Zhou Hongbin, Li Jiuke, Zhang Yiting, Chen Zhewen, Chen Ying, Ye Sa
Cancer Center, Department of Pulmonary and Critical Care Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.
Department of Ophthalmology, Hangzhou Aier Eye Hospital, Hangzhou, Zhejiang, China.
Front Oncol. 2023 Jan 13;12:1086742. doi: 10.3389/fonc.2022.1086742. eCollection 2022.
The aim of this study was to evaluate the relationship between platelet-lymphocyte ratio (PLR) and prognosis in small cell lung cancer (SCLC) patients.
A comprehensive search was carried out to collect related studies. Two independent investigators extracted the data of hazard ratio (HR) and 95% confidence interval (CI) for overall survival (OS) or progression-free survival (PFS). A random-effect model was applied to analyze the effect of different PLR levels on OS and PFS in SCLC patients. Moreover, subgroup analysis was conducted to seek out the source of heterogeneity.
A total of 26 articles containing 5,592 SCLC patients were included for this meta-analysis. SCLC patients with a high PLR level had a shorter OS compared with patients with a low PLR level, in both univariate (HR = 1.56, 95% CI 1.28-1.90, < 0.0001) and multivariate (HR = 1.31, 95% CI 1.08-1.59, = 0.007) models. SCLC patients with a high PLR level had a shorter PFS compared with patients with a low PLR level, in the univariate model (HR = 1.71, 95% CI 1.35-2.16, < 0.0001), but not in the multivariate model (HR = 1.17, 95% CI 0.95-1.45, = 0.14). Subgroup analysis showed that a high level of PLR shortened OS in some subgroups, including the Asian subgroup, the younger subgroup, the mixed-stage subgroup, the chemotherapy-dominant subgroup, the high-cutoff-point subgroup, and the retrospective subgroup. PLR level did not affect OS in other subgroups.
PLR was a good predictor for prognosis of SCLC patients, especially in patients received chemotherapy dominant treatments and predicting OS.
https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022383069.
本研究旨在评估小细胞肺癌（SCLC）患者血小板淋巴细胞比率（PLR）与预后之间的关系。
进行全面检索以收集相关研究。两名独立研究人员提取总生存（OS）或无进展生存（PFS）的风险比（HR）及95%置信区间（CI）的数据。应用随机效应模型分析不同PLR水平对SCLC患者OS和PFS的影响。此外，进行亚组分析以找出异质性来源。
本荟萃分析共纳入26篇文章，包含5592例SCLC患者。在单因素（HR = 1.56，95% CI 1.28 - 1.90，P < 0.0001）和多因素（HR = 1.31，95% CI 1.08 - 1.59，P = 0.007）模型中，PLR水平高的SCLC患者较PLR水平低的患者OS更短。在单因素模型中（HR = 1.71，95% CI 1.35 - 2.16，P < 0.0001），PLR水平高的SCLC患者较PLR水平低的患者PFS更短，但在多因素模型中并非如此（HR = 1.17，95% CI 0.95 - 1.45，P = 0.14）。亚组分析显示，在一些亚组中，包括亚洲亚组、年轻亚组、混合分期亚组、以化疗为主的亚组、高截断点亚组和回顾性亚组，PLR水平高会缩短OS。在其他亚组中，PLR水平不影响OS。
PLR是SCLC患者预后的良好预测指标，尤其在接受以化疗为主治疗的患者中及预测OS时。
