Prognostic significance of the neutrophil-to-lymphocyte ratio in primary liver cancer: a meta-analysis.
Prognostic significance of the neutrophil-to-lymphocyte ratio in primary liver cancer: a meta-analysis.
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DOI：
10.1371/journal.pone.0096072
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Ren ZG
中科院分区：
文献类型：
--
作者：
Xue TC;Zhang L;Xie XY;Ge NL;Li LX;Zhang BH;Ye SL;Ren ZG
中性粒细胞/淋巴细胞比率(NLR)是反映全身炎症反应的有用生物标志物。然而，NLR在原发性肝癌(PLC)患者中的预后价值仍然存在争议。我们对26项研究(包括4,461名患者)进行了荟萃分析，以评估治疗前NLR与PLC患者总体生存期(OS)和无病生存期(DFS)的临床结果之间的关系。NLR与肿瘤特征或其他炎症相关参数的相关性也被评估。数据采用德西蒙尼和莱尔德的随机效应模型进行合成，并用95%可信区间(CI)的危险比(HR)或优势比(OR)估计效应大小。我们的分析表明，高NLR预示着PLC的OS(HR，2.102；95%CI：1.741-2.538)和DFS(HR，2.474；95%CI：1.855-3.300)较差。高NLR值与肿瘤血管侵犯(OR：1.889，95%CI：1.487-2.400；p<；0.001)和甲胎蛋白水平升高(OR：1.536；95%CI：1.152-2.048；p = 0.003)相关。因此，我们得出结论，高NLR预示着PLC患者预后不良，也可能预示着PLC的侵袭和转移。亚组分析表明，NLR在胆管癌中的预测作用是有限的，有必要进行进一步的大型研究来证实这些发现。
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.
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