淋巴细胞与C反应蛋白比值在结直肠癌中的预后作用：一项系统评价和Meta分析
Prognostic Role of Lymphocyte-C-Reactive Protein Ratio in Colorectal Cancer: A Systematic Review and Meta Analysis.
作者信息
He Xinglong, Su Ade, Xu Yongcheng, Ma Diaolong, Yang Guoyuan, Peng Yiyun, Guo Jin, Hu Ming, Ma Yuntao
机构信息
The First Clinical School of Gansu University of Chinese Medicine, Lanzhou, China.
General Surgery Clinical Medical Center, Gansu Provincial People's Hospital, Lanzhou, China.
出版信息
Front Oncol. 2022 Jul 6;12:905144. doi: 10.3389/fonc.2022.905144. eCollection 2022.
INTRODUCTION
The lymphocyte-C-reactive protein ratio (LCR) is a new immunoinflammatory score and prognostic marker, but the relationship between this index and the prognosis of colorectal cancer patients remains controversial.Therefore, aim of the study was to assess the relationship between LCR and prognosis for colorectal cancer patients through a systematic evaluation and meta-analysis.
METHODS
We systematically searched PubMed, EMBASE, Web of Science, and Cochrane Library databases for randomized controlled studies and observational studies on the relationship between LCR and prognosis of colorectal cancer patients, all searched from the date of database creation to January 6, 2022.Our primary endpoints observed were overall survival (OS) and disease-free survival (DFS) of colorectal cancer patients, and secondary observables were basic characteristics of included studies, such as country, study duration, sample size, LCR threshold, and pathological characteristics of patients in each study, such as degree of differentiation, gender, tumor location, T stage, and lymphatic metastasis.
RESULTS
A total of 10 case-control studies including 7068 patients were included. Meta-analysis results showed that overall survival (OS) and disease-free survival (DFS) were worse in colorectal cancer patients with lower levels of LCR (HR=0.44, 95% CI=0.38-0.52, P<0.001; HR=0.56, 95% CI=0.41-0.76, P< 0.001).Subgroup analysis based on country, study length, sample size, and LCR threshold showed that lower levels of LCR were all associated with poorer OS (P < 0.05). Regarding pathological characteristics, patients in the low LCR group were generally poorly differentiated (OR=1.79, 95% CI=1.55-2.07, P<0.001), while there was no significant relationship with gender, tumor location, T stage, and lymphatic metastasis (P>0.05).
DISCUSSION/CONCLUSION: LCR can be used as a prognostic marker for colorectal cancer patients, and patients with lower levels of LCR may have a poor prognosis. Due to the limitation of the number and quality of the included studies, the above findings need to be validated by more high-quality studies.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/, identifier CRD42022296563.
引言
淋巴细胞与C反应蛋白比值（LCR）是一种新的免疫炎症评分和预后标志物，但该指标与结直肠癌患者预后之间的关系仍存在争议。因此，本研究的目的是通过系统评价和荟萃分析评估LCR与结直肠癌患者预后之间的关系。
方法
我们系统检索了PubMed、EMBASE、Web of Science和Cochrane图书馆数据库，以查找关于LCR与结直肠癌患者预后关系的随机对照研究和观察性研究，检索时间从数据库创建之日至2022年1月6日。我们观察的主要终点是结直肠癌患者的总生存期（OS）和无病生存期（DFS），次要观察指标是纳入研究的基本特征，如国家、研究持续时间、样本量、LCR阈值，以及每项研究中患者的病理特征，如分化程度、性别、肿瘤位置、T分期和淋巴转移。
结果
共纳入10项病例对照研究，包括7068例患者。荟萃分析结果显示，LCR水平较低的结直肠癌患者的总生存期（OS）和无病生存期（DFS）较差（HR=0.44，95%CI=0.38-0.52，P<0.001；HR=0.56，95%CI=0.41-0.76，P<0.001）。基于国家、研究时长、样本量和LCR阈值的亚组分析显示，较低的LCR水平均与较差的OS相关（P<0.05）。关于病理特征，LCR水平低的组患者通常分化程度差（OR=1.79，95%CI=1.55-2.07，P<0.001），而与性别、肿瘤位置、T分期和淋巴转移无显著关系（P>0.05）。
讨论/结论：LCR可作为结直肠癌患者的预后标志物，LCR水平较低的患者预后可能较差。由于纳入研究的数量和质量有限，上述结果需要更多高质量研究加以验证。
系统评价注册
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