摘要
目的评估血小板淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)对小细胞肺癌(small cell lung cancer,SCLC)患者的预后价值。方法系统检索PubMed、OVID、Cochrane Library、万方、中国知网和维普数据库以获得相关文献。检索时间为建库至2022年1月。根据纳入与排除标准对文献进行筛选、数据提取和质量评价,并使用风险比(hazard risk,HR)和95%置信区间(confidence interval,CI)进行合并分析,以评估PLR的预后价值。结果纳入15篇符合条件的文献,共计4261例SCLC患者。结果表明治疗前PLR升高与总生存期(overall survival,OS)呈负相关[HR=1.311,95%CI(1.125,1.527),P=0.001],而与无进展生存期(progression-free survival,PFS)不相关[HR=1.112,95%CI(0.966,1.280),P=0.139]。亚组分析显示:高PLR对局限期和局限期+广泛期SCLC患者具有预后价值[局限期:HR=1.556,95%CI(1.327,1.824),P<0.001;局限期+广泛期:HR=1.245,95%CI(1.043,1.486),P=0.015];当PLR的截断值<150,对于SCLC患者预后价值有统计学意义[HR=1.420,95%CI(1.235,1.631),P<0.001];不论种族,治疗前的PLR均对SCLC患者的OS有预后作用[高加索人:HR=1.528,95%CI(1.181,1.976),P<0.001;亚洲人:HR=1.283,95%CI(1.085,1.517),P=0.004]。结论治疗前PLR升高可能与SCLC尤其局限期的SCLC预后不良有关,PLR可作为评估局限期SCLC预后的指标,但仍需更大样本的研究来验证。
Objective To assess the prognostic value of platelet-to-lymphocyte ratio(PLR)in small cell lung cancer(SCLC).Methods We searched PubMed,OVID,Cochrane Library,Wanfang database,China National Knowledge Infrastructure,and CQVIP database to obtain relevant literature published up to January 2022.We screened the literature,extracted data and evaluated the quality according to the inclusion and exclusion criteria,and then performed a meta-analysis by using the hazard risk(HR)and 95%confidence interval(CI)to assess the prognostic value of PLR.Results A total of 4261 patients with SCLC were included in 15 eligible studies.The results showed that high pretreatment PLR was negatively associated with overall survival(OS)[HR=1.311,95%CI(1.125,1.527),P=0.001],but not with progression-free survival(PFS)[HR=1.112,95%CI(0.966,1.280),P=0.139].Subgroup analyses showed that high PLR had prognostic value in patients with limited period and limited period+extensive phase SCLC[limited period:HR=1.556,95%CI(1.327,1.824),P<0.001;limited period+extensive phase:HR=1.245,95%CI(1.043,1.486),P=0.015];when the cut-off value of PLR was less than 150,the result was significant for patients with SCLC[HR=1.420,95%CI(1.235,1.631),P<0.001];regardless of race,PLR had prognostic value in SCLC patients[Caucasian:HR=1.528,95%CI(1.181,1.976),P<0.001;Asian:HR=1.283,95%CI(1.085,1.517),P=0.004].Conclusions High pretreatment PLR may be related to the poor prognosis of SCLC,especially limited period SCLC.PLR could be a prognostic factor in SCLC,but more larger-sample studies are still needed to verify that.
作者
王进
许莉
王洋
邹琳琳
罗丹
王导新
WANG Jin;XU Li;WANG Yang;ZOU Linlin;LUO Dan;WANG Daoxin(Department of Respiratory and Critical Care Medicine,,the First People’s Hospital of Chongqing Liang Jiang New Area,Chongqing 401121,P.R.China;Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,P.R.China)
出处
《华西医学》
CAS
2022年第1期40-47,共8页
West China Medical Journal
基金
国家自然科学基金(81670071)。
