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Prognostic Significance of Neutrophil Lymphocyte Ratio in Patients with Gastric Cancer: A Meta-Analysis

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  • Xi Zhang
  • Wei Zhang
  • Li-jin Feng

Abstract

Background: Several studies have shown that neutrophil lymphocyte ratio (NLR) may be associated with the prognosis of gastric cancer (GC), but the results are controversial. Methods: This 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 identifyall relevant studies. Data were collected from studies comparing overall survival (OS), disease-free survival (DFS) and progression-free survival (PFS) in patients with GC. Results: Ten 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. Conclusion: This meta-analysis indicated that elevated NLR may be associated with a worse prognosis for patients with GC.

Suggested Citation

  • Xi Zhang & Wei Zhang & Li-jin Feng, 2014. "Prognostic Significance of Neutrophil Lymphocyte Ratio in Patients with Gastric Cancer: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(11), pages 1-7, November.
    • Handle: RePEc:plo:pone00:0111906
    DOI: 10.1371/journal.pone.0111906
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    References listed on IDEAS

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    1. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
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    1. Osama Abu-Shawer & Mohammad Abu-Shawer & Abdullah Shurman & Ali Lattouf & Ayman Haimour & Omar Hamdan & Razan Mansour & Tamer Altamimi & Maysa Al-Hussaini, 2020. "The clinical value of peripheral immune cell counts in pancreatic cancer," PLOS ONE, Public Library of Science, vol. 15(6), pages 1-13, June.
    2. Yukinori Takenaka & Takahiro Kitamura & Ryohei Oya & Naoki Ashida & Kotaro Shimizu & Kazuya Takemura & Yoshifumi Yamamoto & Atsuhiko Uno, 2017. "Prognostic role of neutrophil–lymphocyte ratio in nasopharyngeal carcinoma: A meta-analysis," PLOS ONE, Public Library of Science, vol. 12(7), pages 1-12, July.
    3. Jin Wang & Xu Zhou & Yu Liu & Zheng Li & Xiang Li, 2017. "Prognostic significance of neutrophil-to-lymphocyte ratio in diffuse large B-cell lymphoma: A meta-analysis," PLOS ONE, Public Library of Science, vol. 12(4), pages 1-15, April.
    4. Xuechao Liu & Shangxiang Chen & Jianjun Liu & Dazhi Xu & Wei Li & Youqing Zhan & Yuanfang Li & Yingbo Chen & Zhiwei Zhou & Xiaowei Sun, 2017. "Impact of systemic inflammation on gastric cancer outcomes," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-13, March.
    5. Mi-Rae Kim & A-Sol Kim & Hye-In Choi & Jae-Hun Jung & Ji Yeon Park & Hae-Jin Ko, 2020. "Inflammatory markers for predicting overall survival in gastric cancer patients: A systematic review and meta-analysis," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-17, July.

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