NLR和PLR对接受一线含铂化疗的小细胞肺癌患者预后影响的Meta分析

Effect of NLR and PLR on prognosis of small-cell lung cancer patients received platinum-based first-line chemotherapy:A Meta-analysis

目的:探讨中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)与接受一线含铂化疗的小细胞肺癌(SCLC)患者预后的关联性,阐明NLR和PLR在SCLC患者预后中的意义。方法:检索PubMed、EMbase、Web of Science、Cochrane Library和中国知网(CNKI)数据库,检索时限从建库到2021年3月,收集接受一线含铂化疗的SCLC[包括局限期SCLC(LS-SCLC)和广泛期SCLC(ES-SCLC)]患者的临床研究。使用STATA 14.0软件对符合纳入与排除标准的研究进行Meta分析,观察NLR和PLR在不同疾病分期和不同病理类型SCLC患者的预后作用。结果:共检索1012篇文献,最终纳入11篇文献共3634例SCLC患者。高NLR组患者的总生存期(OS)[风险比(HR)=1.45,95%置信区间(95%CI):1.26~1.67,P<0.01]和无进展生存期(PFS)(HR=1.53,95%CI:1.29~1.82,P<0.01)明显低于低NLR组;高PLR组患者的OS与低PLR组患者比较差异无统计学意义(HR=1.17,95%CI:0.87~1.56,P=0.293)。亚组分析,在不同疾病分期、不同病理类型、不同种族、分析模式和NLR临界(cutoff)值≥4的亚组,高NLR组患者的OS明显低于低NLR组(P<0.05);在LS-SCLC人群和PLRcutoff值<160人群,高PLR组患者的OS明显低于低PLR组(P<0.01)。结论:在接受一线含铂化疗的SCLC患者中,高NLR与SCLC患者的预后不良有关,高PLR与LS-SCLC患者的预后不良有关。

Objective:To investigate the associations of the neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR)with the prognosis in the small-cell lung cancer(SCLC)patients received platinum-based first-line chemotherapy,and to clarify the significance of NLR and PLR in the prognosis of the SCLC patients.Methods:Literature retrieval were conducted in PubMed,EMbase,Web of Science,Cochrane Library and China National Knowledge Internet(CNKI)databases.The retrieval period was from the establishment to March 2021.The clinical studies of patients with SCLC including limited stage SCLC(LS-SCLC)and extensive stage SCLC(ES-SCLC)received platinum-based first-line chemotherapy.Meta-analysis was performed on the literatures that met the inclusion and exclusion criteria by STATA 14.0 software,and the prognostic effects of NLR and PLR in the SCLC patients with different disease stages and pathological types were observed.Results:A total of 1012 literatures were retrieved.Finally,eleven studies encompassing 3634 SCLC patients were included.The combined outcomes demonstrated that the overall survival(OS)[hazard ratio(HR)=1.45,95%confidence interval(95%CI):1.26-1.67,P<0.01]and progression-free survival(PFS)(HR=1.53,95%CI:1.29-1.82,P<0.01)of the patients in high NLR group were lower than those in low NLR group,while there was no difference in the OS between high NLR group and low NLR group(HR=1.17,95%CI:0.87-1.56,P=0.293).In subgroup analysis,the OS in higher NLR group in different stages,different pathological types,different regions,analysis modes,and NLR cutoff value≥4 in subgroups were lower than those in lower NLR group(P<0.05);the OS in LS-SCLC and PLR cutoff value<160 patients in higher NLR group were lower than those in lower PLR group.Conclusion:In the SCLC patients received platinum-based first-line chemotherapy,higher NLR is associated with poor prognosis in the SCLC patients,and higher PLR is associated with poor prognosis in the LS-SCLC patients.