Prognostic role of the neutrophil-to-lymphocyte ratio in pancreatic cancer: a meta-analysis.
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ABSTRACT:
SUBMITTER: Cheng H
PROVIDER: S-EPMC4521184 | biostudies-other | 2015
REPOSITORIES: biostudies-other
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Project description:BACKGROUND:The prognostic role of neutrophil-to-lymphocyte ratio (NLR) in esophageal cancer (EC) remains controversial. METHODS:The aim of this study was to evaluate the association between NLR and oncologic outcome of EC patients through a meta-analysis. A systematic search was performed in PubMed, Web of Science and Embase for relevant studies. Meta-analysis was performed using hazard ratio (HR) and95% confidence interval (CI) as effect measures. RESULTS:Finally, 33 articles with 11,039patients were included in our study. The synthesized results indicated that the elevated NLR was negatively related to overall survival (OS) (HR?=?1.39, 95% CI: 1.23-1.54). When the patients were stratified according to country, pathological type, treatment strategies, sample size, and different HR estimate method, high NLR was also significantly correlated with poor OS. Similarly, elevated NLR was also associated with shorter disease-free survival (DFS), progress-free survival (PFS), relapse-free survival (RFS), and cancer-specific survival (CSS). CONCLUSION:The elevated pretreatment NLR is associated with poor oncological outcomes in patients with EC. NLR may be a significant predictive biomarker in EC. Further large-cohort studies are needed to confirm these findings.
| S-EPMC6310576 | biostudies-other
Project description:BackgroundInflammatory markers are used to predict prognosis of nasopharyngeal carcinoma (NPC). Previous reports of neutrophil-to-lymphocyte ratio (NLR) and NPC mortality are inconsistent. This study aimed to quantify the prognostic impact of NLR on NPC.MethodsThe primary outcome was overall survival (OS), and the secondary outcomes were disease-specific survival (DSS), progression-free survival (PFS) and distant metastasis-free survival (DMFS). We systematically searched electronic databases, identified articles reporting an association between NLR and NPC prognosis. Hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted, and pooled HRs for each outcome were estimated using random effect models.ResultsNine studies enrolling 5397 patients were included in the analyses. NLR greater than the cutoff value was associated with poor overall survival (HR 1.51, 95% CI 1.27-1.78), disease-specific survival (HR 1.44, 95% CI 1.22-1.71), progression-free survival (HR 1.53, 95% CI 1.22-1.90), and distant metastasis-free survival (HR 1.83, 95% CI 1.14-2.95).ConclusionsElevated NLR predicts worse OS, DSS, PFS and DMFS in patients with NPC.
| S-EPMC5513538 | biostudies-literature
Project description:BackgroundInflammation and cancer are closely related to each other. As a parameter that can reflect inflammation and host immune reaction, elevated blood neutrophil to lymphocyte ratio (NLR) has been confirmed to be correlated with poor prognosis in a variety of cancers. However, this remains controversial in breast cancer. Thus, we performed this updated meta-analysis to further clarify whether high NLR could be a predictor of survival in breast cancer patients.MethodsWe searched on PubMed Database and Cochrane Library. Overall survival (OS), disease-free survival (DFS), and cancer-specific survival were used as outcome events, and hazard ratio (HR) was chosen as the parameter to evaluate the correlation.ResultEighteen eligible studies were involved in this meta-analysis. The synthesized analysis demonstrated that elevated NLR was associated with poor DFS [HR = 1.72, 95% confidence interval (95% CI) = 1.30-2.27], OS (HR = 1.87, 95% CI = 1.41-2.48), and cancer-specific survival (HR = 2.09, 95% CI = 1.04-4.21). The correlation was stronger in triple-negative breast cancer (TNBC) (OS: HR = 2.58, 95% CI = 1.63-4.06; DFS: HR = 3.51, 95% CI = 1.97-6.24).ConclusionHigher NLR was correlated to poor prognosis of breast cancer patients. As a clinical parameter that we can easily obtain, NLR might be a potential predictor in patients' survival to assist with physicians' treatment decisions.
| S-EPMC5690700 | biostudies-literature
Project description:BackgroundSeveral studies have shown that neutrophil lymphocyte ratio (NLR) may be associated with the prognosis of gastric cancer (GC), but the results are controversial.MethodsThis study was performed to evaluate the prognostic implications of neutrophil lymphocyte ratio of GC in all available studies. We surveyed 2 medical databases, PubMed and EMBASE, to identify all relevant studies. Data were collected from studies comparing overall survival (OS), disease-free survival (DFS) and progression-free survival (PFS) in patients with GC.ResultsTen studies (n = 2,952) evaluated the role of NLR as a predictor of outcome were involved for this meta-analysis (10 for OS, 3 for DFS, and 2 for PFS). Overall and disease-free survival were significantly better in patients with low NLR value and the pooled HRs was significant at 1.83 ([95% CI], 1.62-2.07) and 1.58 ([95% CI], 1.12-2.21), respectively. For progression-free survival, the pooled hazard ratio of NLR was significant at 1.54 ([95% CI], 1.22-1.95). No evidence of significant heterogeneity or publication bias for OS and DFS was seen in any of the included studies.ConclusionThis meta-analysis indicated that elevated NLR may be associated with a worse prognosis for patients with GC.
