Guo Fuyu, Chen Jiamei, Zhang Hengkai
The Second Clinical Medical College of Jilin University, Changchun, China.
School of Public Health, Jilin University, Changchun, China.
Front Med (Lausanne). 2025 Feb 5;12:1503614. doi: 10.3389/fmed.2025.1503614. eCollection 2025.
This study aimed to explore the predictive value of the neutrophil-to-lymphocyte ratio (NLR) for outcomes in Acquired Immune Deficiency Syndrome (AIDS) patients.
PubMed, Embase, Cochrane, and Web of Science were conducted to search literature up to May 2024 and cohort and case-control studies were included. The primary outcomes were mortality and progression-free survival (PFS). Pooled odds ratios (ORs) or hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. We conducted sensitivity analyses to assess result stability, reliability, and subgroup analyses to identify sources of heterogeneity using Review Manager 5.4.1. Egger's tests were performed with Stata 15.1, and funnel plots were generated using Review Manager 5.4.1. Microsoft Excel was used for the initial data summarization.
Fourteen studies involving 30,752 AIDS patients were included. The pooled data showed higher NLR significantly associated with increased mortality (OR: 1.85, 95% CI: 1.43-2.41, < 0.00001) and shorter progression-free survival (PFS) (HR: 2.46, 95% CI: 1.32-4.59, = 0.005). Subgroup analyses revealed that NLR's predictive value was greater in studies with post-ART measurements. Sensitivity analyses show stable and reliable results. Egger's test and funnel plot analysis revealed no significant publication bias.
NLR is a key prognostic biomarker for predicting mortality and progression-free survival (PFS) in AIDS patients. Incorporating NLR into predictive models may improve prognostic assessments and guide clinical decision-making.
PROSPERO (CRD42024532918: https://www.crd.york.ac.uk/PROSPERO).
本研究旨在探讨中性粒细胞与淋巴细胞比值（NLR）对获得性免疫缺陷综合征（AIDS）患者预后的预测价值。
检索截至2024年5月的PubMed、Embase、Cochrane和Web of Science数据库中的文献，纳入队列研究和病例对照研究。主要结局为死亡率和无进展生存期（PFS）。采用随机效应模型计算合并比值比（OR）或风险比（HR）及95%置信区间（CI）。使用Review Manager 5.4.1进行敏感性分析以评估结果的稳定性和可靠性，并进行亚组分析以识别异质性来源。使用Stata 15.1进行Egger检验，并使用Review Manager 5.4.1生成漏斗图。使用Microsoft Excel进行初始数据汇总。
纳入了14项涉及30752例AIDS患者的研究。汇总数据显示，较高的NLR与死亡率增加显著相关（OR：1.85，95%CI：1.43 - 2.41，P < 0.00001）和无进展生存期（PFS）缩短（HR：2.46，95%CI：1.32 - 4.59，P = 0.005）。亚组分析显示，在ART后测量的研究中，NLR的预测价值更大。敏感性分析显示结果稳定可靠。Egger检验和漏斗图分析未发现显著的发表偏倚。
NLR是预测AIDS患者死亡率和无进展生存期（PFS）的关键预后生物标志物。将NLR纳入预测模型可能会改善预后评估并指导临床决策。
PROSPERO（CRD42024532918：https://www.crd.york.ac.uk/PROSPERO）
