Prognostic significance of the neutrophil-to-lymphocyte ratio in primary liver cancer: a meta-analysis.
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...
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2014-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC4008563?pdf=render |
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| author | Tong-Chun Xue Lan Zhang Xiao-Yin Xie Ning-Ling Ge Li-Xin Li Bo-Heng Zhang Sheng-Long Ye Zheng-Gang Ren |
| author_facet | Tong-Chun Xue Lan Zhang Xiao-Yin Xie Ning-Ling Ge Li-Xin Li Bo-Heng Zhang Sheng-Long Ye Zheng-Gang Ren |
| author_sort | Tong-Chun Xue |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-23T10:18:40Z |
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| id | doaj.art-632a7530c2b64d8dbbbf8fcc8ab318bc |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-23T10:18:40Z |
| publishDate | 2014-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-632a7530c2b64d8dbbbf8fcc8ab318bc2022-12-21T17:50:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032014-01-0195e9607210.1371/journal.pone.0096072Prognostic significance of the neutrophil-to-lymphocyte ratio in primary liver cancer: a meta-analysis.Tong-Chun XueLan ZhangXiao-Yin XieNing-Ling GeLi-Xin LiBo-Heng ZhangSheng-Long YeZheng-Gang RenThe 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.http://europepmc.org/articles/PMC4008563?pdf=render |
| spellingShingle | Tong-Chun Xue Lan Zhang Xiao-Yin Xie Ning-Ling Ge Li-Xin Li Bo-Heng Zhang Sheng-Long Ye Zheng-Gang Ren Prognostic significance of the neutrophil-to-lymphocyte ratio in primary liver cancer: a meta-analysis. PLoS ONE |
| title | Prognostic significance of the neutrophil-to-lymphocyte ratio in primary liver cancer: a meta-analysis. |
| title_full | Prognostic significance of the neutrophil-to-lymphocyte ratio in primary liver cancer: a meta-analysis. |
| title_fullStr | Prognostic significance of the neutrophil-to-lymphocyte ratio in primary liver cancer: a meta-analysis. |
| title_full_unstemmed | Prognostic significance of the neutrophil-to-lymphocyte ratio in primary liver cancer: a meta-analysis. |
| title_short | Prognostic significance of the neutrophil-to-lymphocyte ratio in primary liver cancer: a meta-analysis. |
| title_sort | prognostic significance of the neutrophil to lymphocyte ratio in primary liver cancer a meta analysis |
| url | http://europepmc.org/articles/PMC4008563?pdf=render |
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