| S-EPMC4234250 | biostudies-literature
Project description:ObjectiveRecent studies have reported that neutrophil-to-lymphocyte ratio (NLR) is associated with cardiovascular disease. The aim of the present study was to investigate the prognostic value of NLR in aortic disease.MethodsWe systematically searched electronic databases (Cochrane, PubMed, Elsevier, Medline, and Embase) from their inception to March 2020. Observational studies that evaluated the relationship between NLR and aortic disease were eligible for critical appraisal. Data were extracted from applicable articles, risk ratio (RR), weighted mean differences (MD) and 95% confidence intervals (CI) were calculated by RevMan 5.3, and statistical heterogeneity was assessed by the I2 statistic.ResultsFourteen studies enrolling 4066 individuals were included in the meta-analysis. Compared with the control group, NLR was significantly higher in the aortic disease group (MD 3.44, 95%CI: 0.81-6.07, P = 0.01, I2 = 99%). The NLR was also significantly higher in non-survivors with aortic disease, compared to the survivors (MD 4.62, 95%CI: 2.75-6.50, P < 0.00001, I2 = 60%). Compared with the aortic disease patients with a low NLR, mortality was significantly higher in those with a high NLR (RR 2.63, 95%CI: 1.79-3.86, P < 0.00001, I2 = 67%).ConclusionBased on current evidence, an elevated NLR was associated with aortic disease and in-hospital mortality. Raised NLR also demonstrated a significantly increased the risk of mortality after surgical repair in aortic disease patients. NLR may be a good prognostic biomarker in aortic disease and deserve further research in this area.
| S-EPMC7419193 | biostudies-literature
Project description:Published data on the prognostic significance of neutrophil-to-lymphocyte ratio (NLR) in non-small cell lung cancer (NSCLC) are controversial. We performed a meta-analysis to more accurately assess its prognostic value. The analysis was performed based on the data from 14 studies with 3,656 patients to estimate the correlation between NLR and overall survival (OS) and progression-free survival (PFS) in NSCLC. Hazard ratio (HR) with 95% confidence interval (CI) were calculated to estimate the effect. We also conducted subgroup analysis and meta-regression analysis. The results demonstrated that elevated pretreatment NLR predicted poorer OS (HR: 1.70, 95% CI: 1.39-2.09) and PFS (HR: 1.63, 95% CI: 1.27-2.09) in patients with NSCLC. Subgroup analysis indicated that cut-off value of 5 showed consistently prognostic value. There was no significant heterogeneity or publication bias for OS and PFS for included studies. This meta-analysis revealed that elevated pretreatment NLR might be a predicative factor of poor prognosis for NSCLC patients.
| S-EPMC4513342 | biostudies-other
Project description:The neutrophil-to-lymphocyte ratio (NLR) is a useful biomarker that reflects systemic inflammation responses. However, the prognostic value of the NLR in patients with primary liver cancer (PLC) remains controversial. We performed a meta-analysis of 26 studies (comprising 4,461 patients) to evaluate the association between the pre-treatment NLR and clinical outcomes of overall survival (OS) and disease-free survival (DFS) in patients with PLC. The correlation between NLR and tumor characteristics or other inflammation-related parameters was also assessed. Data were synthesized using the random-effects model of DerSimonian and Laird, and the hazard ratio (HR) or odds ratio (OR) with 95% confidence interval (CI) was used to estimate effect size. Our analysis indicated that a high NLR predicted poor OS (HR, 2.102; 95% CI: 1.741-2.538) and DFS (HR, 2.474; 95% CI: 1.855-3.300) for PLC. A high NLR was associated with the presence of tumor vascular invasion (OR: 1.889, 95% CI: 1.487-2.400; p<0.001) and an elevated alpha-fetoprotein level (OR: 1.536; 95% CI: 1.152-2.048; p = 0.003). Thus, we conclude that a high NLR indicates a poor prognosis for patients with PLC and may also be predictive for PLC invasion and metastasis. Subgroup analysis suggested that the predictive role of NLR in cholangiocarcinoma is limited, and a further large study to confirm these findings is warranted.
