预处理中性粒细胞与淋巴细胞比值与癌症免疫治疗临床结局的关联：来自 30 项荟萃分析的证据综合。
Association of pretreatment neutrophil-to-lymphocyte ratio with clinical outcomes in cancer immunotherapy: An evidence synthesis from 30 meta-analyses.
机构信息
Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China.
Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China; Institute of Respiratory Health, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China; Precision Medicine Center, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China; The Research Units of West China, Chinese Academy of Medical Sciences, West China Hospital, Chengdu 610041, Sichuan, China; State Key Laboratory of Respiratory Health and Multimorbidity, Chengdu 610041, Sichuan, China.
出版信息
Int Immunopharmacol. 2024 May 10;132:111936. doi: 10.1016/j.intimp.2024.111936. Epub 2024 Apr 4.
BACKGROUND
The Neutrophil-to-lymphocyte ratio (NLR) holds relevance in cancer immunotherapy outcomes, yet its validation remains limited. Thus, we conducted an umbrella review to comprehensively assess the association between pretreatment NLR and immunotherapy outcomes, along with evaluating their credibility and strength.
METHODS
Electronic databases, including PubMed, Web of Science, Embase, Scopus, and Cochrane, were systematically searched for eligible systematic reviews and meta-analyses. Quality assessment and evidence grading utilized AMSTAR, GRADE, and additional classification criteria, following PRISMA and PRIOR guidelines.
RESULTS
Thirty unique meta-analyses were included, with 24 associations (80%) exhibiting statistical significance. Notably, associations between pretreatment NLR and the prognosis of renal cell carcinoma, hepatocellular carcinoma, melanoma, and non-small cell lung cancer garnered highly suggestive or convincing evidence grading.
CONCLUSIONS
Elevated pretreatment NLR correlates with poor outcomes in cancer immunotherapy, suggesting its potential as a biomarker for identifying appropriate treatment populations and predicting clinical outcomes. Nevertheless, further validation through prospective cohort studies is warranted.
背景
中性粒细胞与淋巴细胞比值（NLR）在癌症免疫治疗结果中具有相关性，但其实证验证仍然有限。因此，我们进行了一项伞式综述，以全面评估治疗前 NLR 与免疫治疗结果之间的关联，并评估其可信度和强度。
方法
系统地检索了包括 PubMed、Web of Science、Embase、Scopus 和 Cochrane 在内的电子数据库，以获取合格的系统评价和荟萃分析。使用 AMSTAR、GRADE 以及其他分类标准进行质量评估和证据分级，遵循 PRISMA 和 PRIOR 指南。
结果
共纳入 30 项独特的荟萃分析，其中 24 项关联（80%）具有统计学意义。值得注意的是，治疗前 NLR 与肾细胞癌、肝细胞癌、黑色素瘤和非小细胞肺癌预后之间的关联具有高度提示性或令人信服的证据分级。
结论
升高的治疗前 NLR 与癌症免疫治疗的不良结局相关，提示其可能作为识别合适治疗人群和预测临床结局的生物标志物。然而，仍需要通过前瞻性队列研究进行进一步验证。
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