癌结节对胃癌患者预后的影响:一项队列研究的Meta分析

The value of tumor deposits on the prognosis of patients with gastric cancer:a Meta-analysis of a cohort study

目的探讨癌结节对胃癌患者预后的影响,为新的TNM分期制定提供依据。方法在Pubmed、Embase、Medline和Cochrane library上检索了从数据库建立以来至2021年6月的所有相关文献。审查和筛选出所有符合纳入排除标准的研究,应用纽卡斯尔渥太华量表(NOS)评估纳入研究的质量。采用随机效应模型合并总体生存率、无复发生存率和无疾病生存率的风险比。应用Stata 14.0统计软件对数据进行分析。结果共纳入17项研究,包括19 996例胃癌患者。合并的总体生存率风险比为1.487(95%置信区间:1.379~1.595),无异质性和发表偏倚;合并的无复发风险比为1.625(95%置信区间:1.332~1.917),无异质性;合并的无疾病风险比为1.463(95%置信区间:1.292~1.633),无异质性。结论癌结节可以作为胃癌患者预后的独立预测因素,纳入胃癌TNM分期中的N分期较为合理。

Objective This study aims to synthesize the effect of tumor deposits on the prognosis of patients with gastric cancer,in order to provide evidence for the modification of TNM staging system.Methods We searched PubMed,Embase,Medline and Cochrane Library from inception through June 2021 for relevant studies.We reviewed and screened studies according to the inclusion and exclusion criteria,and the quality of the included studies was assessed by the Newcastle-Ottawa Scale(NOS).We used a random effect model to synthesize the hazard ratios of overall survival,recurrence-free survival and disease-free survival.Stata 14.0 statistical software was employed to analyze the data.Results A total of 17 studies,including 19996 patients with gastric cancer,were included.The pooled hazard ratio of overall survival was 1.487[95%confidence interval(CI):1.379-1.595]without heterogeneity or publication bias.The pooled hazard ratio of recurrence-free survival was 1.625(95%CI:1.332-1.917)without heterogeneity.The pooled hazard ratio of disease-free survival was 1.463(95%confidence interval:1.292 to 1.633)without heterogeneity.Conclusion Tumor deposit can be regarded as an independent prognostic factor of gastric cancer,and should be included as N stage in the TNM staging system.