根治性胃切除术后晚期肺癌炎症指数对胃癌患者预后的预测价值：倾向评分匹配队列研究和荟萃分析。

Prognostic value of the advanced lung cancer inflammation index in patients with gastric cancer after radical gastrectomy: a propensity-score matching cohort study and meta-analysis.

机构信息

Department of Gastrointestinal Cancer Center, Chongqing University Cancer Hospital, Chongqing, 400030, China.

Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, 400030, China.

出版信息

BMC Cancer. 2024 May 13;24(1):583. doi: 10.1186/s12885-024-12349-9.

BACKGROUND

Insufficient evidence existed about the prognostic role of the advanced lung cancer inflammation index (ALI) for gastric cancer patients who underwent curative resection. The aim of this study was to identify the predictive ability of ALI for survival after curative gastrectomy.

METHODS

We retrospectively analyzed 328 gastric cancer patients who received curative gastrectomy from the database of Chongqing University Cancer Hospital, and investigated the prognostic role of the preoperative ALI compared with clinicopathological variables and other serum biomarkers, such as preoperative neutrophil-to-lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and Lymphocyte-monocyte ratio (LMR). To minimize intergroup differences, propensity score matching (PSM) analysis was employed. Additionally, we performed a meta-analysis of four cohort studies published up to October 2023 following the PRISMA guidelines.

RESULTS

In the overall cohort, patients in the low ALI group had a significantly worse overall survival compared to those in the high ALI group (P < 0.0001). Subgroup analysis identified that ALI maintained its prognostic significance across different subgroups. In addition, ROC analysis showed that ALI had a higher AUC value for 3-year overall survival compared to NLR, PLR, and LMR (0.576 vs. 0.573 vs. 0.557 vs. 0.557). Multivariate analysis indicated that ALI, other than other serum biomarkers, was an independent risk factor for decreased overall survival in GC patients following curative surgery (HR = 1.449; 95%CI: 1.028-2.045; P = 0.034). Consistently, PSM analysis supported all of these findings. The meta-analysis including 4 studies evaluating 2542 patients, confirmed the association between the low ALI and poor survival outcomes.

CONCLUSION

The preoperative ALI was an independent prognostic factor for survival in gastric cancer patients who underwent curative gastrectomy.

背景

对于接受根治性胃切除术的胃癌患者，高级肺癌炎症指数（ALI）的预后作用证据不足。本研究旨在确定 ALI 对根治性胃切除术后生存的预测能力。

方法

我们回顾性分析了来自重庆大学肿瘤医院数据库的 328 例接受根治性胃切除术的胃癌患者，并调查了术前 ALI 与临床病理变量和其他血清生物标志物（如术前中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和淋巴细胞-单核细胞比值（LMR））相比的预后作用。为了最小化组间差异，我们采用了倾向评分匹配（PSM）分析。此外，我们根据 PRISMA 指南对截至 2023 年 10 月发表的四项队列研究进行了荟萃分析。

结果

在总队列中，低 ALI 组患者的总生存明显差于高 ALI 组（P<0.0001）。亚组分析表明，ALI 在不同亚组中仍具有预后意义。此外，ROC 分析显示，ALI 对 3 年总生存的 AUC 值高于 NLR、PLR 和 LMR（0.576 对 0.573 对 0.557 对 0.557）。多变量分析表明，ALI 是除其他血清生物标志物外，GC 患者根治性手术后总生存下降的独立危险因素（HR=1.449；95%CI：1.028-2.045；P=0.034）。同样，PSM 分析支持了所有这些发现。纳入 4 项研究共 2542 例患者的荟萃分析证实了低 ALI 与不良生存结局之间的关联。