评估胃肠道和胰腺神经内分泌肿瘤分级与总体生存之间的关系:一项系统回顾和荟萃分析

IF 0.9 Q4 GASTROENTEROLOGY & HEPATOLOGY
Preeti Malik, Neel Patel, Azadeh Khayyat, Muhammad Asad, Sameer Dawoodi, Sangeetha Chandramohan, Nkechi Unachukwu, Bibimariyam Nasyrlaeva, Laseena Vaisyambath, Sriram B. Chowdary, Vikramaditya Samala Venkata, Urvish Patel
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引用次数: 0

摘要

背景:神经内分泌肿瘤(NET)是一组罕见的上皮性肿瘤,存在于胃肠道(GI)(67.5%)和支气管肺树(25.3-30%),其中15%的病例原发部位无法确定。虽然内窥镜筛查、病理技术的改进和早期发现已经显示出NET生存率的提高,但晚期、转移性和低分化NET的预后非常差。在这项研究中,我们旨在评估胃肠道和胰腺(GEPs) NETs的分级对总生存期的影响。方法:我们根据PRISMA指南检索了2011年5月至2021年5月期间描述原发性GEP NETs总生存期或预后因素的观察性研究。研究描述了初级3级GEP NETs对总生存率的影响。进行荟萃分析,获得合并风险比及其95%置信区间(95% CI)。使用随机效应模型创建森林样地,并进行敏感性分析以解释异质性。结果:纳入7项研究,共7692例确诊患者。在我们的荟萃分析中,3级GEP NETs与较高的生存不良几率相关(合并风险比:2.73;95% ci: 1.36-5.47;P = 0.005),研究间存在92%的异质性(P <0.0001)。为了解释这种异质性,通过删除漏斗图上的两个外围研究(Fathi et al.和Foubert et al.)进行敏感性分析。敏感性分析后的结果没有改变,仍然显示3级与生存不良有显著关联(合并风险比:4.53;95% ci: 3.54-5.78;p & lt;0.00001),研究间无异质性(p = 0.72;I2 = 0%)。结论:我们的荟萃分析发现,3级GEP NETs与较差的生存率相关,需要进一步的研究来确定与GEP NETs中较差生存率相关的其他危险因素,以提高其死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Assessing the Relationship between Gastrointestinal and Pancreatic Neuroendocrine Tumor Grade and Overall Survival: A Systematic Review and Meta-Analysis
Background: Neuroendocrine tumors (NET) are a rare group of epithelial neoplasms present in the gastrointestinal tract (GI) (67.5%) and bronchopulmonary tree (25.3–30%), and in 15% of cases, their primary sites cannot be identified. Although endoscopic screening, improvements in pathological techniques, and early detection have shown improvements in NET survival rates, the prognosis of advanced, metastatic, and poorly differentiated NET is very poor. In this study, we aimed to evaluate the effect of gastrointestinal and pancreatic (GEPs) NETs’ grade on overall survival. Method: We searched observational studies describing the overall survival or prognostic factors of primary GEP NETs from May 2011–May 2021 following the PRISMA guidelines. Studies describing the effect of primary grade 3 GEP NETs on overall survival were included. A meta-analysis was performed, and a pooled hazard ratio and their 95% confidence interval (95% CI) were obtained. Forest plots were created using random effects models and a sensitivity analysis was performed to account for the heterogeneity. Results: Seven studies with 7692 confirmed patients were included. In our meta-analysis, grade 3 GEP NETs were associated with higher odds of poor survival (pooled HR: 2.73; 95% CI: 1.36–5.47; p = 0.005), with a 92% heterogeneity between studies (p < 0.0001). To account for this heterogeneity, a sensitivity analysis was performed by removing two outlying studies (Fathi et al. and Foubert et al.) on funnel plots. The results after the sensitivity analysis did not change and still showed a significant association of grade 3 with a poor survival (pooled HR: 4.53; 95% CI: 3.54–5.78; p < 0.00001), with no heterogeneity between studies (p = 0.72; I2 = 0%). Conclusions: Our meta-analysis found that grade 3 GEP NETs are associated with poor survival and additional future studies are needed to identify other risk factors associated with poor survival in GEP NETs to improve their mortality.
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