Department of Cardiothoracic Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Gen Thorac Cardiovasc Surg. 2024 Sep;72(9):553-561. doi: 10.1007/s11748-024-02044-8. Epub 2024 May 27.
Previous studies reported that the cribriform pattern (CP) was associated with poor prognosis in lung adenocarcinoma (ADC) patients; therefore, a meta-analysis was performed to thoroughly evaluate the prognostic impact of cribriform pattern in postoperative ADC patients.
Eligible studies were retrieved from PubMed, Embase databases, and Web of Science until April 2023. Studies evaluating the effect of the cribriform pattern on the prognosis of postoperative ADC patients were included. Subsequently, subgroup analysis was conducted according to the proportion of the cribriform pattern, with disease-free survival (DFS) and/or overall survival (OS) as outcomes. Hazard ratios (HRs) and 95% confidence intervals (CIs) were used as effect estimates in the meta-analyses, which were performed with a random-effects model despite the heterogeneity.
Nine studies published between 2015 and 2022 were included, with 4,289 ADC patients in total. The pooled results revealed a significantly poorer DFS (HR1.56, 95%CI 1.18-2.06, P = 0.11, I = 45%) and OS (HR2.11, 95%CI 1.63-2.72, P = 0.01, I = 56%) in patients with the cribriform pattern. Furthermore, the subgroup analysis showed that patients with a cribriform pattern (DFS: HR1.32, 95% CI 1.04-1.68 OS:HR2.30, 95% CI 1.55-3.39) and patients with a predominantly cribriform pattern (DFS:HR2.04, 95% CI 1.32--3.15 OS: HR1.92, 95% CI 1.41-2.61) were associated with poor prognosis.
The presence of a cribriform pattern is related to poor prognosis in postoperative ADC patients, despite not being a main tumor component. However, the results should be confirmed by large-scale and prospective studies owing to the small sample and potential heterogeneity.
先前的研究报告称，筛状模式（CP）与肺腺癌（ADC）患者的预后不良相关；因此，进行了一项荟萃分析，以彻底评估 CP 对术后 ADC 患者预后的影响。
从 PubMed、Embase 数据库和 Web of Science 中检索到 2023 年 4 月之前符合条件的研究。纳入评估 CP 对术后 ADC 患者预后影响的研究。随后，根据筛状模式的比例进行亚组分析，以无病生存率（DFS）和/或总生存率（OS）为结局。荟萃分析中使用风险比（HR）和 95%置信区间（CI）作为效应估计值，尽管存在异质性，但采用随机效应模型进行分析。
纳入了 2015 年至 2022 年期间发表的 9 项研究，共纳入 4289 例 ADC 患者。汇总结果显示，筛状模式患者的 DFS（HR1.56，95%CI 1.18-2.06，P=0.11，I=45%）和 OS（HR2.11，95%CI 1.63-2.72，P=0.01，I=56%）显著较差。此外，亚组分析显示，筛状模式患者（DFS：HR1.32，95%CI 1.04-1.68 OS：HR2.30，95%CI 1.55-3.39）和主要为筛状模式的患者（DFS：HR2.04，95%CI 1.32-3.15 OS：HR1.92，95%CI 1.41-2.61）与预后不良相关。
尽管筛状模式不是主要肿瘤成分，但它与术后 ADC 患者的预后不良相关。然而，由于样本量小且存在潜在异质性，这些结果需要通过大规模和前瞻性研究来证实。
