血小板-淋巴细胞比值在鼻咽癌预后预测中的作用：Meta分析

Prognostic significance of platelet-to-lymphocyte ratio in patients with nasopharyngeal carcinoma: a Meta-analysis

背景与目的:已发现血小板-淋巴细胞比值(platelet-to-lymphocyte ratio,PLR)可预测鼻咽癌的临床结果。然而,先前关于PLR与鼻咽癌预后的报道不一致。根据Meta分析提供更准确的预后评估。方法:检索了PubMed、Web of Science和Scopus数据库确定评估治疗前PLR在鼻咽癌中的预后作用的研究。终点是总生存期(overall survival,OS)、无进展生存期(progression-free survival,PFS)、疾病特异性生存率(disease-specific survival,DSS)、无远处转移生存期(distant metastasis-free survival,DMFS)。提取风险比(hazard ratio,HR)和95%置信区间(confidence interval,CI),并根据异质性检验选用固定效应模型或随机效应模型估计每个终点的合并HR。结果:共纳入10项研究,涉及4 655例鼻咽癌患者。Meta分析汇总结果显示,升高的治疗前PLR与鼻咽癌患者较差的OS(HR=1.92,95%CI:1.73~2.14,P<0.01)、PFS(HR=1.56,95%CI:1.19~2.06,P=0.002)及DSS(HR=1.65,95%CI:1.19~2.27,P=0.002)相关,但与DMFS无显著相关性(HR=1.69,95%CI:0.97~2.96,P=0.06)。结论:升高的治疗前PLR可以预测鼻咽癌患者更差的OS、PFS和DSS,而对DMFS没有预测价值。

Background and purpose:It has been found that the platelet-to-lymphocyte ratio(PLR)can predict clinical outcomes of nasopharyngeal carcinoma(NPC).However,its prognostic value in patients with NPC remains controversial.The aim of this study was to assess its prognostic value in NPC.Methods:We searched PubMed,Web of Science and Scopus databases to identify studies evaluating the prognostic value of pretreatment PLR in NPC.The end points were overall survival(OS),progression-free survival(PFS),disease-specific survival(DSS)and distant metastasis-free survival(DMFS).Pooled hazard ratio(HR)and associated 95%confidence interval(95%CI)were extracted and synthesized to examine the effects using fixed-effects/random-effects models according to the result of heterogeneity test.Results:A total of 10 studies comprising 4655 patients with NPC were included.The pooled effects of the Meta-analysis demonstrated that patients with elevated PLR had shorter OS(HR=1.92,95%CI:1.73-2.14,P<0.000 01),PFS(HR=1.56,95%CI:1.19-2.06,P=0.002)and DSS(HR=1.65,95%CI:1.19-2.27,P=0.002).However,there was no significant correlation between DMFS and pretreatment PLR.Conclusion:Elevated pretreatment PLR might predict poor prognosis for patients with NPC indicated by shorter OS,PFS and DSS,but not DMFS.