| S-EPMC4008563 | biostudies-literature
Project description:Background: The prognostic value of neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio, and the combined NLR-PLR score in patients with stage IV gastric carcinoma (GC) has not yet been clarified. Therefore, this study aimed to explore the potential association of NLR, PLR, and NLR-PLR score with the prognosis of patients with stage IV GC. Methods: This retrospective study included 466 patients with GC diagnosed between 2010 and 2017. High NLR and high PLR were defined using the median values as the cutoff values. We then combined the NLR and PLR value and generated the NLR-PLR score as a new biomarker. Patients were divided into three groups according to their NLR-PLR score. Univariate and multivariate analyses were conducted to compare survival outcomes. Results: Median overall survival (OS) and progression-free survival (PFS) were 15.5 months (range, 0.7-96.8 months) and 6.7 months (range, 0.5-30.4 months), respectively. The NLR, PLR, and the NLR-PLR scores were correlated with clinical outcomes such as OS and PFS. Median OS for patients with NLR-PLR scores of 0, 1, and 2 was 22.5, 15.7, and 11.2 months, respectively. Median PFS for patients with these NLR-PLR scores of 0, 1, and 2 was 7.8, 7.1, and 5.2 months, respectively (P < 0.001). High NLR-PLR scores predicted poor survival in patients with stage IV GC (all P < 0.05). Conclusion: Our findings provide scientific evidence to support that the NLR-PLR score may be able to independently predict survival outcomes in patients with stage IV GC.
| S-EPMC7317009 | biostudies-literature
Project description:The neutrophil-to-lymphocyte ratio (NLR) plays an important role in the progression of intracerebral hemorrhage (ICH). An increasing number of studies have reported that a high NLR is correlated with poor clinical outcomes among patients with ICH. Here, we conducted a systematic review and meta-analysis to evaluate the prognostic value of NLR in the setting of ICH. We performed a comprehensive search of electronic literature databases to identify all relevant studies evaluating the prognostic role of NLR in patients with ICH. Two researchers independently screened the studies and extracted relevant data. We extracted, pooled, and weighted odds ratio (OR) and 95% confidence interval (CI) values using a generic inverse-variance method, and then evaluated the heterogeneity among studies using Q test and I 2 statistic. Finally, we selected a total of 26 studies including 7,317 patients for the current study. Overall, our results indicated that a high NLR was significantly associated with a poor outcome (OR, 1.32; 95% CI, 1.19-1.46; P < 0.00001), mortality (OR, 1.05; 95% CI, 1.01-1.09; P = 0.02), and neurological deterioration (OR, 1.65; 95% CI, 1.08-2.52; P = 0.02). We did not observe a significant association between NLR and hematoma expansion (OR, 1.04; 95% CI, 0.99-1.08; P = 0.09). Our study indicated that a high NLR is significantly associated with poor clinical outcomes in patients with ICH. As NLR is a simple and easily available biomarker, future studies should focus on exploring its application in the prognostic evaluation of patients with ICH.
| S-EPMC8960242 | biostudies-literature
Project description:Background: Esophageal cancer is one of the most common cancers with significant morbidity and mortality. It is important to predict the prognosis of patients. The purpose of this study was to comprehensively assess the prognostic and clinicopathologic significance of NLR in patients with esophageal cancer. Methods: A systematic literature search was performed using PubMed, Cochrane Library, Embase, Web of Science, MEDLINE, and CNKI. This meta-analysis was conducted in accordance with PRISMA guidelines. Hazard ratio (HR) with 95% confidence interval (CI) was used as the effect estimation to evaluate the prognostic role of NLR. Odds ratio (OR) was used to evaluate the relation between NLR and clinicopathologic characteristics. Results: A total of 8431 patients from 32 studies were included in this meta-analysis. The pooled results showed that elevated NLR might predict poor prognosis: The factors considered included overall survival (OS) (HR, 1.57; 95% CI, 1.40-1.75; P < .001), cancer-specific survival (CSS) (HR, 1.28; 95% CI, 1.09-1.49; P < .001), progression-free survival (PFS) (HR, 1.45; 95% CI, 1.29-1.72; P < .001), and disease-free survival (DFS) (HR,1.58; 95% CI, 1.27-1.97; P < .001). High NLR was also associated with tumor differentiation, tumor length, tumor invasion depth, lymph node metastasis, and clinical stage. No significant association was observed between NLR and metastasis stage (OR, 1.69; 95% CI, 0.98-2.98; P = .058). Conclusions: The results of this meta-analysis suggest that elevated NLR value might predict poor prognosis (OS, CSS, PFS, and DFS), according to abnormal clinicopathologic parameters.
| S-EPMC8785352 | biostudies-literature