中性粒细胞/淋巴细胞比值与接受EGFR-TKIs治疗的非小细胞肺癌患者预后关系的Meta分析

doi:10.13481/j.1671-587x.20200625

Abstract

Abstract: Objective

To investigate the effect of neutrophil/lymphocyte ratio （NLR） in judgement of progrosis in the patients with non-small cell lung cancer（NSCLC） after treated with epidermal growth factor receptor tyrosine kinase inhibitors （EGFR-TKIs）， and to provide the evidence-based medical basis for the prognosis judgement of NSCLC patients.

Methods

PubMed， Cochrane Library， EMBASE， Web of Science and China National Knowledge Internet（CNKI） databases were searched for collecting the studies about the relationship between NLR and the prognosis of NSCLC patients treated with EGFR-TKIs. Meta-analysis was conducted on the literatures that met the inclusion criteria.

Results

Eight studies contained 1 451 NSCLC patients were eventually included in the Meta-analysis. The progression-free survival（PFS）［hazard ratio（HR）=1.75， 95% confidence interval（95%CI）：1.24－2.48， Z=3.17， P=0.002］ and overall survival（OS）（HR=1.87， 95%CI：1.21－2.88， Z=2.84， P=0.005） of the NSCLC patients in high NLR group were significantly lower than those in low NLR group. The subgroup analysis results showed that after grouping by the ethnicity and NLR cutoff value， the PFS of NSCLC patients in the Asian（HR=1.70， 95%CI：1.14－2.53， Z=2.62， P=0.009）， the non-Asian（HR=2.00， 95%CI：1.27－3.15， Z=3.00， P=0.003） and the NLR cutoff value≥3.5（HR=2.21， 95%CI：1.54－3.17， Z=4.29， P<0.001） in high NLR group were significantly low than those in low NLR group.The sensitivity analysis results showed that 8 included studies were stable and reliable.

Conclusion

In the NSCLC patients after treated with EGFR-TKIs， the high level of NLR is associated with the poor prognosis of NSCLC patients.

Key words: neutrophil/lymphocyte ratio, cancer，non-small cell lung, prognosis, Meta-analysis

CLC Number:

R734.2

Guangcai WAN,Hongshuai SUN,Hua ZHU,Xiuyan YU. Meta-analysis on relationship between neutrophil/lymphocyte ratio and prognosis of patients with non-small cell lung cancer treated with EGFR-TKIs[J].Journal of Jilin University(Medicine Edition), 2020, 46(6): 1267-1273.

Figures/Tables 6

Fig. 1

Tab. 1

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Fig. 4

Fig. 5

References 30

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First author	Publication year	Ethnicity	Nation	Stage	Duration time	Sample size	Age/(year)	NLR cutoff value	HR value for PFS	95%CI	NOS score
ONO,et al.^[11]	2020	Asia	Japan	Ⅳ	2009－2016	205	Median 70	3.55	1.780	1.290－2.470	9
DENG,et al.^[12]	2019	Asia	China	Ⅳ	2013－2018	203	Median 59	4.40	1.736	1.020－2.954	9
AGUIAR-BUJANDA,et al.^[15]	2018	Non-Asia	Spain	ⅢB-Ⅳ	2010－2016	385	Mean 62.1	4.39	1.668	0.826－3.368	8
PHAN,et al.^[16]	2018	Asia	Vietnam	NR	2015－2018	112	Median 59	2.96	2.150	1.150－3.990	9
MERIGGI,et al.^[17]	2017	Non-Asia	Italy	Ⅳ	2011－2015	63	NR	3.50	2.275	1.257－4.116	8
MINAMI,et al.^[18]	2017	Asia	Japan	ⅢA-B, Ⅳ	2007－2017	152	Mean 70.3	2.11	1.030	0.970－1.100	8
SIM,et al.^[13]	2016	Asia	Korea	ⅢB-Ⅳ	2005－2011	250	Median 64	3.00	1.239	0.693－2.215	8
LIN,et al.^[14]	2014	Asia	China	NR	2009－2012	81	NR	3.50	3.890	1.980－7.680	8

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Meta-analysis on relationship between neutrophil/lymphocyte ratio and prognosis of patients with non-small cell lung cancer treated with EGFR-TKIs

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