控制营养状态（CONUT）评分对弥漫性大B细胞淋巴瘤患者的预后价值：一项荟萃分析

Prognostic value of the controlling nutritional status (CONUT) score in patients with diffuse large B-cell lymphoma: a meta-analysis.

作者信息

Zhao Jinqiang, Wu Ying

机构信息

Clinical Laboratory, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, 313000, China.

Department of Hematology, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou University, Huzhou, Zhejiang, 313000, China.

出版信息

World J Surg Oncol. 2025 Jan 29;23(1):28. doi: 10.1186/s12957-025-03663-y.

DOI:10.1186/s12957-025-03663-y

PMID:39881386

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11776244/

Abstract

BACKGROUND

The significance of the controlling nutritional status (CONUT) score in predicting the prognostic outcomes of diffuse large B-cell lymphoma (DLBCL) has been widely explored, with conflicting results. Therefore, the present meta-analysis aimed to identify the prognostic significance of the CONUT in DLBCL by aggregating current evidence.

METHODS

The Web of Science, PubMed, Embase, CNKI and Cochrane Library databases were searched for articles from inception to October 15, 2024. The prognostic value of CONUT for DLBCL was analyzed by determining the pooled hazard ratios (HRs) with 95% confidence intervals (CIs). The Newcastle-Ottawa Scale (NOS) was used to analyze study quality.

RESULTS

Eight studies including 2687 cases were included in this work. The NOS scores of these studies were 7-9 (median, 8), demonstrating high quality. Our analyses revealed that an elevated CONUT score significantly predicted poor overall survival (OS) (HR = 1.63, 95%CI = 1.29-2.05, p < 0.001) and inferior progression-free survival (PFS) (HR=1.22, 95%CI = 1.12-1.33, p < 0.001) in patients with DLBCL. Further, the elevated CONUT score showed a significant correlation with the following clinicopathological factors in DLBCL: Ann Arbor stage III-IV, Eastern Cooperative Oncology Group Performance Status (ECOG PS) of 2-4, presence of extranodal disease, ≥high intermediate National Comprehensive Cancer Network International Prognostic Index (NCCN IPI), presence of B symptoms, elevated lactose dehydrogenase (LDH) levels, and presence of bone marrow infiltration.

CONCLUSIONS

An increased CONUT score was dramatically associated with poor OS and PFS in patients with DLBCL, as well as with clinicopathological characteristics representing DLBCL tumor development.

摘要

背景

控制营养状况（CONUT）评分在预测弥漫性大B细胞淋巴瘤（DLBCL）预后结果中的意义已得到广泛探讨，但结果相互矛盾。因此，本荟萃分析旨在通过汇总现有证据来确定CONUT在DLBCL中的预后意义。

方法

检索了Web of Science、PubMed、Embase、中国知网和Cochrane图书馆数据库，查找从数据库建立至2024年10月15日的文章。通过确定合并风险比（HR）及95%置信区间（CI）来分析CONUT对DLBCL的预后价值。采用纽卡斯尔-渥太华量表（NOS）分析研究质量。

结果

本研究纳入了8项研究，共2687例病例。这些研究的NOS评分为7-9分（中位数为8分），表明质量较高。我们的分析显示，CONUT评分升高显著预测DLBCL患者的总生存期（OS）较差（HR = 1.63，95%CI = 1.29-2.05，p < 0.001）和无进展生存期（PFS）较差（HR = 1.22，95%CI = 1.12-1.33，p < 0.001）。此外，CONUT评分升高与DLBCL的以下临床病理因素显著相关：Ann Arbor分期III-IV期、东部肿瘤协作组体能状态（ECOG PS）为2-4、存在结外病变、≥高中间风险的国家综合癌症网络国际预后指数（NCCN IPI）、存在B症状、乳酸脱氢酶（LDH）水平升高以及存在骨髓浸润。