C-reactive protein is a predictor of prognosis in renal cell carcinoma patients receiving tyrosine kinase inhibitors: A meta-analysis
C-reactive protein is a predictor of prognosis in renal cell carcinoma patients receiving tyrosine kinase inhibitors: A meta-analysis
复制标题
C 反应蛋白是接受酪氨酸激酶抑制剂的肾细胞癌患者预后的预测因子：一项荟萃分析。
DOI：
10.1016/j.cca.2017.10.021
复制
发表时间：
2017-12-01
影响因子：
5
通讯作者：
Niu, Yuanjie
中科院分区：
文献类型：
--
作者：
Wang, Zhun;Peng, Shuanghe;Niu, Yuanjie
背景：C-反应蛋白（CRP）在接受酪氨酸激酶抑制剂（TKI）治疗的转移性肾细胞癌（RCC）患者中的预后价值已在先前的研究中进行了研究;然而，结果仍不确定。本研究探讨了TKIs治疗的转移性RCC患者治疗前CRP的预后价值。方法：检索PubMed、Embase、Web of Science和科克伦数据库中研究转移性RCC患者治疗前CRP与预后之间关系的研究。从合格研究中提取总生存期（OS）和无进展生存期（PFS）的风险比（HR）。使用I-2值评估杂合子。如果没有异质性证据，则使用固定效应模型;否则，使用随机效应模型。使用Begg的漏斗图和Egger的回归test.Results：共1199例患者从9项研究中纳入分析的出版偏倚进行了评价。结果显示，CRP水平升高是OS（合并HR = 2.87，95%置信区间[CI]：2.34-3.54，p < 0.001）和PFS（合并HR = 2.39，95% CI：1.75-3.26，p < 0.001）的有效预后标志物。亚组分析显示，在日本进行的研究中，CRP水平升高显著预测OS和PFS较差（OS，合并HR = 3.03，95%CI：2.29-4.01，p < 0.001; PFS，合并HR = 3.6，95%CI：1.62-8.0，p = 0.002），CRP临界值< 0.8（OS，合并HR = 2.93，95% CI：2.21-3.88，p < 0.001; PFS，合并HR = 2.57，95% CI：1.82-3.65，p < 0.001）。这项研究表明，CRP水平升高与接受TKI治疗的转移性RCC患者预后不良相关。
Background The prognostic value of C-reactive protein (CRP) in metastatic renal cell carcinoma (RCC) patients receiving tyrosine kinase inhibitors (TKIs) has been investigated in previous studies; however, the results remain inconclusive. This study investigated the prognostic value of pretreatment CRP in patients with metastatic RCC treated with TKIs.Methods: PubMed, Embase, Web of Science, and Cochrane databases were searched for studies investigating the relationships between pretreatment CRP and prognosis in patients with metastatic RCC. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were extracted from eligible studies. Heterogeneity was assessed using the I-2 value. The fixed-effects model was used if there was no evidence of heterogeneity; otherwise, the random-effects model was used. Publication bias was evaluated using Begg's funnel plots and Egger's regression test.Results: A total of 1199 patients from nine studies were included in the analysis. The results showed that an elevated CRP level was an effective prognostic marker of both OS (pooled HR = 2.87, 95% confidence interval [CI]: 2.34-3.54, p < 0.001) and PFS (pooled HR = 2.39, 95% CI: 1.75-3.26, p < 0.001). Subgroup analysis revealed that an elevated CRP level significantly predicted poor OS and PFS in studies conducted in Japan (OS, pooled HR = 3.03, 95% CI: 2.29-4.01, p < 0.001; PFS, pooled HR = 3.6, 95% CI: 1.62-8.0, p = 0.002), and in cut-off value of CRP < 0.8 (OS, pooled HR = 2.93, 95% CI: 2.21-3.88, p < 0.001; PFS, pooled HR = 2.57, 95% CI: 1.82-3.65, p < 0.001).Conclusions: This study suggests that an elevated CRP level is correlated with poor prognosis in patients with metastatic RCC receiving TKIs treatment.