摘要
目的探讨术前中性粒细胞与淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)在肝内胆管细胞癌(intrahepatic cholangiocarcinoma,ICC)患者肝部分切除术后远期预后中的价值。方法在PubMed、Embase、Web of Science、Cochrane Library、中国知网和万方等中英文数据库检索关于术前NLR与ICC术后预后有关的研究,检索时间至2021年5月,对纳入研究进行质量评价后,采用Review Manager 5.4软件进行统计学分析NLR与ICC预后的关系。结果最终8项研究2192例患者被纳入,术前高NLR组有较差的总生存(overall survival,OS;HR=1.61,95%CI:1.24~2.08,P<0.05)和无瘤生存(disease free survival,DFS;HR=1.70,95%CI:1.15~2.50,P<0.05)。亚组分析结果显示,肝部分切除(HR=1.45,95%CI:1.13~1.85,P<0.01)和肝部分切除+化疗(HR=2.37,95%CI:1.57~3.57,P<0.01)中高NLR组与较差的OS相关。NLR临界值≥2.50时高NLR组具有较差的OS(HR=1.99,95%CI:1.54~2.57,P<0.01)和DFS(HR=2.10,95%CI:1.48~2.96,P<0.01);NLR临界值<2.50时,高NLR组与较差的OS相关(HR=1.33,95%CI:1.01~1.75,P=0.04)。样本量<250例时,高NLR组有较差的OS(HR=1.79,95%CI:1.17~2.75,P<0.01)和DFS(HR=2.10,95%CI:1.48~2.96,P<0.01);样本量≥250例时,高NLR组与较差的OS相关(HR=1.40,95%CI:1.19~1.64,P<0.01)。高NLR组和低NLR组在癌胚抗原(carcinoembryonic antigen,CEA)、肿瘤大小、淋巴结转移和肿瘤分化等临床特征方面比较,差异均具有统计学意义(均P<0.05)。结论NLR可能是ICC肝部分切除术后远期预评估中较为经济和有价值的预后指标。
Objective To explore the prognostic value of preoperative neutrophil-to-lymphocyte ratio(NLR)in the long-term outcome of patients with intrahepatic cholangiocarcinoma(ICC)after partial hepatectomy.Methods PubMed,Embase,Web of Science,Cochrane Library,CNKI,and Wanfang databases were used to retrieve research on the correlation between preoperative NLR and prognosis of ICC until May 2021.After the evaluation of the quality of the included studies,the Review Manager 5.4 software was used to analyze the correlation between NLR and the prognosis of ICC.Results Eight studies with 2192 patients were included.Compared with the low NLR group,the high NLR group had worse overall survival(OS;HR=1.61,95%CI:1.24-2.08,P<0.05)and disease-free survival(DFS;HR=1.70,95%CI:1.15-2.50,P<0.05).Subgroup analysis showed that patients with high NLR in the partial hepatectomy group(HR=1.45,95%CI:1.13-1.85,P<0.01)and the partial hepatectomy combined with chemotherapy group(HR=2.37,95%CI:1.57-3.57,P<0.01)had worse OS.When the NLR cut-off value was≥2.50,the high NLR group had worse OS(HR=1.99,95%CI:1.54-2.57,P<0.01)and DFS(HR=2.10,95%CI:1.48-2.96,P<0.01);when the NLR cut-off value was less than 2.50,the high NLR group was associated with worse OS(HR=1.33,95%CI:1.01-1.75,P=0.04).When the sample size was less than 250 cases,the high NLR group had worse OS(HR=1.79,95%CI:1.17-2.75,P<0.01)and DFS(HR=2.10,95%CI:1.48-2.96,P<0.01);when the sample size was≥250 cases,the high NLR group was associated with worse OS(HR=1.40,95%CI:1.19-1.64,P<0.01).The differences between the high NLR group and the low NLR group in terms of carcinoembryonic antigen(CEA),tumor size,lymph node metastasis and tumor differentiation were statistically significant(all P<0.05).Conclusions NLR may be a more economical and valuable prognostic indicator in the long-term pre-evaluation of ICC after partial hepatectomy.
作者
刘处处
吴美龙
严哲
杨江辉
冯晓彬
Liu Chuchu;Wu Meilong;Yan Zhe;Yang Jianghui;Feng Xiaobin(Department of Hepato-pancreato-biliary Surgery,Qinghai University Affiliated Hospital,Xining 810000,China;Hepato-pancreato-biliary Center,Beijing Tsinghua Changgung Hospital,Tsinghua University,Beijing 102218,China;School of Clinical Medicine,Tsinghua University,Beijing 100084,China;Department of Pathology,Beijing Tsinghua Changgung Hospital,Tsinghua University,Beijing 102218,China)
出处
《实用肿瘤杂志》
CAS
2021年第6期514-519,共6页
Journal of Practical Oncology
基金
国家自然科学基金重大项目(82090053)
国家自然科学基金重点项目(81930119)
北京市自然科学基金(Z190024)。
