Abstract
BackgroundInflammation was considered to perform crucial roles in the development and metastasis of malignancies. A heightened neutrophil-lymphocyte ratio has been described to be associated with detrimental survivals in different malignancies. Debate remains over the impact of heightened neutrophil-lymphocyte ratio on survivals in biliary tract cancer. The review evaluated the prognostic value of neutrophil-lymphocyte ratio in biliary tract cancer.MethodsMEDLINE, the Cochrane Library, EMBASE, and the Chinese SinoMed were systematically searched for relevant articles. Associations between neutrophil-lymphocyte ratio and long-term outcomes were expressed as the hazard ratios and 95% confidence intervals. The odds ratio was utilized to assess the association between neutrophil-lymphocyte ratio and clinicopathological parameters.ResultsFourteen studies consisting of 3217 patients were analyzed: 1278 (39.73%) in the high pretreatment neutrophil-lymphocyte ratio group and 1939 (60.27%) in the low pretreatment neutrophil-lymphocyte ratio one. The results proved that heightened pretreatment neutrophil-lymphocyte ratio was significantly associated with detrimental overall survival and relapse free survival for biliary tract cancer patients. In addition, elevated neutrophil-lymphocyte ratio was positively correlated with higher carbohydrate antigen 19-9 levels, advanced TNM staging and greater lymph node involvement.ConclusionThis meta-analysis marked that an increased pretreatment neutrophil-lymphocyte ratio was significantly linked with detrimental long-term outcomes and clinicopathological parameters for patients with biliary tract cancer.
Highlights
Biliary tract cancer (BTC) encompasses a heterogeneous collective of malignant neoplasms arising from the epithelium of the whole biliary system, the spectrum of which includes cholangiocarcinoma and gallbladder carcinoma (GBC) [1,2,3]
Neutrophillymphocyte ratio (NLR) mirroring primary immune response to diverse pathogen-derived or cancer-derived stimuli has been identified as a valuable predictor with prognostic sense, and detrimental long-term outcomes were commonly linked with the elevation of NLR in different tumors [26,27,28,29,30,31]
M±SD: mean ±standard deviation; ¶: value is mean with or wihtout range in parenthesis; †: value is median with range in parenthesis; # : studies from the database of the Chinese SinoMed
Summary
Biliary tract cancer (BTC) encompasses a heterogeneous collective of malignant neoplasms arising from the epithelium of the whole biliary system, the spectrum of which includes cholangiocarcinoma and gallbladder carcinoma (GBC) [1,2,3]. Inflammatory response was considered to perform crucial roles in tumor development and metastasis [14, 15]. Neutrophillymphocyte ratio (NLR) mirroring primary immune response to diverse pathogen-derived or cancer-derived stimuli has been identified as a valuable predictor with prognostic sense, and detrimental long-term outcomes were commonly linked with the elevation of NLR in different tumors [26,27,28,29,30,31]. Inflammation was considered to perform crucial roles in the development and metastasis of malignancies. A heightened neutrophil-lymphocyte ratio has been described to be associated with detrimental survivals in different malignancies. Debate remains over the impact of heightened neutrophil-lymphocyte ratio on survivals in biliary tract cancer. The review evaluated the prognostic value of neutrophil-lymphocyte ratio in biliary tract cancer
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