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Prognostic role of platelet to lymphocyte ratio in solid tumors: a systematic review and meta-analysis


Templeton, Arnoud J; Ace, Olga; McNamara, Mairéad G; Al-Mubarak, Mustafa; Vera-Badillo, Francisco E; Hermanns, Thomas; Seruga, Boštjan; Ocaña, Alberto; Tannock, Ian F; Amir, Eitan (2014). Prognostic role of platelet to lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Cancer Epidemiology Biomarkers & Prevention, 23(7):1204-1212.

Abstract

BACKGROUND: Inflammation influences cancer development and progression. An elevated platelet to lymphocyte ratio (PLR), a marker of inflammation, has been linked to poor prognosis in several malignancies. Here, we quantify the prognostic impact of this biomarker.
METHODS: A systematic review of databases was conducted to identify publications exploring the association of blood PLR and overall survival (OS) in solid tumors. Data were pooled in a meta-analysis. Pooled HRs for OS by disease group and by PLR cutoff groups were computed and weighted using generic inverse-variance and random-effect modeling.
RESULTS: Twenty studies comprising 12,754 patients were assessed. Cutoffs for PLR defining risk groups ranged from 150 to 300 and were dichotomous (12 studies; group 1) or split into three groups (<150/150-300/>300, 8 studies; group 2). Higher PLR was associated with significantly worse OS in group 1 [HR = 1.87; 95% confidence interval (CI, 1.49-2.34); P < 0.001] and with a nonsignificant association in group 2 (HR per higher category = 1.21; 95%CI, 0.97-1.50; P = 0.10). The size of effect of PLR on OS was greater for metastatic disease (HR[group 1] = 2.0; 95% CI, 1.6-2.7; HR[group 2] = 1.6; 95% CI, 1.1-2.4) than for early-stage disease (HR[group 1] = 1.5; 95% CI, 1.0-2.2; HR[group 2] = 1.0; 95% CI, 0.8-1.3). A significant association was observed for colorectal, hepatocellular, gastroesophageal, ovarian, and pancreatic carcinoma in group 1 and for colorectal cancers in group 2.
CONCLUSION: A high PLR is associated with worse OS in various solid tumors. Further research of its regulation and relevance in daily practice is warranted.
IMPACT: PLR is a readily available and inexpensive biomarker with independent prognostic value in solid tumors.

Abstract

BACKGROUND: Inflammation influences cancer development and progression. An elevated platelet to lymphocyte ratio (PLR), a marker of inflammation, has been linked to poor prognosis in several malignancies. Here, we quantify the prognostic impact of this biomarker.
METHODS: A systematic review of databases was conducted to identify publications exploring the association of blood PLR and overall survival (OS) in solid tumors. Data were pooled in a meta-analysis. Pooled HRs for OS by disease group and by PLR cutoff groups were computed and weighted using generic inverse-variance and random-effect modeling.
RESULTS: Twenty studies comprising 12,754 patients were assessed. Cutoffs for PLR defining risk groups ranged from 150 to 300 and were dichotomous (12 studies; group 1) or split into three groups (<150/150-300/>300, 8 studies; group 2). Higher PLR was associated with significantly worse OS in group 1 [HR = 1.87; 95% confidence interval (CI, 1.49-2.34); P < 0.001] and with a nonsignificant association in group 2 (HR per higher category = 1.21; 95%CI, 0.97-1.50; P = 0.10). The size of effect of PLR on OS was greater for metastatic disease (HR[group 1] = 2.0; 95% CI, 1.6-2.7; HR[group 2] = 1.6; 95% CI, 1.1-2.4) than for early-stage disease (HR[group 1] = 1.5; 95% CI, 1.0-2.2; HR[group 2] = 1.0; 95% CI, 0.8-1.3). A significant association was observed for colorectal, hepatocellular, gastroesophageal, ovarian, and pancreatic carcinoma in group 1 and for colorectal cancers in group 2.
CONCLUSION: A high PLR is associated with worse OS in various solid tumors. Further research of its regulation and relevance in daily practice is warranted.
IMPACT: PLR is a readily available and inexpensive biomarker with independent prognostic value in solid tumors.

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Additional indexing

Item Type:Journal Article, refereed, further contribution
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Urological Clinic
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:July 2014
Deposited On:10 Feb 2015 15:48
Last Modified:05 Apr 2016 18:48
Publisher:American Association for Cancer Research
ISSN:1055-9965
Publisher DOI:https://doi.org/10.1158/1055-9965.EPI-14-0146
PubMed ID:24793958

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