Abstract
BackgroundRecently, reports have classified lymphocyte to monocyte ratio (LMR) as an effective indicator for predicting the prognosis of pancreatic cancer. Nevertheless, the prognostic value of LMR for pancreatic cancer remains controversial. Through meta-analysis, this work intends to evaluate the potential prognostic role of pretreatment LMR in patients diagnosed with pancreatic cancer.MethodsWe reviewed and extracted eligible articles from Web of Science, PubMed, Cochrane Library, and Embase. A meta-analysis was conducted using hazard ratio (HR) and 95% confidence intervals (CIs) to assess the comparison between pretreatment LMR and overall survival (OS) and disease-free survival/recurrence-free survival/time to progression (DFS/RFS/TTP).ResultsIn total, 11 studies (16 cohorts) including 3338 patients diagnosed with pancreatic cancer (PC) were enrolled in our meta-analysis. Notably, we revealed that high pretreatment LMR predicted better overall survival (OS) (HR = 0.68, 95% CI 0.58–0.80, P < 0.001, I-squared = 69.3%, Ph < 0.001) and DFS/RFS/TTP (HR = 0.55, 95% CI 0.31–0.96, P = 0.037, I-squared = 89.9%, Ph < 0.001) in patients with pancreatic cancer. Further, through subgroup analyses, we showed that high pretreatment LMR was significantly associated with the favorable OS regardless of ethnicity, study design, treatment method, variable type, the cut-off value for LMR, and disease stages of I–IV and III–IV.ConclusionThe findings from our study suggest that high pretreatment LMR is associated with better OS and DFS/RFS/TTP in patients diagnosed with pancreatic cancer. As such, it can potentially serve as a novel prognostic biomarker for patients with pancreatic cancer.
Highlights
Reports have classified lymphocyte to monocyte ratio (LMR) as an effective indicator for predicting the prognosis of pancreatic cancer
Inclusion and exclusion criteria Inclusion criteria included (1) Pancreatic cancer (PC) patients were confirmed by pathological examination; (2) pretreatment LMR was detected from serum; (3) studies described the association of pretreatment LMR with disease-free survival (DFS), progression-free survival (PFS) or time to progression (TTP), and overall survival (OS); (4) hazard ratio (HR) with 95% Confidence interval (CI) was reported for data calculation; and (5) the cut-off value of LMR was described
The HRs and 95% CIs of data presented in these studies were obtained through multivariable and/or univariable analysis
Summary
Reports have classified lymphocyte to monocyte ratio (LMR) as an effective indicator for predicting the prognosis of pancreatic cancer. Through meta-analysis, this work intends to evaluate the potential prognostic role of pretreatment LMR in patients diagnosed with pancreatic cancer. The continuous poor prognosis of PC patients may be attributed to the complex chemoresistance mechanisms and invasive phenotype as well as the important role of hypoxia in pancreatic cancers. Clinically available tumor biomarkers are helpful in diagnosis, prognosis, and evaluation of treatment response in patients with digestive system’s tumors. Being the most widely studied biomarker, CA19-9 is highly significant for diagnosis and assessing tumor stage, resectability, treatment response, and prognosis of patients with PC [10,11,12,13]. The high mortality rate in PC patients is partly attributed to the lack of sufficient prognostic biomarkers for predicting treatment response and survival. It is necessary to identify valuable serum biomarkers, which will help clinicians efficiently design individual treatment strategies for PC patients
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