Li Yanqing, Xu Tianxiang, Wang Xin, Jia Xiangdong, Ren Meng, Wang Xiaoxia
Graduate School of Baotou Medical College, Inner Mongolia University of Science and Technology, Baotou, 014000, China.
Abdominal Tumor Surgery, Center of Tumor, Inner Mongolia People's Hospital, Hohhot, 010017, China.
Cancer Cell Int. 2023 Feb 28;23(1):39. doi: 10.1186/s12935-023-02876-z.
The neutrophil-to-lymphocyte ratio is used to reflect body's inflammatory status with prognostic value in different cancers. We aimed to investigate the influence of preoperative NLR in the prognosis of CRLM patients receiving surgery using meta-analysis. Data in Cochrane Library, PubMed, Embase, and Web of Science databases created before October 2022 were recruited. Meta-analysis was carried out with RevMan 5.3 and Stata16 software, and the primary outcome indicators included overall survival (OS), and secondary outcome indicators included disease-free survival (DFS) and relapse-free survival (RFS). The pooled risk ratio (HR) and 95% confidence interval (CI) for each outcome indicator were determined using random-effects models or fixed-effects models. The pooled odds ratio (OR) and corresponding 95% confidence intervals (CI) for NLR and clinicopathological characteristics were determined with a fixed-effects model. 18 papers published between 2008 and 2022 (3184 patients in total) were included. The pooled analysis found that high preoperative NLR was correlated with poor OS (multivariate HR = 1.83, 95% CI = 1.61-2.08, p < 0.01), DFS (multivariate HR = 1.78, 95% CI = 1.16-2.71, p < 0.01) and RFS (multivariate HR = 1.46, 95% CI = 1.15-1.85, p < 0.01), but NLR was not related to clinicopathological features of CRLM patients correlation. In conclusion, NLR is an independent risk factor for poor prognosis in patients with CRLM. More large-scale clinical researches are required in the future to demonstrate the inclusion of preoperative NLR as a prognostic indicator for CRLM patients to guide postoperative adjuvant chemotherapy.
中性粒细胞与淋巴细胞比值用于反映机体炎症状态，对不同癌症具有预后价值。我们旨在通过荟萃分析研究术前中性粒细胞与淋巴细胞比值（NLR）对接受手术的结直肠癌肝转移（CRLM）患者预后的影响。收集了2022年10月之前创建的Cochrane图书馆、PubMed、Embase和Web of Science数据库中的数据。使用RevMan 5.3和Stata16软件进行荟萃分析，主要结局指标包括总生存期（OS），次要结局指标包括无病生存期（DFS）和无复发生存期（RFS）。使用随机效应模型或固定效应模型确定每个结局指标的合并风险比（HR）和95%置信区间（CI）。使用固定效应模型确定NLR与临床病理特征的合并优势比（OR）和相应的95%置信区间（CI）。纳入了2008年至2022年发表的18篇论文（共3184例患者）。汇总分析发现，术前高NLR与较差的OS（多变量HR = 1.83，95%CI = 1.61 - 2.08，p < 0.01）、DFS（多变量HR = 1.78，95%CI = 1.16 - 2.71，p < 0.01）和RFS（多变量HR = 1.46，95%CI = 1.15 - 1.85，p < 0.01）相关，但NLR与CRLM患者的临床病理特征无关。总之，NLR是CRLM患者预后不良的独立危险因素。未来需要更多大规模临床研究来证明将术前NLR纳入CRLM患者的预后指标以指导术后辅助化疗。
