Abstract
BackgroundConflicting evidence exists regarding the effects of platelet/lymphocyte ratio (PLR) and lymphocyte/monocyte ratio(LMR) on the prognosis of colorectal cancer (CRC) patients. This study aimed to evaluate the roles of the PLR and LMR in predicting the prognosis of CRC patients via meta-analysis.MethodsEligible studies were retrieved from the PubMed, Embase,andChina National Knowledge Infrastructure (CNKI) databases, supplemented by a manual search of references from retrieved articles. Pooled hazard ratios (HR) with 95% confidence intervals (95% CI) were calculated using the generic inverse variance and random-effect model to evaluate the association of PLR and LMR with prognostic variables in CRC, including overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS).ResultsThirty-three studies containing 15,404 patients met criteria for inclusion. Pooled analysis suggested that elevated PLR was associated with poorer OS (pooled HR = 1.57, 95% CI: 1.41 – 1.75, p< 0.00001, I2=26%) and DFS (pooled HR = 1.58, 95% CI: 1.31 – 1.92, p< 0.00001, I2=66%). Conversely, high LMR correlated with more favorable OS (pooled HR = 0.59, 95% CI: 0.50 – 0.68, p< 0.00001, I2=44%), CSS (pooled HR = 0.54, 95% CI: 0.40 – 0.72, p< 0.00001, I2=11%) and DFS (pooled HR = 0.82, 95% CI: 0.71– 0.94,p=0.005, I2=29%).ConclusionsElevated PLR was associated with poor prognosis, while high LMR correlated with more favorable outcomes in CRC patients. Pretreatment PLR and LMR could serve as prognostic predictors in CRC patients.
Highlights
colorectal cancer (CRC) represents the third most common cause of cancer-related death in men and women in the united states [1]
Pooled analysis suggested that elevated platelet/ lymphocyte ratio (PLR) was associated with poorer overall survival (OS) and disease-free survival (DFS)
Elevated PLR was associated with poor prognosis, while high LMR correlated with more favorable outcomes in CRC patients
Summary
CRC represents the third most common cause of cancer-related death in men and women in the united states [1]. Diagnosis and treatment of CRC, a large number of the patients are still diagnosed at an advanced stage and the therapeutic options are limited, resulting in a 5-year survival rate of only about 65% much lower than expected [2]. The discovery of prognostic factors is of clinical importance www.impactjournals.com/oncotarget to guide therapeutic options and surveillance strategies. The discovery of prognostic biomarkers mainly depends on surgical specimens, which may not be representative of the veritable burden of CRC [4]. As many prognostic factors are evaluated postoperatively, there are still pending circulating biomarkers of early predicting clinical outcome. Conflicting evidence exists regarding the effects of platelet/ lymphocyte ratio (PLR) and lymphocyte/monocyte ratio(LMR) on the prognosis of colorectal cancer (CRC) patients. This study aimed to evaluate the roles of the PLR and LMR in predicting the prognosis of CRC patients via meta-analysis
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