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Prognostic value of systemic hemato-immunological indices in uterine cervical cancer: A systemic review, meta-analysis, and meta-regression of observational studies.

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机构: [1]Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, People's republic of China [2]Clinical Nursing Research Institute, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, People's republic of China [3]Department of Oncology, Anyue Hospital of Traditional Chinese Medicine, Second Ziyang Hospital of Traditional Chinese Medicine, Ziyang, Sichuan, People's republic of China [4]Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran [5]Department of Obstetrics, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, People's republic of China [6]Laboratory of Systems Biology and Bioinformatics, Institute of Biochemistry and Biophysics, University of Tehran, Tehran, Iran [7]Department of Obstetrics and Gynecology, Army Medical Center of PLA (Daping Hospital), Army Medical University (Third Military Medical University), Chongqing 400038, People's Republic of China
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关键词: Systemic immune-inflammation response Uterine cervical cancer Prognostic marker Meta-analysis Meta-regression

摘要:
To estimate the prognostic efficacy of several systemic hemato-immunological indices for the treatment of cervical cancer as well as to determine whether the systemic hemato-immunological indices are associated with an increased risk of cervical collision cancer. A systematic search was conducted to identify studies that evaluated the prognostic impact of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), thrombocyte-to-lymphocyte ratio (TLR), C-reactive protein/albumin ratio (CAR), and systemic immune-inflammation index (SII) in cervical cancer patients. The endpoints were overall survival (OS) or progression-free survival (PFS) and clinicopathologic parameters. A meta-analysis using random-effect models was performed to calculate hazard ratios (HRs) or odds ratios with 95% confidence intervals. Twenty-two retrospective cohort studies involving 9558 patients were included. Our results show that high NLR, PLR, TLR, and CAR indicated poor prognosis for patients with cervical cancer (HRs = 2.46, 1.88, 3.70, and 3.94, respectively; all P ≤ 0.001). Subgroup analysis suggested that the highest NLR and PLR were more precise biomarkers in patients who were diagnosed with FIGO stage I-III cervical cancer after treatment with chemo-radiotherapy. High TLR and high LMR displayed significant prognostic value in late-FIGO stage III-IV cervical cancer (HRs = 4.33 and 2.032, respectively). Additionally, CAR was associated with poor survival in patients with advanced-FIGO stage cervical cancer and larger tumor size. According to the difference of NLR, the younger (43-51 years old) cervical cancer patients had a tendency of increased collision risk. However, cervical cancer patients in the 52-61 years age group were more vulnerable than their respective counterparts using the pooled estimate for PLR. Our findings support a prognostic role for elevated CAR and TLR besides that of NLR and PLR in advanced-FIGO stage cervical cancer. Copyright © 2020. Published by Elsevier Inc.

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出版当年[2021]版:
大类 | 2 区 医学
小类 | 2 区 肿瘤学 2 区 妇产科学
最新[2023]版:
大类 | 2 区 医学
小类 | 1 区 妇产科学 2 区 肿瘤学
第一作者:
第一作者机构: [1]Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, People's republic of China [2]Clinical Nursing Research Institute, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, People's republic of China
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通讯作者:
通讯机构: [1]Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan 646000, People's republic of China [7]Department of Obstetrics and Gynecology, Army Medical Center of PLA (Daping Hospital), Army Medical University (Third Military Medical University), Chongqing 400038, People's Republic of China [*1]Department of Obstetrics and Gynecology, Army Medical Center of PLA (Daping Hospital), Army Medical University (Third Military Medical University),#10 Changjiang Branch Road, Yuzhong District, Chongqing 400038, People's Republic of China. [*2]Department of Oncology, The Affiliated Hospital of Southwest Medical University, #25 Taiping Street, Jiangyang District, Luzhou, Sichuan Province 646000, People's republic of China
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