Prognostic role of the neutrophil-lymphocyte ratio in renal cell carcinoma: a meta-analysis.
Prognostic role of the neutrophil-lymphocyte ratio in renal cell carcinoma: a meta-analysis.
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DOI：
10.1136/bmjopen-2014-006404
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发表时间：
2015-04-08
期刊：
影响因子：
2.9
通讯作者：
Zhang S
中科院分区：
文献类型：
--
作者：
Hu K;Lou L;Ye J;Zhang S
越来越多的证据表明，癌症相关炎症与癌症患者预后不良有关。中性粒细胞-淋巴细胞比率(NLR)作为肾癌(RCC)预测指标的作用仍存在争议。我们进行了荟萃分析，以确定NLR与肾癌患者的临床结局之间的关系。这些研究是在2014年3月从PubMed和EMBASE数据库中确定的。进行Meta分析，得出总体生存期(OS)和无复发/进展生存期(RFS/PFS)的合并比例比(95%CI)。纳入15个队列，包括3357名患者。我们的分析结果表明，NLR升高预示着肾癌患者较差的OS(HR=1.82，95%CI为1.51~2.19)和RFS/PFS(HR=2.18，95%CI为1.75~2.71)。当按研究区域、样本量、治疗干预、肾癌类型和研究质量分层时，这些发现是可靠的。然而，在评估RFS/PFS中定义“升高的NLR”的临界值方面，这一结果存在显著差异(p=0.004)。我们的荟萃分析中的异质性为轻度到中度。NLR升高提示肾癌患者预后较差。应该监测肾癌患者的NLR，以便进行合理的风险分层和个体化治疗。
Increasing evidence suggests that cancer-associated inflammation is associated with poor prognosis in patients with cancer. The role of the neutrophil–lymphocyte ratio (NLR) as a predictor in renal cell carcinoma (RCC) remains controversial. We conducted the meta-analysis to determine the association between NLR and clinical outcome of patients with RCC. Studies were identified from PubMed and EMBASE databases in March 2014. Meta-analysis was performed to generate combined HRs with 95% CIs for overall survival (OS) and recurrence-free/progress-free survival (RFS/PFS). 15 cohorts containing 3357 patients were included. Our analysis results indicated that elevated NLR predicted poorer OS (HR=1.82, 95% CI 1.51 to 2.19) and RFS/PFS (HR=2.18, 95% CI 1.75 to 2.71) in patients with RCC. These findings were robust when stratified by study region, sample size, therapeutic intervention, types of RCC and study quality. However, it differed significantly by assessment of the cut-off value defining ‘elevated NLR’ in RFS/PFS (p=0.004). The heterogeneity in our meta-analysis was mild to moderate. Elevated NLR indicates a poorer prognosis for patients with RCC. NLR should be monitored in patients with RCC for rational risk stratification and treatment individualisation.
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