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术前中性粒细胞与淋巴细胞比值与接受食管癌切除术的患者生存结局之间的关联：一项系统评价和荟萃分析

Association between preoperative neutrophil-to-lymphocyte ratio and the survival outcomes of esophageal cancer patients underwent esophagectomy: a systematic review and meta-analysis.

作者信息

Wu Xun, Liu SiJie, Li FengWei, Chen YingTai

机构信息

Department of Thoracic Surgery, Beijing Aerospace General Hospital, Beijing, China.

出版信息

Front Oncol. 2024 Aug 19;14:1404711. doi: 10.3389/fonc.2024.1404711. eCollection 2024.

DOI:10.3389/fonc.2024.1404711
PMID:39224809
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11366628/
Abstract

OBJECTIVES

The purpose of this study was to assess the association between preoperative neutrophil-to-lymphocyte ratio (NLR) and the survival outcomes of esophageal cancer patients who underwent esophagectomy, the latest and comprehensive systematic review performed.

METHODS

Related literature retrieved from PubMed, Web of Science, Embase, and Cochrane before January 2024, according to the inclusion criteria. Outcomes measured were overall survival (OS), disease-free survival (DFS), relapse-free survival (RFS), and cancer-specific survival (CSS).

RESULTS

Eighteen studies with 6,119 esophageal cancer patients were retained for analysis. Meta-analysis demonstrated that OS (HR: 1.47; 95% CI: 1.29, 1.67; < 0.00001), DFS (HR: 1.62; 95% CI: 1.29, 2.05; < 0.0001), and CSS (HR: 1.62; 95% CI: 1.29, 2.05; < 0.0001) were significantly shorter in the high NLR group compared with the low NLR group. In addition, meta-analysis revealed a similar RFS (HR: 1.47; 95% CI: 0.92, 2.35; = 0.10) among the two groups. Subgroup analysis of OS and DFS based on mean/median age, NLR cutoff, and region found that all subgroups remained significant difference between two groups.

CONCLUSION

Among esophageal cancer patients who underwent esophagectomy, preoperative NLR can be used as prognostic factor independently. High-preoperative NLR is associated with poor prognosis. More large-scale, multicenter prospective clinical studies are needed to further validate the relationship between preoperative NLR and prognosis of esophageal cancer.

摘要

目的

本研究旨在评估术前中性粒细胞与淋巴细胞比值（NLR）与接受食管切除术的食管癌患者生存结局之间的关联，进行了最新且全面的系统评价。

方法

根据纳入标准，检索2024年1月之前PubMed、Web of Science、Embase和Cochrane上的相关文献。测量的结局指标为总生存期（OS）、无病生存期（DFS）、无复发生存期（RFS）和癌症特异性生存期（CSS）。

结果

保留18项研究共6119例食管癌患者进行分析。荟萃分析表明，高NLR组的OS（风险比：1.47；95%置信区间：1.29，1.67；P<0.00001）、DFS（风险比：1.62；95%置信区间：1.29，2.05；P<0.0001）和CSS（风险比：1.62；95%置信区间：1.29，2.05；P<0.0001）与低NLR组相比显著缩短。此外，荟萃分析显示两组间RFS相似（风险比：1.47；95%置信区间：0.92，2.35；P=0.10）。基于平均/中位数年龄、NLR临界值和地区对OS和DFS进行亚组分析发现，所有亚组两组间仍存在显著差异。

结论

在接受食管切除术的食管癌患者中，术前NLR可独立作为预后因素。术前高NLR与预后不良相关。需要更多大规模、多中心的前瞻性临床研究来进一步验证术前NLR与食管癌预后之间的关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d181/11366628/4c8fcc3187f2/fonc-14-1404711-g007.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d181/11366628/4c8fcc3187f2/fonc-14-1404711-g007.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d181/11366628/4c8fcc3187f2/fonc-14-1404711-g007.jpg

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