控制营养状况评分是肝细胞癌患者生存的预测指标：一项荟萃分析和Meta回归分析

Controlling nutritional status score is a predictor of survival in hepatocellular carcinoma: A meta-analysis and meta-regression.

作者信息

Chen Yi, Cao Hong, Yao Jia

机构信息

Yi Chen, Department of Interventional Radiotherapy, Huzhou Central Hospital, Affiliated Central Hospital of HuZhou University, Huzhou, Zhejiang Province 313000, P.R. China.

Hong Cao, Department of Interventional Radiotherapy, Huzhou Central Hospital, Affiliated Central Hospital of HuZhou University, Huzhou, Zhejiang Province 313000, P.R. China.

出版信息

Pak J Med Sci. 2025 Apr;41(4):1226-1233. doi: 10.12669/pjms.41.4.11660.

OBJECTIVE

The controlling nutritional status score (CONUT) has been utilized for prognostication of several cancers but its utility for hepatocellular carcinoma (HCC) is still unclear. We reviewed evidence on the ability of CONUT to predict overall survival (OS) and disease-free survival (DFS) in patients with HCC.

METHODS

Online repositories of PubMed, Embase, CENTRAL, and Web of Science were searched by two reviewers for English language studies and were available before 15 March 2024. Hazard ratio (HR) and 95% confidence intervals were calculated for both OS and DFS.

RESULTS

A total of fourteen studies were available. Meta-analysis showed that CONUT was a significant predictor for OS (HR: 1.64 95% CI: 1.30, 2.06) and DFS (HR: 1.32 95% CI: 1.17, 1.50) in HCC. The effect size failed to change in significance on sensitivity analysis. Subgroup analysis based on country and treatment of HCC did not change the results. Subgroup analysis and meta-regression showed that a higher CONUT cut-off led to a stronger association between CONUT and OS in HCC.

CONCLUSIONS

CONUT can be an easy-to-use and rapid prognostic indicator for HCC. High CONUT scores are associated with worse OS and DFS.

目的

控制营养状态评分（CONUT）已用于多种癌症的预后评估，但其在肝细胞癌（HCC）中的效用仍不明确。我们回顾了关于CONUT预测HCC患者总生存期（OS）和无病生存期（DFS）能力的证据。

方法

两名研究者检索了PubMed、Embase、CENTRAL和Web of Science在线数据库，查找截至2024年3月15日的英文研究。计算了OS和DFS的风险比（HR）及95%置信区间。

结果

共纳入14项研究。荟萃分析显示，CONUT是HCC患者OS（HR：1.64，95%CI：1.30，2.06）和DFS（HR：1.32，95%CI：1.17，1.50）的显著预测指标。敏感性分析结果显示效应量无显著变化。基于国家和HCC治疗方法的亚组分析未改变结果。亚组分析和荟萃回归显示，较高的CONUT临界值导致CONUT与HCC患者OS之间的关联更强。