目的 系统评价肌肉减少症对肺癌患者生存期的影响.方法 通过中国知网、万方数据库、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science、Cochrane Library、MEDLINE数据库检索自建库至2022年12月31日关于肌肉减少症对肺癌患者生存期影响的相关文献.采用RevMan 5.3及Stata 15.0软件进行分析,主要结局指标包括总生存期(OS)和无进展生存期(PFS).结果 最终纳入14篇队列研究文献,共1923例患者.Meta分析结果显示,肌肉减少症是肺癌患者OS的危险因素(HR=1.47,95%CI:1.20～1.81,P=0.0003),不是肺癌患者PFS的影响因素(HR=0.88,95%CI:0.39～1.96,P=0.75).根据样本量进行亚组分析结果显示,肌肉减少症是肺癌患者OS的危险因素(P﹤0.05);根据肿瘤类型进行亚组分析结果显示,肌肉减少症是非小细胞肺癌(NSCLC)患者OS的危险因素(P﹤0.05);根据地区进行亚组分析结果显示,在欧美国家中,肌肉减少症是肺癌患者OS的危险因素(P﹤0.05).结论 肌肉减少症是肺癌患者OS的危险因素,肌肉减少症可以作为预测肺癌患者OS的指标,而对PFS的影响未来仍需更多研究进一步证实.
Meta-analysis of the impact of sarcopenia on survival of lung cancer patients
Objective To systemically evaluate the impact of sarcopenia on survival of lung cancer patients.Method The relevant articles about the impact of sarcopenia on survival of lung cancer patients were searched through CNKI,Wanfang,VIP,CBM,PubMed,Embase,Web of Science,Cochrane Library and MEDLINE databases from construction to December 31,2022.RevMan 5.3 and Stata 15.0 softwares were used for analysis.The main outcome indexes included overall survival(OS)and progression-free survival(PFS).Result Finally,14 articles with a total of 1923 patients were included.The results of Meta-analysis showed that sarcopenia was a risk factor for OS in lung cancer patients(HR=1.47,95%CI:1.20-1.81,P=0.0003),but not an influencing factor for PFS in lung cancer patients(HR=0.88,95%CI:0.39-1.96,P=0.75).Subgroup analysis according to the sample size showed that sarcopenia was a risk factor for OS in lung cancer patients(P<0.05).Subgroup analysis according to tumor type showed that sarcopenia was a risk factor for OS in non-small cell lung cancer(NSCLC)patients(P<0.05).Subgroup analysis according to region showed that sarcopenia was a risk factor for OS in lung cancer patients in Europe and United States(P<0.05).Conclusion Sarcopenia is a risk factor for OS in lung cancer patients,and sarcopenia can be used as a predictive index of OS in lung cancer patients,while the impact on PFS needs more research in the future.
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