老年营养风险指数对泌尿系统癌症患者的预后影响：一项荟萃分析。
Prognostic impact of geriatric nutritional risk index on patients with urological cancers: A meta-analysis.
作者信息
Wu Quan, Ye Fagen
机构信息
Clinical Laboratory, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China.
Department of Urology, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, China.
出版信息
Front Oncol. 2023 Jan 11;12:1077792. doi: 10.3389/fonc.2022.1077792. eCollection 2022.
BACKGROUND
Despite previous research examining the predictive value of the geriatric nutritional risk index (GNRI) in individuals with urological cancers (UCs), results have been conflicting. This study aimed to comprehensively explore the potential link between GNRI and the prognosis of UCs using a meta-analysis.
METHODS
The Cochrane Library, PubMed, Embase, and Web of Science databases were systematically and exhaustively searched. We estimated the prognostic importance of the GNRI in patients with UCs by calculating the pooled hazard ratios (HRs) and 95% confidence intervals (CIs) on survival outcomes. Publication bias was identified using Egger's test and Begg's funnel plot.
RESULTS
Eight trials with 6,792 patients were included in our meta-analysis. Patients with UCs who had a lower GNRI before treatment had a higher risk of experiencing worse overall survival (HR = 2.62, 95% CI = 1.69-4.09, p < 0.001), recurrence-free survival/progression-free survival (HR = 1.77, 95% CI = 1.51-2.08, p < 0.001), and cancer-specific survival (HR = 2.32, 95% CI = 1.28-4.20, p = 0.006). Moreover, the subgroup analysis did not change the predictive significance of the GNRI in individuals with UCs. Neither Egger's nor Begg's test indicated substantial bias in this analysis.
CONCLUSION
As a result of our meta-analysis, we found that a low GNRI strongly predicts poor prognosis for patients with UCs. A lower pretreatment GNRI indicates poor survival outcomes in UCs.
背景
尽管先前有研究探讨老年营养风险指数（GNRI）在泌尿系统癌症（UCs）患者中的预测价值，但结果相互矛盾。本研究旨在通过荟萃分析全面探讨GNRI与UCs预后之间的潜在联系。
方法
系统全面地检索了Cochrane图书馆、PubMed、Embase和Web of Science数据库。我们通过计算生存结局的合并风险比（HRs）和95%置信区间（CIs）来评估GNRI在UCs患者中的预后重要性。使用Egger检验和Begg漏斗图识别发表偏倚。
结果
我们的荟萃分析纳入了八项试验，共6792例患者。治疗前GNRI较低的UCs患者总体生存情况较差的风险更高（HR = 2.62，95% CI = 1.69 - 4.09，p < 0.001），无复发生存/无进展生存情况较差的风险更高（HR = 1.77，95% CI = 1.51 - 2.08，p < 0.001），以及癌症特异性生存情况较差的风险更高（HR = 2.32，95% CI = 1.28 - 4.20，p = 0.006）。此外，亚组分析并未改变GNRI在UCs患者中的预测意义。Egger检验和Begg检验均未表明该分析存在实质性偏倚。
结论
通过我们的荟萃分析，我们发现低GNRI强烈预测UCs患者预后不良。治疗前较低的GNRI表明UCs患者生存结局较差。
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