摘要
目的 系统评价术前控制营养状态(CONUT)评分在胃癌术后患者预后中的价值.方法 计算机检索中国知网、万方、中国生物医学文献图书馆、维普、PubMed、Web of Science、Cochrane Library、Embase数据库,收集将术前CONUT评分应用于胃癌术后患者预后的相关研究,检索时间为建库至2023年4月20日.按照纳排标准筛选文献、提取数据、质量评价后,采用RevMan 5.3和Stata 15.0软件进行Meta分析.结果 共纳入17项研究,总计患者9 233例.Meta分析结果显示,与CONUT低分组相比,CONUT高分组患者总生存期[HR=1.70,95％CI(1.54,1.87),P＜0.01]、肿瘤特异性生存期[HR=2.55,95％CI(1.23,5.27),P=0.01]、无进展生存期[HR=1.53,95％CI(1.29,1.82),P＜0.01]更差.同时,CONUT 评分与并发症[OR=2.10,95％CI(1.53,2.90),P＜0.01]、神经浸润[OR=1.54,95％CI(1.02,2.32),P=0.04]、死亡率[OR=2.24,95％CI(1.25,4.01),P＜0.01]、T3/4[OR=2.06,95％CI(1.73,2.46),P＜0.01]、N2/3[OR=1.76,95％CI(1.51,2.05),P＜0.01]、Ⅲ 期[OR=1.62,95％CI(1.39,1.90),P＜0.01]显著相关,但与肿瘤分化无关[OR=0.88,95％CI(0.75,1.04),P=0.13].结论 术前CONUT评分与胃癌患者术后并发症和临床病理参数相关,是患者预后的独立预测指标.
Abstract
Objective To evaluate the prognostic value of controlling nutritional status score(CONUT)in patients undergoing gastrectomy for gastric cancer.Methods CNKI,Wanfang,China Biomedical Literature Library,VIP,PubMed,Web of Science,Cochrane Library,and Embase databases were electronically searched for collecting relevant studies on the application of preoperative CONUT scores to the prognosis of gastric cancer patients after surgery.The search period was from database establishment to April 20,2023.After screening literature,extracting data,and assessing quality assessment,Meta-analysis was performed using the RevMan 5.3 and Stata 15.0 software.Results A total of 17 studies involving 9 233 patients were included.The results of Meta-analysis showed that,compared with the low CONUT group,patients in the high CONUT group had poorer overall survival[HR=1.70,95％CI(1.54,1.87),P＜0.01],tumor specific survival[HR=2.55,95％CI(1.23,5.27),P=0.01],and progression free survival[HR=1.53,95％CI(1.29,1.82),P＜0.01].The CONUT score was significantly correlated with complications[OR=2.10,95％CI(1.53,2.90),P＜0.01],nerve infiltration[OR=1.54,95％CI(1.02,2.32),P=0.04],mortality[OR=2.24,95％CI(1.25,4.01),P＜0.01],T3/4[OR=2.06,95％CI(1.73,2.46),P＜0.01],N2/3[OR=1.76,95％CI(1.51,2.05),P＜0.01],Stage Ⅲ[OR=1.62,95％CI(1.39,1.90),P＜0.01],but not with tumor differentiation[OR=0.88,95％CI(0.75,1.04),P=0.13].Conclusion Preoperative CONUT score is an independent prognostic indicator of gastric cancer patients,associated with postoperative complications and clinicopathological parameters of gastric cancer.
基金项目
湖南省自然科学基金面上项目(2022JJ30462)
怀化市科技创新平台(2021R2206)
维普
万方数据