骨肉瘤是儿童和青少年中最常见的原发性骨恶性肿瘤类型。细胞因子对骨肉瘤预后的影响已经得到研究并报道。本荟萃分析旨在评估细胞因子作为骨肉瘤生物标志物的预后价值。我们在PubMed、Embase和Cochrane图书馆等数据库中检索了有关细胞因子在骨肉瘤预后价值的研究。从符合条件的研究中提取了总生存期（OS）、无病生存期和无转移生存期（MFS）的数据。计算了综合风险比（HR）和95%可信区间（CI）。此分析包括了11项研究，涉及755名患者。肿瘤中高浓度的巨噬细胞迁移抑制因子（MIF）与缩短OS（HR=2.01，95% CI：1.18-3.42，P=0.010）和MFS（HR=2.51，95% CI：1.47-4.01，P=0.001）显著相关。血清中升高的T细胞免疫球蛋白和粘膜结合域3（Tim-3）水平与骨肉瘤患者疾病进展风险增加相关（HR=3.14，95% CI：2.88-3.03，P<0.001）。然而，白细胞介素6（IL-6）和肿瘤坏死因子与骨肉瘤预后没有明显相关性。由于相关研究较少，其他相关细胞因子（干扰素-α/β受体、组织因子、巨噬细胞抑制因子1（MIC-1）和IL-23）无法进行综合分析。总之，肿瘤中的MIF水平和血清中的Tim-3水平可能是骨肉瘤不良预后的潜在生物标志物。要确认这一发现并将这些生物标志物应用于临床，需要进一步开展大规模、高质量的研究。

Osteosarcoma is the most prevalent type of primary bone malignancy in children and adolescents. The effect of cytokines on osteosarcoma prognosis has been studied and reported. This meta-analysis aimed to assess the prognostic value of cytokines as osteosarcoma biomarkers. Databases including PubMed, Embase, and Cochrane Library were searched for studies on the prognostic value of cytokines in osteosarcoma. From the eligible studies, data on overall survival (OS), disease-free survival, and metastasis-free survival (MFS) were extracted. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated. A total of 11 studies involving 755 patients were included in this analysis. High macrophage migration inhibitory factor (MIF) expression in tumors was significantly associated with shortened OS (HR = 2.01, 95% CI: 1.18-3.42, P = 0.010) and MFS (HR = 2.51, 95% CI: 1.47-4.01, P = 0.001). Elevated T cell immunoglobulin and mucin domain-3 (Tim-3) levels in serum correlated with increased risk of disease progression in patients with osteosarcoma (HR = 3.14, 95% CI: 2.88-3.03, P < 0.001). However, interleukin 6 (IL-6) and tumor necrosis factor were not substantially associated with osteosarcoma prognosis. Owing to a paucity of research, other relevant cytokines [interferon-α/β receptor, tissue factor, macrophage inhibitory cytokine 1 (MIC-1), and IL-23] could not be combined. In conclusion, MIF levels in tumors and Tim-3 levels in serum can be potential biomarkers of poor prognosis in osteosarcoma. To confirm this finding and implement these biomarkers into clinical applications, additional large-scale, high-quality studies are needed.