Zeng Di, Wang Yaoqun, Wen Ningyuan, Lu Jiong, Li Bei, Cheng Nansheng
Division of Biliary Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Research Center for Biliary Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Front Oncol. 2024 Aug 29;14:1437978. doi: 10.3389/fonc.2024.1437978. eCollection 2024.
Recent evidence indicates that inflammation plays a major role in the pathogenesis and progression of CCA. This meta-analysis seeks to evaluate the prognostic implications of preoperative inflammatory markers, specifically NLR, PLR, and LMR, in patients with eCCA. By focusing on these preoperative biomarkers, this study aims to provide valuable insights into their prognostic value and potential utility in clinical practice.
For this analysis, comprehensive searches were conducted in PubMed, Embase, and Web of Science databases from inception to May 2024. The primary outcomes of interest focused on the association between the levels of NLR, PLR, and LMR and the prognosis of eCCA patients. Statistical analyses were conducted using STATA 17.0 software.
The meta-analysis, involving 20 retrospective studies with 5553 participants, revealed significant correlations between preoperative biomarkers and the prognosis of eCCA patients. Elevated NLR, PLR, and decreased LMR levels were extensively studied regarding overall survival (OS) in eCCA patients. Elevated NLR was an independent predictor of poor OS (HR 1.86, p < 0.001), similar to elevated PLR (HR 1.76, p < 0.001), while decreased LMR predicted poor OS (HR 2.16, p < 0.001). Subgroup analyses based on eCCA subtypes and curative surgery status showed consistent results.
In conclusion, our study emphasizes the clinical significance of assessing NLR, PLR, and LMR preoperatively to predict patient prognosis. Elevated NLR and PLR values, along with decreased LMR values, were linked to poorer overall survival (OS). Large-scale prospective cohort studies are required to confirm their independent prognostic value in eCCA.
https://www.crd.york.ac.uk/prospero/, identifier CRD42024551031.
最近的证据表明，炎症在CCA的发病机制和进展中起主要作用。本荟萃分析旨在评估术前炎症标志物，特别是中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和淋巴细胞与单核细胞比值（LMR）对肝外胆管癌（eCCA）患者的预后影响。通过关注这些术前生物标志物，本研究旨在深入了解它们的预后价值以及在临床实践中的潜在应用。
对于本次分析，从数据库建立至2024年5月在PubMed、Embase和Web of Science数据库中进行了全面检索。主要关注的结果集中在NLR、PLR和LMR水平与eCCA患者预后之间的关联。使用STATA 17.0软件进行统计分析。
该荟萃分析纳入了20项回顾性研究，共5553名参与者，结果显示术前生物标志物与eCCA患者的预后之间存在显著相关性。在eCCA患者的总生存期（OS）方面，广泛研究了升高的NLR、PLR以及降低的LMR水平。升高的NLR是OS不良的独立预测因素（风险比[HR] 1.86，p < 0.001），与升高的PLR情况类似（HR 1.76，p < 0.001），而降低的LMR则预示着OS不良（HR 2.16，p < 0.001）。基于eCCA亚型和根治性手术状态的亚组分析显示结果一致。
总之，我们的研究强调了术前评估NLR、PLR和LMR以预测患者预后的临床意义。升高的NLR和PLR值以及降低的LMR值与较差的总生存期（OS）相关。需要大规模前瞻性队列研究来证实它们在eCCA中的独立预后价值。
