Prognostic value of lymph node micrometastasis in esophageal cancer: A systematic review and meta-analysis.
Prognostic value of lymph node micrometastasis in esophageal cancer: A systematic review and meta-analysis.
复制标题
食管癌淋巴结微转移的预后价值：系统评价和荟萃分析。
DOI：
10.3389/fonc.2022.1025855
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发表时间：
2022
影响因子：
4.7
通讯作者：
Zhang, Min
中科院分区：
文献类型：
--
作者：
Yang, Jing;Liu, Qianqian;Bai, Yuping;Zhao, Haitong;He, Tingting;Zhao, Ziru;Huang, Min;Jiang, Mengyuan;Zhang, Rui;Zhang, Min
淋巴结微转移（LNM）是否增加食管癌患者的风险仍存在争议。我们进行了系统回顾和荟萃分析，以探讨LNM在食管癌患者预后中的价值。两名评审员独立检索了电子数据库，包括PubMed、Embase和科克伦图书馆，以获得2022年2月之前的合格引文。我们用随机效应模型计算了风险比的合并估计值。证据的确定性由建议评估、开发和评价等级（GRADE）方法确定。进行敏感性分析以评估稳定性。使用漏斗图和Egger检验评估发表偏倚。我们还进行了亚组分析，以探讨异质性的来源。共纳入16项研究，1，652例患者。与LNM阳性相比，LNM阴性患者的总生存期（OS）显著增加（HR 1.95; 95%CI，1.53-2.49; P < 0.001; I2 = 0.0%，P = 0.930;证据确定性：低）。与LNM阳性相比，LNM阴性患者的无复发生存率（RFS）显著增加（HR 3.39; 95%CI，1.87-6.16; P < 0.001; I2 = 50.18%，P = 0.060;证据确定性：中度）。两组之间的复发率无显著差异（证据确定性：低）。敏感性分析显示趋势稳定。此外，漏斗图和Egger检验未显示显著的发表偏倚。LNM阳性预示食管癌的预后，RFS的证据是中等的。未来相关的高质量研究是必要的，以进一步验证我们的结果，并提供指导方针的参考。 ，标识符（CRD 42022321768）。
Whether lymph node micrometastasis (LNM) increases the risk in esophageal cancer patients remains controversial. We conducted a systematic review and meta-analysis to explore the prognosis value of LNM in esophageal cancer patients. Two reviewers independently searched electronic databases, including PubMed, Embase, and the Cochrane Library, for eligible citations until February 2022. We calculated pooled estimates of the hazards ratio with a random-effects model. The certainty of evidence was determined by the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) method. A sensitivity analysis was performed to assess the stability. Publication bias was assessed using funnel plots and Egger’s test. We also performed subgroup analysis to explore the source of heterogeneity. A total of 16 studies, with 1,652 patients, were included. The overall survival (OS) was significantly increased with LNM negativity compared with LNM positivity (HR 1.95; 95% CI, 1.53–2.49; P < 0.001; I2 = 0.0%, P = 0.930; certainty of evidence: low). Relapse-free survival (RFS) was significantly increased with LNM negativity compared with LNM positivity (HR 3.39; 95% CI, 1.87–6.16; P < 0.001; I2 = 50.18%, P = 0.060; certainty of evidence: moderate). No significant difference was observed in recurrence between the two groups (certainty of evidence: low). Sensitivity analysis revealed a stable trend. In addition, the funnel plot and Egger’s test did not show significant publication bias. LNM positivity worsens the prognosis in esophageal cancer, and the evidence for RFS is moderate. Future relevant high-quality studies are warranted to validate our results further and provide a reference for guidelines. , identifier (CRD42022321768).
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