中性粒细胞与淋巴细胞比值对肝癌预后影响的Meta分析

刘健; 高驰丹; 张立鑫; 权刚; 张雨顺; 李敬东

doi:10.3969/j.issn.1001-5256.2017.07.020

中性粒细胞与淋巴细胞比值对肝癌预后影响的Meta分析

DOI: 10.3969/j.issn.1001-5256.2017.07.020

1. 四川省南充市川北医学院肝胆一科
2. 四川省南充市川北医学院病理科

详细信息

中图分类号: R735.7
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出版历程
- 收稿日期: 2017-02-04
- 出版日期: 2017-07-20

Influence of neutrophil-lymphocyte ratio on prognosis of liver cancer:a meta-analysis

First Department of Hepatobiliary Surgery, The Affiliated Hospital of North Sichuan Medical College

摘要

摘要: 目的探讨中性粒细胞与淋巴细胞比值(NLR)与肝癌患者预后的关系。方法检索Pub Med、Embase、Cochrane Library、中国生物医学文献数据库、维普、万方等数据库建库至2016年10月公开发表的关于NLR与肝癌预后关系研究的中英文文献,筛选后的文献数据用Review Manager 5.3软件进行统计分析,发表性偏倚采用漏斗图进行分析评价。结果纳入12项符合标准的研究,共计3325例肝癌患者。Meta分析结果显示,NLR升高的肝癌患者,其总体生存期[风险比(HR)=1.56,95%可信区间(95%CI):1.46~1.66,P<0.001]、无病生存期(HR=1.57,95%CI:1.23~2.00,P<0.001)和无复发生存期(HR=1.54,95%CI:1.36~1.74,P<0.001)明显缩矩。结论 NLR升高的肝癌患者预后较差,临床上应重视NLR指标,使肝癌患者及时得到预后评估和合理治疗。
- 肝肿瘤 /
- 中性白细胞 /
- 淋巴细胞 /
- 预后 /
- Meta分析
Abstract: Objective To investigate the association between neutrophil-lymphocyte ratio (NLR) and prognosis of liver cancer.Methods Pub Med, Embase and Cochrane Library, CBM, VIP, Wanfang Data were searched for Chinese and English articles on the association between NLR and prognosis of liver cancer published up to October 2016.Review Manager 5.3 was used for statistical analysis of data in these articles, and funnel plots were used to evaluate publication bias.Results A total of 12 studies which met the inclusion criteria were included, with 3325 liver cancer patients in total.The meta-analysis showed that liver cancer patients with an increased NLR had significant reductions in overall survival time (hazard ratio [HR]=1.56, 95% confidence interval [95% CI]:1.46-1.66, P<0.001) , disease-free survival (HR=1.57, 95% CI:1.23-2.00, P<0.001) , and recurrence-free survival (HR=1.54, 95% CI:1.36-1.74, P<0.001) .Conclusion Liver cancer patients with an increased NLR tend to have poor prognosis, and NLR should be taken seriously in clinical practice to provide timely prognostic evaluation and rational treatment for liver cancer patients.
- liver neoplasms /
- neutrophils /
- lymphocytes /
- prognosis /
- Meta-analysis

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参考文献(24)

[1]SUN DN, HUANG X.Roles and mechanism of NF-κB in hepatocellular carcinoma development[J].China Med Herald, 2016, 13 (18) :42-45. (in Cninese) 孙丹妮, 黄洵.NF-κB在肝细胞癌发生发展中的作用及其机制研究进展[J].中国医药导报, 2016, 13 (18) :42-45.

[2] JEMAL A, BRAY F, CENTER MM, et al.Global cancer statistics[J].CA Cancer J Clin, 2011, 61 (2) :60-90.

[3]GRIVENNIKOV SI, GRETEN FR, KARIN M.Immunity, inflammation, and cancer[J].Cell, 2010, 140 (6) :883-899.

[4]Poon RT.Prevention of recurrence after resection of hepatocellular carcinoma:a daunting challenge[J].Hepatology, 2011, 54 (3) :757-759.

[5]TRALHAO JG, DAGHER I, LINO T, et al.Treatment of tumour recurrence after resection of hepatocellular carcinoma.Analysis of 97 consecutive patients[J].Eur J Surg Oncol, 2007, 33 (6) :746-751.

[6]OH BS, JANG JW, KWON JH, et al.Prognostic value of C-reactive protein and neutrophil-to-lymphocyte ratio in patients with hepatocellular carcinoma[J].BMC Cancer, 2013, 13 (1) :1-9.

[7]SULLIVAN KM, GROESCHL RT, TURAGA KK, et al.Neutrophil-to-lymphocyte ratio as a predictor of outcomes for patients with hepatocellular carcinoma:a Western perspective[J].J Surg Oncol, 2014, 109 (2) :95-97.

[8]YAMAMURA K, SUGIMOTO H, KANDA M, et al.Comparison of inflammation-based prognostic scores as predictors of tumor recurrence in patients with hepatocellular carcinoma after curative resection[J].J Hepatobiliary Pancreat Sci, 2014, 21 (9) :682-688.

