预后营养指数评估根治性膀胱切除术患者预后的Meta分析

唐文超; 李远伟; 陈佳; 覃奕澎; 吴志颖; 付慧锋

doi:10.3971/j.issn.1000-8578.2021.21.0326

预后营养指数评估根治性膀胱切除术患者预后的Meta分析

Prognostic Evaluation of Prognostic Nutrition Index for Patients with Radical Cystectomy: A Meta-analysis

摘要

摘要:
目的系统评价预后营养指数(PNI)与行根治性膀胱切除术(RC)的膀胱癌(BC)患者预后的关系。
方法全面检索自建库至2021年1月30日前在PubMed、Embase、Web of Science、知网、万方、维普、中华医学期刊数据库中关于PNI和RC术后BC患者预后关系的文献，使用RevMan5.3软件进行Meta分析。
结果共纳入含1273例患者的6篇文献进行Meta分析。结果显示：低PNI与RC术后BC患者的OS显著相关(HR=2.0, 95%CI: 1.56~2.56); 低PNI与RC术后患者的RFS、PFS和DSS有明显差异(HR=1.93, 95%CI: 1.51~2.48)。亚组分析显示中国组(HR=2.13, 95%CI: 1.62~2.81)与日本组(HR=1.78, 95%CI: 1.08~2.94)中PNI与RC术后BC患者预后关系差异均有统计学意义; PNI截断值在46.08~51.30区间内对RC术后BC患者均具有较好的预后预测效果。
结论 PNI水平与RC术后BC患者OS显著相关，低PNI可作为此类患者预后预测的有效标志物。

Abstract:
Objective To systematically evaluate the relation between prognostic nutrition index (PNI) and prognosis of bladder cancer (BC) patients treated with radical cystectomy (RC).
Methods We searched the literatures about the relation between PNI and the prognosis of patients treated with radical cystectomy published from the inception to January 30, 2021 in PubMed, Embase, Web of Science, CNKI, Wanfang, VIP and Chinese Medical Journal Database, and used RevMan5.3 software for Meta analysis.
Results We included six literatures which comprise a total of 1273 patients. The results showed that there was a significant correlation between low PNI and OS of BC patients treated with RC (HR=2.0, 95%CI: 1.56-2.56), and there was a significant difference in RFS, PFS and DSS between low PNI and BC patients treated with RC (HR=1.93, 95%CI: 1.51-2.48). In the subgroup analysis, there were statistical differences in PNI and the prognosis of BC patients treated with RC between the Chinese group (HR=2.13, 95%CI: 1.62-2.81) and the Japanese group (HR=1.78, 95%CI: 1.08-2.94), and the PNI cutoff value had a good predictive effect on the prognosis of patients in the range of 46.08-51.30.
Conclusion There is a significant relation between the level of PNI and OS of bladder cancer patients treated with radical cystectomy. Low PNI can be used as an effective marker to predict the prognosis of patients.

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