The aim of this study was to conduct a comprehensive review of the predictive significance of PNI in HNSCC survival outcomes. A systematic search was conducted across multiple databases, and all studies published in the last decade were screened (Research Registry ID: reviewregistry1853). The included studies were assessed using the Quality in Prognosis Studies tool. Survival outcome data were extracted, combined, and presented as hazard ratios (HR) with a 95% confidence interval (CI). Totally, 74 studies encompassing 27,559 patients were analyzed and revealed a cumulative occurrent rate of 30% for PNI in HNSCC. PNI+ HNSCC patients had a worse overall survival (HR: 1.91, 95% CI: 1.71–2.13), disease-specific survival (HR: 1.79, 95% CI: 1.55–2.07), disease-free survival (HR: 1.82, 95% CI: 1.69–1.96), local recurrence (HR: 2.54, 95% CI: 1.93–3.33), locoregional recurrence (HR: 2.27, 95% CI: 1.82–2.82), locoregional relapse free survival (HR: 1.77, 95% CI: 1.28–2.45), distant metastasis (HR: 1.82, 95% CI: 1.34–2.48), and distant metastasis-free survival (HR: 2.97, 95% CI: 1.82–4.85) compared to those PNI– patients. The available evidence unequivocally establishes PNI as a critical prognostic factor for worse survival in HNSCC patients.
本研究旨在系统评估神经周围侵犯（PNI）对头颈部鳞状细胞癌（HNSCC）患者生存结局的预测价值。通过多数据库系统性检索，筛选了近十年发表的所有相关研究（研究注册号：reviewregistry1853），并采用预后研究质量评估工具对纳入文献进行质量评价。提取并整合生存结局数据，以风险比（HR）及95%置信区间（CI）呈现分析结果。共纳入74项研究，涵盖27,559例患者，分析显示HNSCC中PNI的总体发生率为30%。与PNI阴性患者相比，PNI阳性患者的总体生存率（HR: 1.91, 95% CI: 1.71–2.13）、疾病特异性生存率（HR: 1.79, 95% CI: 1.55–2.07）、无病生存率（HR: 1.82, 95% CI: 1.69–1.96）更差，局部复发（HR: 2.54, 95% CI: 1.93–3.33）、区域复发（HR: 2.27, 95% CI: 1.82–2.82）、区域无复发生存率（HR: 1.77, 95% CI: 1.28–2.45）、远处转移风险（HR: 1.82, 95% CI: 1.34–2.48）及无远处转移生存率（HR: 2.97, 95% CI: 1.82–4.85）均显著恶化。现有证据明确表明，PNI是HNSCC患者不良预后的关键预测因子。
肿瘤(癌症)患者之家