[9]da FONSECA LG, BARROSO-SOUSA R, BENTO ADA S, et al.Pre-treatment neutrophil-to-lymphocyte ratio affects survival in patients with advanced hepatocellular carcinoma treated with sorafenib[J].Med Oncol, 2014, 31 (11) :264.

[10]GIAKOUSTIDIS A, NEOFYTOU K, KHAN AZ, et al.Neutrophil to lymphocyte ratio predicts pattern of recurrence in patients undergoing liver resection for colorectal liver Metastasis and thus the overall survival[J].J Surg Oncol, 2015, 111 (4) :445-450.

[11]FAN W, ZHANG Y, WANG Y, et al.Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios as predictors of survival and metastasis for recurrent hepatocellular carcinoma after transarterial chemoembolization[J].PLo S One, 2015, 10 (3) :e0119312.

[12]OKAMURA Y, ASHIDA R, ITO T, et al.Preoperative neutrophil to lymphocyte ratio and prognostic nutritional index predict overall survival after hepatectomy for hepatocellular carcinoma[J].World JSurg, 2015, 39 (6) :1501-1509.

[13]CHEN Q, YANG LX, LI XD, et al.The elevated preoperative neutrophil-to-lymphocyte ratio predicts poor prognosis in intrahepatic cholangiocarcinoma patients undergoing hepatectomy[J].Tumour Biol, 2015, 36 (7) :5283-5289.

[14]SUKATO DC, TOHME S, CHALHOUB D, et al.The prognostic role of neutrophil-to-lymphocyte ratio in patients with unresectable hepatocellular carcinoma treated with radioembolization[J].J Vasc Interv Radiol, 2015, 26 (6) :816-824.e1.

[15]LU SD, WANG YY, PENG NF, et al.Preoperative ratio of neutrophils to lymphocytes predicts postresection survival in selected patients with early or intermediate stage hepatocellular carcinoma[J].Medicine (Baltimore) , 2016, 95 (5) :e2722.

[16]JI F, LIANG Y, FU SJ, et al.A novel and accurate predictor of survival for patients with hepatocellular carcinoma after surgical resection:the neutrophil to lymphocyte ratio (NLR) combined with the aspartate aminotransferase/platelet count ratio index (APRI) [J].BMC Cancer, 2016, 16:137.

[17]HU XG, MAO W, PARK YK, et al.Blood neutrophil-to-lymphocyte ratio predicts tumor recurrence in patients with hepatocellular carcinoma within milan criteria after hepatectomy[J].Yonsei Med J, 2016, 57 (5) :1115-1123.

[18]LI YB, ZHANG J, LI GP, et al.Correlation of neutrophil-tolymphocyte ratio with the clinicopathological characteristics and prognosis of early primary hepatocellular carcinoma[J].Tumor, 2016, 36 (7) :784-790. (in Chinese) 李友炳, 张军, 李国平, 等.中性粒细胞/淋巴细胞比值与早期原发性肝细胞癌临床病理特征及预后的相关性[J].肿瘤, 2016, 36 (7) :784-790.

[19]WANG WJ, ZHAO Y, XIA DD, et al.Predictive value of neutrophil-lymphocyte ratio and its dynamic change in patients with hepatocellular carcinoma undergoing transarterial chemoembolization[J].J Clin Hepatol, 2016, 32 (6) :1139-1144. (in Chinese) 王文军, 赵艳, 夏冬东, 等.中性粒细胞与淋巴细胞比值及其动态变化对经肝动脉化疗栓塞术治疗的肝细胞癌患者预后的预测价值[J].临床肝胆病杂志, 2016, 32 (6) :1139-1144.

[20]EIR N, VIZOSO FJ.Imflammation and cancer[J].World J Gastrointest Surg, 2012, 4 (3) :62-72.

[21]HOFMAN PM.Pathobiology of the neutrophil-intestinal epithelial cell interaction:role in carcinogenesis[J].World J Gastroenterol, 2010, 16 (46) :5790-5800.

[22]ROXBURGH CS, MCMILLAN DC.Role of systemic inflammatory response in predicting survival in patients with primary operable cancer[J].Future Oncology, 2010, 6 (1) :149-163.

[23]SCONOCCHIA G, EPPENBERGER S, SPAGNOLI GC, et al.NKcells and T cells cooperate during the clinical course of colorectal cancer[J].Oncoimmunology, 2014, 3 (8) :e952197.

[24]ZHOU WY, ZHANG JP.The association of pre-treatment neutrophil-to-lymphocyte ratios with response of neoadjuvant theropy, clinical outcome in patients with IB2-IIB cervical cancer[J].Clin J Med Offic, 2016, 44 (2) :119-123. (in Chinese) 周文毓, 张建平.IB2-IIB期宫颈癌新辅助化疗治疗前中性粒细胞与淋巴细胞比值对疗效及预后预测意义[J].临床军医杂志, 2016, 44 (2) :119-123.

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