绝对淋巴细胞计数和中性粒细胞与淋巴细胞比值对转移性乳腺癌患者的预后价值：一项系统评价和荟萃分析

The prognostic value of absolute lymphocyte count and neutrophil-to-lymphocyte ratio for patients with metastatic breast cancer: a systematic review and meta-analysis.

作者信息

Sang Bulin, Fan Yuxin, Wang Xurao, Dong Lixian, Gong Yuanyuan, Zou Wenhong, Zhao Guanhua, He Jianchang

机构信息

Clinical Pharmacology Research Center, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, China.

College of Pharmacy, Dali University, Dali, China.

出版信息

Front Oncol. 2024 Mar 7;14:1360975. doi: 10.3389/fonc.2024.1360975. eCollection 2024.

DOI:10.3389/fonc.2024.1360975

PMID:38515567

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10955091/

Abstract

BACKGROUND

Neutrophil-to-lymphocyte ratio (NLR) is considered a potential prognostic marker in early breast cancer. However, the prognosis of absolute lymphocyte count (ALC) and NLR in metastatic breast cancer (MBC) has been reported in a few studies, and conclusions are still conflicting. This present manuscript aims to provide further solid evidence regarding the prognostic values of ALC and NLR in MBC patients.

METHOD

Eligible studies that reported the associations between ALC or NLR and MBC were included by searching relative electronic databases. Overall survival (OS) and progression-free survival (PFS) were used as outcome measures. The hazard ratio (HR) values and 95% confidence interval (CI) of the outcome measures were collected as effect sizes, and further analysis and discussion were conducted according to the pooled HR, subgroup analysis, publication bias, and interstudy heterogeneity.

RESULTS

Twenty-nine studies comprising 3,973 patients with MBC were included. According to our findings, lower ALC was significantly associated with poorer prognosis of OS (HR = 0.57, 95% CI 0.48 to 0.68) and PFS (HR = 0.68, 95% CI 0.58 to 0.79), and greater NLR was associated with poorer OS (HR = 1.50, 95% CI 1.35 to 1.67) and PFS (HR = 1.82, 95% CI 1.42 to 2.35). Furthermore, the prognostic values of ALC and NLR in MBC were also observed in the subgroup analyses regarding cutoff values and ethnicities.

CONCLUSION

Low ALC and elevated NLR were observed to be significantly associated with adverse OS and PFS in MBC, indicating that ALC and NLR may act as potential prognostic biomarkers of MBC patients. Meanwhile, our results will also provide some novel evidence and research clues for the selection and development of clinical treatment strategies for MBC patients.

SYSTEMATIC REVIEW REGISTRATION

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42021224114.

摘要

背景

中性粒细胞与淋巴细胞比值（NLR）被认为是早期乳腺癌的潜在预后标志物。然而，关于转移性乳腺癌（MBC）中绝对淋巴细胞计数（ALC）和NLR的预后情况，仅有少数研究报道，且结论仍存在冲突。本研究旨在提供关于ALC和NLR在MBC患者中预后价值的进一步确凿证据。

方法

通过检索相关电子数据库纳入报道了ALC或NLR与MBC之间关联的合格研究。总生存期（OS）和无进展生存期（PFS）用作结局指标。收集结局指标的风险比（HR）值和95%置信区间（CI）作为效应量，并根据合并的HR、亚组分析、发表偏倚和研究间异质性进行进一步分析和讨论。

结果

纳入了29项研究，共3973例MBC患者。根据我们的研究结果，较低的ALC与较差的OS预后（HR = 0.57，95% CI 0.48至0.68）和PFS预后（HR = 0.68，95% CI 0.58至0.79）显著相关，较高的NLR与较差的OS预后（HR = 1.50，95% CI 1.35至1.67）和PFS预后（HR = 1.82，95% CI 1.42至2.35）相关。此外，在关于临界值和种族的亚组分析中也观察到了ALC和NLR在MBC中的预后价值。