Neutrophil-to-lymphocyte ratio predicts prognosis of patients with hepatocellular carcinoma: a systematic review and meta-analysis.
Neutrophil-to-lymphocyte ratio predicts prognosis of patients with hepatocellular carcinoma: a systematic review and meta-analysis.
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中性粒细胞与淋巴细胞比率预测肝细胞癌患者的预后：系统评价和荟萃分析
DOI：
10.21037/tcr-20-3237
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发表时间：
2021-04
影响因子：
0.9
通讯作者：
Wu F
中科院分区：
文献类型：
--
作者：
Lin S;Hu S;Ran Y;Wu F
背景中性粒细胞与淋巴细胞比率（NLR）是肝细胞癌（HCC）患者预后不良的预测因素之一。为了回应关于NLR预测能力的矛盾数据，我们进行了一项荟萃分析，以确定其在HCC患者中的预后价值。方法系统检索PubMed、EMBASE、科克伦图书馆、中国知网、万方数据库，更新日期为2020年9月21日。纳入标准：纳入了报告接受治疗的HCC患者血清NLR水平的预后价值的RCT研究。采用比值比（OR）和诊断比值比（DOR）的合并估计值评估NLR在HCC患者中的预后性能。总生存期（OS）是主要结局，无进展生存期（PFS）是次要结局。在荟萃分析中汇总了报告风险比和95%置信区间（CI）或P值的研究数据。此外，纳入研究的偏倚风险评估由科克伦风险偏倚评估工具规定。结果该分析包括9项研究，共包含3，862例HCC患者。高基线NLR与不良预后或复发显著相关。基于患者的汇总估计值分析如下：灵敏度，0.68（95% CI：0.58-0.77）;特异性，0.73（95% CI：0.61-0.82）; DOR，6.347（95% CI：5.450-7.391）。合并阳性似然比（PLR）和阴性似然比（NLHR）分别为2.5（95% CI：1.8-3.6）和0.43（95% CI：0.33-0.57）。此外，反映预后准确性的汇总受试者工作特征（SROC）曲线下面积（AUC）为0.76（95%CI：0.72-0.80）。因此，亚组荟萃分析和总体荟萃分析的结果相互一致。结论我们的研究结果表明，NLR是HCC患者的一个有效的预后因素，特别是对于那些来自东亚高发人群的HCC患者。未来，需要更大样本量和更多高质量证据的试验来进一步改善患者结局。
Background Neutrophil-to-lymphocyte ratio (NLR) is one predictive factor for poor prognosis of patients with hepatocellular carcinoma (HCC). In response to contradictory data concerning the predictive ability of NLR, we performed a meta-analysis for the determination of its prognostic value in patients with HCC. Methods We systematically searched several databases including PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure and Wan Fang databases with the updated date of September 21, 2020. Inclusion criteria: RCT studies reporting the prognostic value of the serum levels of NLR in HCC patients receiving treatment were enrolled. Pooled estimates of odds ratio (OR) and diagnostic odds ratio (DOR) were used to assess the prognostic performance of NLR in HCC patients. Overall survival (OS) was the primary outcome and progression-free survival (PFS) was secondary outcomes. Data from studies reporting a hazard ratio and 95% confidence interval (CI) or a P value were pooled in a meta-analysis. Furthermore, risk of bias assessment of included studies is specified by Cochrane Risk Bias Assessment Tool. Results This analysis included 9 studies containing a total of 3,862 HCC patients. High baseline NLR was significantly correlated with poor prognosis or recurrence. The patient-based analysis of pooled estimates was as follows: sensitivity, 0.68 (95% CI: 0.58–0.77); specificity, 0.73 (95% CI: 0.61–0.82); DOR, 6.347 (95% CI: 5.450–7.391). The pooled positive likelihood ratio (PLR) and negative likelihood ratio (NLHR) were 2.5 (95% CI: 1.8–3.6) and 0.43 (95% CI: 0.33–0.57). Furthermore, the area under the curve (AUC) of summary receiver operating characteristic (SROC) reflecting the prognostic accuracy was 0.76 (95% CI: 0.72–0.80). Results obtained from subgroup meta-analyses and overall meta-analyses were accordingly consistent with each other. Conclusions Our findings suggested that NLR is an effective prognostic factor for patients with HCC, especially for those from East Asian populations with high incidence. In the future, trials with larger sample sizes and more high-quality evidence are needed to further improve patient outcomes.
术前中性粒细胞与淋巴细胞比率是复发性肝细胞癌热消融后复发的预测因子：回顾性分析
影响因子：
3.7
作者：
Li X;Han Z;Cheng Z;Yu J;Liu S;Yu X;Liang P
通讯作者：
Liang P