Abstract
The present study was aim to investigate the prognostic role of platelet to lymphocyte ratio (PLR) for patients with gastric cancer (GC) using meta-analysis. A total of 13 studies (14 cohorts) with 6,280 subjects were included. By pooling hazard ratios (HRs) and 95% confidence intervals (CIs) and odds ratios (ORs) and 95% CIs from each study, we found that elevated PLR was significantly associated with poorer overall survival (OS) (HR: 1.3, 95% CI: 1.1–1.52, p = 0.001; I2 = 68.5%, Ph < 0.001) but not with poor disease-free survival (DFS) (HR: 1.6, 95% CI: 0.88–2.9, p = 0.122; I2 = 87.8%, Ph < 0.001). Subgroup analysis showed that a high PLR significantly predicted poor OS in Caucasian populations, patients receiving chemotherapy and patients at advanced stage. In addition, the cut-off value of PLR > 160 showed adequately prognostic value. Furthermore, elevated PLR was associated with lymph node metastasis and CEA levels in GC. Our meta-analysis showed that elevated PLR could be a significant prognostic biomarker for poor OS in patients with GC.
Highlights
During the past several decades, gastric cancer (GC) incidence rates have been declining in most Western countries [1, 2], GC still ranks fourth in incidence among all cancers and is the third leading cause of cancerrelated deaths worldwide [3]
Subgroup analysis was conducted according to ethnicity, sample size, treatment, tumor stage and cut-off value of platelet to lymphocyte ratio (PLR), the results showed that elevated PLR had more significantly prognostic value for overall survival (OS) in Caucasian populations (HR: 1.5, 95% confidence intervals (CIs): 1.2–1.86, p < 0.001; Ι2 = 21.9%, Ph = 0.279)
The current study was designed to investigate the prognostic value of elevated PLR for OS and disease-free survival (DFS) in patients with GC by meta-analysis
Summary
During the past several decades, gastric cancer (GC) incidence rates have been declining in most Western countries [1, 2], GC still ranks fourth in incidence among all cancers and is the third leading cause of cancerrelated deaths worldwide [3]. Laboratory parameters which reflect the status of systemic inflammation, have been investigated as prognostic biomarkers in various cancers. These inflammatory markers include modified Glasgow Prognostic Score (mGPS), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) [9, 10]. PLR has been suggested as an independent prognostic factor in several solid tumors including colorectal cancer [11], non-small cell lung cancer [12], pancreatic cancer [13] and gastric cancer [14]. As meta-analysis is an effectively analytic approach to pool these controversial findings, we conducted a meta-analysis to reveal the prognostic significance of PLR for overall survival (OS) and disease-free survival (DFS) and the associations between PLR and clinicopathological features in patients with GC
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