摘要
目的:探讨中性粒细胞/淋巴细胞比值(NLR)在判断接受表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)治疗的非小细胞肺癌(NSCLC)患者预后中的作用,为NSCLC患者的预后判断提供循证医学依据。方法:检索PubMed、Cochrane library、EMBASE、Web of Science和中国知网(CNKI)数据库公开发表的有关NLR与接受EGFR-TKIs治疗的NSCLC患者预后关系的研究。对符合纳入标准的文献进行Meta分析。结果:最终纳入8篇文献共1451例患者。高NLR组患者的无进展生存期(PFS)[风险比(HR)=1.75,95%置信区间(95%CI):1.24~2.48,Z=3.17,P=0.002]和总生存期(OS)(HR=1.87,95%CI:1.21~2.88,Z=2.84,P=0.005)明显低于低NLR组。亚组分析,按种族、NLR cutoff值分组后,高NLR组患者的PFS在亚裔人群(HR=1.70,95%CI:1.14~2.53,Z=2.62,P=0.009)、非亚裔人群(HR=2.00,95%CI:1.27~3.15,Z=3.00,P=0.003)和NLR cutoff值≥3.5人群(HR=2.21,95%CI:1.54~3.17,Z=4.29,P<0.001)明显低于低NLR组。敏感性分析,纳入的8篇研究结果稳定可信。结论:在接受EGFR-TKIs治疗的NSCLC患者中,高NLR与NSCLC患者的预后不良有关联。
Objective:To investigate the effect of neutrophil/lymphocyte ratio(NLR)in judgement of progrosis in the patients with non-small cell lung cancer(NSCLC)after treated with epidermal growth factor receptor tyrosine kinase inhibitors(EGFR-TKIs),and to provide the evidence-based medical basis for the prognosis judgement of NSCLC patients.Methods:PubMed,Cochrane Library,EMBASE,Web of Science and China National Knowledge Internet(CNKI)databases were searched for collecting the studies about the relationship between NLR and the prognosis of NSCLC patients treated with EGFR-TKIs.Meta-analysis was conducted on the literatures that met the inclusion criteria.Results:Eight studies contained 1451 NSCLC patients were eventually included in the Meta-analysis.The progression-free survival(PFS)[hazard ratio(HR)=1.75,95%confidence interval(95%CI):1.24-2.48,Z=3.17,P=0.002]and overall survival(OS)(HR=1.87,95%CI:1.21-2.88,Z=2.84,P=0.005)of the NSCLC patients in high NLR group were significantly lower than those in low NLR group.The subgroup analysis results showed that after grouping by the ethnicity and NLR cutoff value,the PFS of NSCLC patients in the Asian(HR=1.70,95%CI:1.14-2.53,Z=2.62,P=0.009),the non-Asian(HR=2.00,95%CI:1.27-3.15,Z=3.00,P=0.003)and the NLR cutoff value≥3.5(HR=2.21,95%CI:1.54-3.17,Z=4.29,P<0.001)in high NLR group were significantly low than those in low NLR group.The sensitivity analysis results showed that 8 included studies were stable and reliable.Conclusion:In the NSCLC patients after treated with EGFR-TKIs,the high level of NLR is associated with the poor prognosis of NSCLC patients.
作者
万广财
孙洪帅
朱华
于秀艳
WAN Guangcai;SUN Hongshuai;ZHU Hua;YU Xiuyan(Department of Clinical Laboratory,Tumor Hospital,Jilin Province,Changchun 130012,China)
出处
《吉林大学学报（医学版）》
CAS
CSCD
北大核心
2020年第6期1267-1273,共7页
Journal of Jilin University：Medicine Edition
基金
吉林省卫计委卫生与健康技术创新项目资助课题(2018J025)。
