血小板与淋巴细胞比率对胃癌预后影响的Meta分析

Prognostic value of platelet-lymphocyte ratio in gastric cancer:A Meta-analysis

目的:探讨血小板与淋巴细胞比率(platelet-lymphocyte ratio,PLR)对胃癌患者预后评估的价值。方法:检索PubMed、Medline、Embase、Cochrane Library和中文数据库如中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数字化期刊全文数据库等,纳入关于PLR和胃癌患者预后关系的中英文文献,由2名研究者独立选择文献和提取数据资料并对纳入文献进行质量评估,采用Review Manager 5.3和Stata 15.1软件进行统计分析。结果:最终共纳入29项符合标准的研究,共计13696名胃癌患者。Meta分析结果显示治疗前高水平PLR的胃癌患者,其总生存期(overall survival,OS)明显缩短(HR=1.13,95%CI:1.03~1.24,P=0.01),但是与无病生存期(disease-free survival,DFS)(HR=1.19,95%CI:0.79~1.81,P=0.41)和无进展生存期(progression-free survival,PFS)(HR=1.10,95%CI:0.88~1.37,P=0.41)没有明显相关性。结论:治疗前高水平PLR是胃癌患者OS较短的重要临床预后指标,为临床医务工作人员评价胃癌患者的预后提供依据。但是仍需要更多大规模、多中心、更全面的实验研究进行验证。

Objective:To investigate the prognostic value of pretreatment platelet-lymphocyte ratio(PLR)in gastric cancer.Methods:An extensive literary search for relevant studies was conducted on PubMed,Medline,Embase,Cochrane Library,China National Knowledge Infrastructure(CNKI),China Biology Medicine(CBM),Wanfang Database and so on.We included Chinese and English literature on the relationship between prognosis of patients with PLR and gastric cancer.Study selection,data extraction and quality evaluation were conducted independently by two reviewers.Meta-analysis was conducted by using Review Manager 5.3 and Stata 15.1 software.Results:29 publications including 13696 gastric cancer patients were collected.The pooled HR showed that elevated PLR was associated with a significantly poorer overall survival(OS)(HR=1.13,95%CI:1.03~1.24,P=0.01).However,there was no obvious prognostic value for disease-free survival(DFS)(HR=1.19,95%CI:0.79~1.81,P=0.41)and progression-free survival(PFS)(HR=1.10,95%CI:0.88~1.37,P=0.41)in patients with gastric cancer.Conclusion:High-level PLR before treatment is an important prognostic clinical standard for patients with gastric cancer,which provides a basis for clinical staff to evaluate the prognosis of patients with gastric cancer.However,more large-scale,multi-center,and more comprehensive experimental studies are still to be validated.