分析的 5 项研究的汇总数据也显示，有肌内脂肪含量的患者的 PFS 明显较差（HR=1.27，95%CI 1.00-1.62，P=0.049）。敏感性分析显示 OS 的结果稳定。但对于 PFS，结果并不稳健。肌内脂肪含量可能是肺癌患者 OS 和 PFS 不良生存结局的独立指标。需要进一步的研究来证实我们的结果。
