治疗前淋巴细胞减少与恶性实体瘤患者预后相关性Meta分析

Meta-analysis of the correlation between pretreatment lymphopenia and prognosis in malignant solid tumors

目的越来越多的临床研究显示,治疗前淋巴细胞减少能够影响血液系统恶性肿瘤肿瘤患者的抗肿瘤治疗疗效和生存预后。然而,其在恶性实体瘤患者中的预后价值仍然存在一定争议。因此,本研究探讨治疗前淋巴细胞减少与非血液性恶性实体瘤患者预后的关系,以进一步指导临床工作。方法计算机检索PubMed、Web of Science、Medline和EMBASE四大数据库从建库至2017-12公开发表的相关文献。纳入研究确定治疗前淋巴细胞减少与恶性实体瘤患者总生存(overall survival,OS)和无进展生存(progression-free survival,PFS)的关系。计算风险比(hazard ratio,HR)和95%的置信区间(confidence interval,CI),采用Stata 12.0进行Meta分析。结果 32项符合标准的研究共计5 322例恶性实体瘤患者纳入分析。结果显示,治疗前淋巴细胞减少与患者较短的OS相关,HR合并值为1.50,95%CI为1.26~1.78,P<0.001;并且与患者较短的PFS也具有相关性,HR合并值为1.34,95%CI为1.18~1.54,P<0.001。结论治疗前淋巴细胞减少可能是恶性实体瘤患者预后差的一个独立危险因素。

OBJECTIVE At present,more and more clinical studies showed that pretreatment lymphopenia could affect the treatment effect and survival as well as prognosis of patients with hematological malignancies.However,the prognostic significance of pretreatment lymphopenia in non-hematologic malignant solid tumors remains controversial.In this study the Meta-analysis was used to evaluate the correlation between the pretreatment lymphopenia and the prognosis of patients with malignant solid tumors.METHODS Related articles published on PubMed,Web of Science,Medline and EMBASE databases until December 2017 were included in our research to evaluate the relationship between pretreatment lymphopenia and overall survival（OS）or progression-free survival（PFS）in non-hematologic malignant solid tumors.The hazard ratio（HR）and 95%confidence interval（CI）were calculated and the Stata 12.0 software was used for Meta-analysis.RESULTS A total of 5 322 individuals from thirty-two studies were included in the Meta-analysis.The analysis results revealed that the pretreatment lymphopenia was associated with worse OS（pool HR=1.50,95%CI=1.26-1.78,P〈0.001）and PFS（pool HR=1.34,95%CI=1.18-1.54,P〈0.001）in non-hematologic malignant solid tumors.CONCLUSION Pretreatment lymphopenia may be an independent adverse prognostic indicator for malignant solid tumors.