Abstract

Many studies have reported that the geriatric nutritional risk index (GNRI) and C-reactive protein to albumin ratio (CAR) may be associated with prognosis of esophageal cancer (EC); however, the results are inconsistent. Therefore, we performed a meta-analysis to evaluate the effect of preoperative GNRI and CAR on the prognosis of EC. PubMed, Embase, Cochrane Library, and Web of Science databases were searched. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were used to analyze the relationship between GNRI/CAR and prognosis. Publication bias was estimated using Begg’s funnel plot asymmetry test and Egger’s test. A total of 21 studies comprising 5,018 patients were included in the meta-analysis. A decreased GNRI was significantly associated with poorer overall survival (OS) (HR = 1.808, 95% CI: 1.489-2.196, P < 0.001) and cancer-specific survival (CSS) (HR = 1.769, 95% CI: 1.193-2.624, P = 0.005), and an increased CAR was significantly associated with lower OS (HR = 2.179, 95% CI: 1.587-2.992, P < 0.001), CSS (HR = 1.733, 95% CI: 1.333-2.253, P < 0.001), and recurrence-free survival (HR = 2.178, 95% CI: 1.328-3.573, P = 0.002). Thus, preoperative GNRI and CAR may be noninvasive and powerful tools for predicting survival outcomes in patients with EC.

摘要

许多研究报道老年营养风险指数（GNRI）和C反应蛋白白蛋白比（CAR）可能与食管癌（EC）的预后相关；但是，结果不一致。因此，我们进行了一项荟萃分析，以评估术前 GNRI 和 CAR 对 EC 预后的影响。搜索了 PubMed、Embase、Cochrane Library 和 Web of Science 数据库。汇总风险比（HRs）和95%置信区间（CIs）用于分析GNRI/CAR与预后之间的关系。使用 Begg 漏斗图不对称检验和 Egger 检验估计发表偏倚。荟萃分析共纳入 21 项研究，包括 5,018 名患者。GNRI 下降与较差的总生存期 (OS) 显着相关（HR = 1.808, 95% CI: 1.489-2.196,P  < 0.001) 和癌症特异性生存期 (CSS) (HR = 1.769, 95% CI: 1.193-2.624, P  = 0.005)，CAR 增加与 OS 降低显着相关 (HR = 2.179, 95% CI: 1.587 -2.992, P  < 0.001), CSS (HR = 1.733, 95% CI: 1.333-2.253, P  < 0.001) 和无复发生存期 (HR = 2.178, 95% CI: 1.328-3.573, P  = 0.002)。因此，术前 GNRI 和 CAR 可能是预测 EC 患者生存结果的无创且强大的工具。