Zhu Lihui, Liu Shuo, Wang Da, Yu Miao, Cai Hui
School of Clinical Medicine, Ningxia Medical University, Yinchuan, China.
NHC Key Laboratory of Diagnosis and Therapy of Gastrointestinal Tumor Gansu Provincial Hospital, Lanzhou, Gansu, China.
Curr Ther Res Clin Exp. 2024 Mar 9;101:100741. doi: 10.1016/j.curtheres.2024.100741. eCollection 2024.
The hypercoagulable state of cancer patients is associated with their high mortality rate. Coagulation indicators may have an important role in the prognosis of gastric cancer patients and deserve to be explored in various aspects.
We conducted a meta-analysis to explore the correlation between coagulation and prognosis of gastric cancer.
A comprehensive systematic search was conducted in PubMed, Embase, Web of Science databases, and the Cochrane Library up to February 16, 2024. Literature screening and data extraction were performed by two independent reviewers. The processed data we pooled using either a random-effects model or a fixed-effects model and finally described overall survival with a risk ratio (hazard ratio [HR]) and predicted the likelihood of different clinicopathological events with a dominance ratio (OR).
A total of 64 studies were screened for inclusion in the data analysis. Performing a meta-analysis of three indicators we derived that the risk of d-dimer (D-D), fibrinogen (FIB), and platelets (PLTs) were: HR = 1.85 (95% confidence interval [CI]: 1.59-2.15, = 15), HR = 1.77 (95% CI: 1.57-1.99, = 28), HR = 1.16 (95% CI: 1.12-1.21, = 29). In addition to this, all three were associated with advanced clinicopathological stage (D-D: OR = 2.25, FIB: OR = 2.07, PLT: OR = 1.84), T stage (D-D: OR = 2.30, FIB: OR = 2.38, PLT: OR = 2.22) and lymph node metastasis (D-D: OR = 1.79, FIB: OR = 1.70, PLT: OR = 1.51).
Overall, the findings suggest that the three indicators, D-D, FIB, and PLT count, have significant predictive value for the prognosis of gastric cancer. They were associated with an advanced clinicopathological stage and a high risk of lymph node metastasis.
癌症患者的高凝状态与其高死亡率相关。凝血指标可能在胃癌患者的预后中发挥重要作用，值得从各个方面进行探索。
我们进行了一项荟萃分析，以探讨凝血与胃癌预后之间的相关性。
截至2024年2月16日，在PubMed、Embase、Web of Science数据库和Cochrane图书馆进行了全面的系统检索。由两名独立评审员进行文献筛选和数据提取。我们使用随机效应模型或固定效应模型对处理后的数据进行汇总，最后用风险比（风险比[HR]）描述总生存期，并用优势比（OR）预测不同临床病理事件的可能性。
共筛选出64项研究纳入数据分析。对三项指标进行荟萃分析后，我们得出D-二聚体（D-D）、纤维蛋白原（FIB）和血小板（PLTs）的风险分别为：HR = 1.85（95%置信区间[CI]：1.59 - 2.15，= 15），HR = 1.77（95%CI：1.57 - 1.99，= 28），HR = 1.16（95%CI：1.12 - 1.21，= 29）。除此之外，这三项指标均与临床病理分期晚期（D-D：OR = 2.25，FIB：OR = 2.07，PLT：OR = 1.84）、T分期（D-D：OR = 2.30，FIB：OR = 2.38，PLT：OR = 2.22）和淋巴结转移（D-D：OR = 1.79，FIB：OR = 1.70，PLT：OR = 1.51）相关。
总体而言，研究结果表明，D-D、FIB和PLT计数这三项指标对胃癌预后具有显著的预测价值。它们与临床病理分期晚期和淋巴结转移高风险相关。
