Abstract
This study was designed to explore the association between elevated platelet to lymphocyte ratio (PLR) and prognosis of patients with non-small cell lung cancer (NSCLC) by meta-analysis. A total of 11 studies with 3,430 subjects were included and the combined hazard ratio (HR) and 95% confidence intervals (95% CI) were calculated. The data showed that elevated PLR predicted poor overall survival (OS) (HR = 1.42; 95% CI: 1.25–1.61, p < 0.001; I2 = 63.6, Ph = 0.002) and poor disease-free survival (DFS)/progression-free survival (PFS) (HR = 1.19; 95% CI: 1.02–1.4, p = 0.027; I2 = 46.8, Ph = 0.111). Subgroup analysis showed elevated PLR did not predict poor OS in patients included in large sample studies (HR = 1.44; 95% CI: 0.94–2.21, p = 0.098) whereas petients with Caucasian ethnicity (HR = 1.59; 95% CI: 1.27–1.98, p < 0.001) and PLR cut-off value >180 (HR = 1.61; 95% CI: 1.3–1.99, p < 0.001) had enhanced prognostic efficiency for OS. Subgroup analysis also demonstrated that high PLR did not predict poor DFS/PFS in Asian patients. In conclusion, our meta-analysis suggested that elevated PLR was associated with poor OS and DFS/PFS in NSCLC. In addition, high PLR especially predicted poor OS in Caucasians but had no association with poor DFS/PFS in Asians.
Highlights
Collected the available publications and conducted this meta-analysis to disclose the prognostic role of PLR for overall survival (OS), disease-free survival (DFS)/progress-free survival (PFS) in non-small cell lung cancer (NSCLC)
As for the PLR in DFS/PFS, the results showed that elevated PLR did not predict poor DFS/PFS in Asians (HR = 1.12; 95% CI: 0.94–1.34, p = 0.205; I2 = 46.6 Ph = 0.154) whereas high PLR was correlated with shortened DFS/PFS in small sample studies(HR = 1.55; 95% CI: 1.09–2.22, p = 0.015; I2 = 13.8,Ph = 0.281) (Table 2)
In the present study, using the method of meta-analysis, we explored the prognostic impact of pretreatment PLR on OS and DFS/PFS in patients with NSCLC
Summary
The cut-off values used by the included studies ranged from 106 to 300, the median value of which was 171, so we selected PLR = 180 to divide the cut-off values in the following subgroup analysis. Eleven studies[15,16,17,18,19,20,21,22,23,24,25] with 3,430 patients reported the data of pretreatment PLR and OS in NSCLC. There were five studies[18,19,20,24,25] with 1,635 patients presenting the HR and 95% CI of PLR and DFS/PFS. The combined data showed that elevated PLR was associated with shorter DFS/ PFS (HR = 1.19; 95% CI: 1.02–1.4, p = 0.027) with moderate heterogeneity (I2 = 46.8, Ph = 0.111; Table 2, Fig. 3). The results showed that the pooled HRs for OS and DFS/PFS were not substantially changed (Fig. 4), indicating the robustness of our findings
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