摘要
[目的]评估中国Ⅲ~Ⅳ期非小细胞肺癌患者生存预后模型文献质量,并进行系统评价与分析。[方法]从PubMed、中国知网、万方数据、维普中文期刊获取2020年1月1日至2024年2月29日已发表的中国Ⅲ~Ⅳ期非小细胞肺癌文献信息,利用STATA MP18软件进行数据分析,对纳入文献进行偏倚风险及适用性评价,并对生存预后模型的预测因子进行Meta分析。[结果] 9篇文献共10个模型最终被纳入研究,纳入模型均为高风险偏倚,模型预测性能较好(AUC:0.614~0.915)。脏器转移(HR=1.23,95%CI:1.18~1.29)、吸烟史(HR=1.42,95%CI:1.22~1.64)、TNM分期(HR=1.86,95%CI:1.68~2.07)、中性粒细胞-淋巴细胞比值(HR=1.92,95%CI:1.66~2.21)、血小板-淋巴细胞比值(HR=3.22,95%CI:1.57~6.61)、化疗周期(HR=0.68,95%CI:0.53~0.87)是生存预后模型的影响因素。[结论]现有关于中国Ⅲ~Ⅳ期非小细胞肺癌患者生存预后模型效果较好,但大多缺乏外部验证,偏倚风险高,预后模型的建立及验证应严格遵守指南。临床工作者需要重点关注及评估有吸烟史、化疗次数不足、晚期伴有脏器转移患者的生存风险,同时进行炎症因子检测与评估。
[Objective] To evaluate the published survival prediction models for Chinese patients with stage Ⅲ~Ⅳnon-small cell lung cancer through systematic review and meta-analysis.[Methods] The relevant studies were retrieved from PubMed,CNKI,Wanfang Data and VIP Data from January 1,2020 to February 29,2024.Data analysis and chart drawing were carried out using STATA/MP18 software,and the risk of bias and applicability of the included literature were evaluated.Meta-analysis was performed on the predictors of the survival prognosis model.[Results] A total of 10 models from 9 studies were finally included in the analysis.The included models had high risk bias,and the prediction performance of the models was good(AUC:0.614 ~0.915).Metastasis(HR=1.23,95%CI:1.18~1.29),smoking history(HR=1.42,95%CI:1.22~1.64),TNM stage(HR=1.86,95%CI:1.68~2.07),neutrophil/lymphocyte ratio(HR=1.92,95%CI:1.66~2.21),platelet/lymphocyte ratio(HR=3.22,95%CI:1.57~6.61),chemotherapy cycle(HR=0.68,95%CI:0.53~0.87) were the influencing factors of survival for Chinese patients with stage Ⅲ ~ Ⅳ non-small cell lung cancer.[Conclusion] The published survival and prognosis models for Chinese patients with stage Ⅲ~Ⅳ non-small cell lung cancer are generally effective,but have a high risk of bias and lack external validation.The study indicates that clinicians should pay more attention to patients with smoking history,insufficient chemotherapy,and late stage with metastasis,and conduct inflammatory factor detection and evaluation at the same time.
作者
刘琼妮
杨丽
何依娜
胡凯文
周天
LIU Qiongni;YANG Li;HE Yina;HU Kaiwen;ZHOU Tian(Dongfang Hospital Beijing University of Chinese Medicine,Beijing 100078,China;Beijing University of Chinese Medicine,Beijing 100029,China;Hainan Provincial Center for Disease Control and Prevention,Haikou 571129,China)
出处
《肿瘤学杂志》
CAS
2024年第5期394-399,共6页
Journal of Chinese Oncology
基金
国家重点研发计划项目(2018YFC1705102)
北京中医药大学揭榜挂帅项目(2023-JYB-JBZD-006)。
