淋巴细胞与单核细胞比值在食管癌患者中的预后价值：一项系统评价和荟萃分析

Prognostic value of lymphocyte to monocyte ratio in patients with esophageal cancer: a systematic review and meta-analysis.

作者信息

Han Yongqi, Zheng Song, Chen Yijing

机构信息

Department of Oncology, The Fourth School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China.

Department of Oncology, Hangzhou First People's Hospital, Hangzhou, China.

出版信息

Front Oncol. 2024 Nov 26;14:1401076. doi: 10.3389/fonc.2024.1401076. eCollection 2024.

DOI:10.3389/fonc.2024.1401076

PMID:39659783

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11628381/

Abstract

OBJECTIVES

To report the largest systematic review and meta-analysis to evaluate prognostic value of lymphocyte to monocyte ratio (LMR) in patients with esophageal cancer.

METHODS

We conducted a systematic literature retrieval via PubMed, Embase, Web of Science, and Cochrane until December, 2023 for studies which evaluated the prognostic value of LMR in patients with esophageal cancer. Outcomes measured were overall survival (OS), disease-free survival (DFS), relapse-free survival (RFS), and progression-free survival (PFS).

RESULTS

11 studies including 3,377 patients with esophageal cancer were included for meta-analysis. Meta-analysis demonstrated that OS (HR: 1.65; 95% CI: 1.19, 2.31; = 0.003) and DFS (HR: 1.48; 95% CI: 1.09, 2.01; = 0.01) were significantly shorter in the low LMR group compared with the high LMR group. In addition, meta-analysis revealed a similar PFS (HR: 1.58; 95% CI: 1.00, 2.51; = 0.05) and RFS (HR: 1.17; 95% CI: 0.93, 1.46; = 0.18) in the two groups. Subgroup analysis found that the predictive value of LMR for OS remained significant in resectable and unresectable esophageal cancers, and in studies with follow-up ≥24 months and < 24 months. Subgroup analysis based on treatment methods found that the prognostic value of LMR was significant for both patients who received PD-1/PD-L1 inhibitors and those who did not receive PD-1/PD-L1 inhibitors. However, subgroup analysis based on LMR threshold found that the significance remained in studies with LMR threshold<3.5 (HR: 2.09; 95% CI: 1.13, 3.87; P = 0.02) but disappeared in studies with LMR threshold ≥ 3.5 (HR: 1.39; 95% CI: 0.93, 2.07; P = 0.11).

CONCLUSIONS

Low LMR is associated with poor prognosis in patients with esophageal cancer. Due to the simple availability and low cost of routine blood tests in clinical practice, LMR can be widely used to assess prognosis and construct risk prediction models for patients with esophageal cancer.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO, identifier CRD42024509796.

摘要

目的

报告规模最大的系统评价和荟萃分析，以评估淋巴细胞与单核细胞比值（LMR）在食管癌患者中的预后价值。

方法

我们通过PubMed、Embase、Web of Science和Cochrane进行了系统的文献检索，截至2023年12月，检索评估LMR在食管癌患者中预后价值的研究。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）和无进展生存期（PFS）。

结果

纳入11项研究，共3377例食管癌患者进行荟萃分析。荟萃分析表明，与高LMR组相比，低LMR组的OS（风险比：1.65；95%置信区间：1.19，2.31；P = 0.003）和DFS（风险比：1.48；95%置信区间：1.09，2.01；P = 0.01）显著缩短。此外，荟萃分析显示两组的PFS（风险比：1.58；95%置信区间：1.00，2.51；P = 0.05）和RFS（风险比：1.17；95%置信区间：0.93，1.46；P = 0.18）相似。亚组分析发现，LMR对OS的预测价值在可切除和不可切除的食管癌中均保持显著，在随访≥24个月和<24个月的研究中也保持显著。基于治疗方法的亚组分析发现，LMR对接受PD-1/PD-L1抑制剂治疗的患者和未接受PD-1/PD-L1抑制剂治疗的患者的预后价值均显著。然而，基于LMR阈值的亚组分析发现，在LMR阈值<3.5的研究中具有显著意义（风险比：2.09；95%置信区间：1.13，3.87；P = 0.02），而在LMR阈值≥3.5的研究中则无显著意义（风险比：1.39；95%置信区间：0.93，2.07；P = 0.11）。