Abstract
BackgroundSeveral studies have shown that neutrophil lymphocyte ratio (NLR) may be associated with the prognosis of gastric cancer (GC), but the results are controversial.MethodsThis 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.ResultsTen 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.ConclusionThis meta-analysis indicated that elevated NLR may be associated with a worse prognosis for patients with GC.
Highlights
Despite the incidence of gastric cancer is decreasing, it remains one of the most frequent causes of cancer-related death worldwide [1]
We identified 15 potentially relevant articles concerning neutrophil lymphocyte ratio (NLR) and prognosis of gastric cancer
A total of 10 articles [13,14,24,25,26,27,28,29,30,31] that met the inclusion and exclusion criteria were retrieved. Of these reports selected for further evaluation, 10 investigated the prognostic role of NLR for overall survival (OS), 3 for disease-free survival (DFS) and 2 for progression-free survival (PFS), respectively
Summary
Despite the incidence of gastric cancer is decreasing, it remains one of the most frequent causes of cancer-related death worldwide [1]. Elevations of serum tumor markers can be an independent predictor of adverse prognosis [7]. None of these have been demonstrated to be sufficiently effective for clinical use. Patients with elevated NLR have a relative lymphocytopenia and neutrophil leukocytosis in favor of protumor inflammatory response, which gained its prognostic value in patients with colorectal cancer [10], lung cancer [11], pancreatic ductal adenoma [12], etc. Several studies have shown that neutrophil lymphocyte ratio (NLR) may be associated with the prognosis of gastric cancer (GC), but the results are controversial
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