中性粒细胞/淋巴细胞比值与口腔鳞状细胞癌预后相关性的Meta分析

Meta analysis of the relationship between the neutrophils/lymphocytes ratio and prognosis in patients with oral squamous cell carcinoma

目的探讨中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)与口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)患者预后及其临床病理特征的相关性。方法检索PubMed、Web of Science、Cochrane以及Embase等数据库中关于NLR与OSCC预后及临床病理特征相关性的文献,纳入结局的指标包括总体生存率(overall survival,OS)、无病生存率(disease free survival,DFS)、疾病特异性生存期(disease specific survival,DSS)、肿瘤大小、颈淋巴结转移、肿瘤分期、淋巴结包膜外侵犯、周围神经侵犯,采用RevMan5.3软件进行分析。结果纳入23篇文献,共计6180例患者。分析显示NLR与OS[HR=1.62,95%CI(1.38,1.91),P<0.001]、DFS[HR=1.48,95%CI(1.24,1.77),P<0.001]、DSS[HR=1.87,95%CI(1.60,2.20),P<0.001]呈负相关。此外,较高的NLR值与肿瘤大小[OR=2.68,95%CI(1.84,3.90),P<0.001]、颈淋巴结转移[OR=1.59,95%CI(1.35,1.88),P<0.001]、肿瘤分期[OR=2.85,95%CI(2.35,3.47),P<0.001]、淋巴结包膜外侵犯[OR=1.72,95%CI(1.23,2.40),P=0.001]、周围神经侵犯[OR=1.70,95%CI(1.29,2.24),P<0.001]呈正相关,均具有统计学意义;但是与年龄[OR=0.96,95%CI(0.71,1.29),P=0.77)]、性别[OR=1.08,95%CI(0.88,1.33),P=0.55)]、分化程度[OR=1.15,95%CI(0.92,1.43),P=0.22]无显著相关性。结论NLR升高与OSCC的预后及临床病理特征有显著相关性,或许是一个独立预后因素。

Objective To clarify the prognostic value of the neutrophil to lymphocyte ratio(NLR)in oral squamous cell carcinoma(OSCC)patients.Methods The literature on the correlation between NLR and the prognosis and clini⁃copathological features of OSCC was searched in PubMed,Web of Science,Cochrane and Embase.The outcome indica⁃tors,including overall survival(OS),disease⁃free survival(DFS),disease⁃specific survival(DSS),tumor size,cervical lymph node metastasis,tumor stage,extracapsular lymph node invasion and peripheral nerve invasion,were analyzed by RevMan5.3 software.Results In total,6180 patients were included in 23 studies.The analysis showed that NLR was significantly negatively correlated with OS[HR=1.62,95%CI(1.38,1.91),P<0.001],DFS[HR=1.48,95%CI(1.24,1.77),P<0.001]and DSS[HR=1.87,95%CI(1.60,2.20),P<0.001].In addition,higher NLR values were positively correlated with tumor size[OR=2.68,95%CI(1.84,3.90),P<0.001],cervical lymph node metastasis[OR=1.59,95%CI(1.35,1.88),P<0.001],tumor stage[OR=2.85,95%CI(2.35,3.47),P<0.001],extralymphatic invasion[OR=1.72,95%CI(1.23,2.40),P=0.001],and peripheral nerve invasion[OR=1.70,95%CI(1.29,2.24),P<0.001].How⁃ever,there was no significant correlation with age[OR=0.96,95%CI(0.71,1.29),P=0.77],sex[OR=1.08,95%CI(0.88,1.33),P=0.55],or degree of differentiation[OR=1.15,95%CI(0.92,1.43),P=0.22].Conclusion Elevated NLR was significantly associated with the prognosis and clinicopathological features of OSCC and might be an indepen⁃dent prognostic factor.