低钠血症与非小细胞肺癌患者临床病理及预后特征相关性的系统评价与Meta分析  

The association of hyponatremia with clinicopathological and prognostic characteristics of non-small cell lung cancer patients:A systematic review and meta-analysis

作　　者：王晓玮[1] 常帅 宋文鹏 车国卫[2] WANG Xiaowei;CHANG Shuai;SONG Wenpeng;CHE Guowei(Department of Cardiothoracic Surgery,Chengdu Second People's Hospital,Chengdu,610017,P.R.China;Lung Cancer Center/Department of Thoracic Surgery,West China Hospital,Sichuan University,Chengdu,610041,P.R.China)

机构地区：[1]成都市第二人民医院胸心外科,成都610017 [2]四川大学华西医院肺癌中心/胸外科,成都610041

出　　处：《中国胸心血管外科临床杂志》2023年第3期428-433,共6页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：四川省科技厅重点项目(2020YFS0252);四川省干部保健科研重点课题(HZ2019-103)。

摘　　要：目的探究治疗前的低钠血症与非小细胞肺癌(non-small cell lung cancer,NSCLC)患者临床病理及预后特征的相关性。方法检索PubMed、EMbase、Web of Science、维普、知网、万方等数据库中建库至2021年7月12日发表的相关文献,文献质量评价采用纽卡斯尔-渥太华量表(Newcastle-Ottawa Scale,NOS)评分。采用相对危险度(relative risk,RR)或风险比(hazard ratio,HR)及对应的95%置信区间(confidence interval,CI)探究低钠血症与NSCLC患者临床病理特征及预后之间的相关性。预后指标包括总生存期(overall survival,OS)和无进展生存期(progression-free survival,PFS)。所有统计分析由STATA 15.0软件完成。结果共纳入10项高质量研究(NOS评分≥6分),包括10045例研究对象,均来自亚洲或欧洲地区。Meta分析结果显示,低钠血症更易出现在男性[RR=1.18,95%CI(1.02,1.36),P=0.026]、非腺癌[RR=0.86,95%CI(0.81,0.91),P<0.001]和TNM分期Ⅲ~Ⅳ期[RR=1.17,95%CI(1.12,1.21),P<0.001]患者中,同时治疗前低钠血症与NSCLC患者OS[HR=1.83,95%CI(1.53,2.19),P<0.001]和PFS[HR=1.54,95%CI(1.02,2.34),P=0.040]较差明显相关,治疗前的低钠血症是NSCLC患者预后不良的一个危险因素。结论男性、非腺癌和偏晚期的NSCLC患者更易出现低钠血症,且治疗前的血钠水平可作为NSCLC患者的预后评估指标之一,伴有低钠血症的患者预后较差。但上述结论仍需更多研究进一步论证。Objective To explore the association of pretreatment hyponatremia with clinicopathological and prognostic characteristics of non-small cell lung cancer(NSCLC)patients.Methods The PubMed,EMbase,Web of Science,VIP,CNKI and WanFang databases were searched from the inception to July 12,2021 for relevant literatures.The quality of included studies was assessed by the Newcastle-Ottawa Scale(NOS)score.The relative risk(RR)and hazard ratio(HR)with 95%confidence interval(CI)were combined to assess the relationship between pretreatment hyponatremia and clinicopathological and prognostic characteristics.The prognostic indicators included the overall survival(OS)and progression-free survival(PFS).All statistical analysis was conducted by the STATA 15.0 software.Results A total of 10 high-quality studies(NOS score≥6 points)involving 10045 patients were enrolled and all participants were from Asian or European regions.The pooled results demonstrated that male[RR=1.18,95%CI(1.02,1.36),P=0.026],non-adenocarcinoma[RR=0.86,95%CI(0.81,0.91),P<0.001]and TNMⅢ-Ⅳstage[RR=1.17,95%CI(1.12,1.21),P<0.001]patients were more likely to experience hyponatremia.Besides,pretreatment hyponatremia was significantly related to worse OS[HR=1.83,95%CI(1.53,2.19),P<0.001]and PFS[HR=1.54,95%CI(1.02,2.34),P=0.040].Pretreatment hyponatremia was a risk factor for poor prognosis of NSCLC patients.Conclusion Male,nonadenocarcinoma and advance stage NSCLC patients are more likely to experience hyponatremia.Meanwhile,the pretreatment sodium level can be applied as one of the prognostic evaluation indicators in NSCLC and patients with hyponatremia are more likely to have poor survival.However,more researches are still needed to verify above findings.

关 键 词：低钠血症 非小细胞肺癌 临床病理特征 预后 系统评价/META分析 

分 类 号：R734.2[医药卫生—肿瘤]