Singh Vishwajeet, Singh Mukul Kumar, Kumar Anil, Sahu Dinesh Kumar, Jain Mayank, Pandey Anuj Kumar, Singh Shubhendu, Verma Ajay Kumar
Department of Urology, King George's Medical University, Lucknow, Uttar Pradesh India.
Central Research Facility, Post Graduate Institute of Child Health, Noida, Uttar Pradesh India.
Indian J Clin Biochem. 2025 Apr;40(2):176-190. doi: 10.1007/s12291-024-01187-y. Epub 2024 Feb 9.
The prognostic biomarkers, or metabolites, have gained relevance due to their significance in predicting clinical and therapeutic outcomes and guiding informed therapy options. This systematic review and meta-analysis aimed to evaluate the prognostic significance of metabolites in non-muscle-invasive bladder cancer (NMIBC) through an array of literature. The PubMed, Web of Science, Embase, and Cochrane Library databases were comprehensively searched for eligible studies published between January 2010 and August 2022, using related keywords and MeSH terms. Two reviewers performed the extraction process, and a third reviewer settled possible controversies. The New Castle Ottawa scale (NOS) was used to determine the quality of selected studies. Pooled hazard ratios (H.R.s) with 95% confidence intervals (C.I.s) were calculated to establish the relationship of metabolites with NMIBC outcomes (recurrence-free survival (RFS), progression-free survival (PFS), and overall survival (O.S.) to establish their prognostic roles. A total of 15 studies, with a sample size of 5491, were included and analyzed in this study. Various metabolites were found to be correlated with the outcomes of the study: PFS (pooled HR, 4.48; 95% CI, 1.70-11.80, p = 0.002), RFS (pooled HR, 2.85; 95% CI, 1.91-4.26; p = 0.00001), and OS (HR, 1.78; 95% CI, 1.07-2.98; p = 0.03). Pretreatment metabolites or markers in NMIBC patients had a relationship with recurrence prediction and disease outcomes in bladder cancer. Therefore, metabolites may equally serve as a critical, independent prognostic predictor for NMIBC patients. This could be considered in most related clinical decisions in bladder cancer.
预后生物标志物或代谢物因其在预测临床和治疗结果以及指导明智的治疗选择方面的重要性而受到关注。本系统评价和荟萃分析旨在通过一系列文献评估代谢物在非肌层浸润性膀胱癌（NMIBC）中的预后意义。使用相关关键词和医学主题词（MeSH）对PubMed、科学网、Embase和Cochrane图书馆数据库进行全面检索，以查找2010年1月至2022年8月期间发表的符合条件的研究。两名评审员进行提取过程，第三名评审员解决可能的争议。使用纽卡斯尔渥太华量表（NOS）来确定所选研究的质量。计算合并风险比（HR）及其95%置信区间（CI），以建立代谢物与NMIBC结果（无复发生存期（RFS）、无进展生存期（PFS）和总生存期（OS））之间的关系，以确定它们的预后作用。本研究共纳入并分析了15项研究，样本量为5491。发现各种代谢物与研究结果相关：PFS（合并HR，4.48；95%CI，1.70-11.80，p = 0.002）、RFS（合并HR，2.85；95%CI，1.91-4.26；p = 0.00001）和OS（HR，1.78；95%CI，1.07-2.98；p = 0.03）。NMIBC患者的治疗前代谢物或标志物与膀胱癌的复发预测和疾病结果有关。因此，代谢物同样可作为NMIBC患者关键的独立预后预测指标。这在大多数膀胱癌相关临床决策中都可予以考虑。
