Background: Current research shows that platelet to lymphocyte ratio (PLR) has important prognostic value in renal cell carcinoma, esophageal cancer, gastric cancer, liver cancer and colon cancer. The aim of the study is to evaluate the prognostic value of PLR in non-small cell lung cancer (NSCLC) through meta-analysis.
Methods: Literature search for PubMed, EMBASE, Web of Science, Medline, Cochrane Library, China National Knowledge Internet (CNKI), China Biomedical Medicine disc (CBMdisc), VIP, Wanfang Database using computer electronic system to study the association between PLR and overall survival (OS) and disease-free survival (DFS). Each eligible study data is extracted and a meta-analysis is performed using the hazard risk (HR) and 95% confidence interval (95%CI) to assess the prognostic value of PLR, the time limit for the search is to build the library until November 2018.
Results: We include a total of 15 research literatures involving 5,524 patients for meta-analysis. According to the results of the meta-analysis: The OS of the higher PLR group is significantly lower than that of the lower PLR group (HR=1.69, 95%CI: 1.45-1.97, P<0.000,01, I²=46.2%, Pheterogeneity=0.026); the DFS of the higher PLR group is significantly lower than that of the lower PLR group (HR=1.41, 95%CI: 1.14-1.74, P=0.001, I²=46.2%, Pheterogeneity=0.026). Subgroup analysis show that the OS of the higher PLR group is still significantly lower than the lower PLR group (P<0.05) after grouping by ethnicity, sample size, PLR cutoff value and treatment.
Conclusions: Increased PLR is associated with poor prognosis in NSCLC, so PLR may be an important biological predictive marker for NSCLC patients, however, its clinical application still needs to be verified through more research in the future.
【中文题目：血小板淋巴细胞比值作为非小细胞肺癌预后因素的meta分析】 【中文摘要：背景与目的 目前研究显示，血小板淋巴细胞比值（platelet lymphocyte ratio, PLR）在肾细胞癌、食管癌、胃癌、肝癌以及结肠癌中均有重要的预后价值。本研究旨在通过meta分析，评估PLR对非小细胞肺癌（non-small cell lung cancer, NSCLC）患者的预后价值。方法 使用计算机电子系统对PubMed、EMBASE、Web of Science、Medline、Cochrane Library、中国知网、中国生物医学文献数据库、维普、万方数据库进行系统文献检索，查阅研究PLR与总生存期（overall survival, OS）和无病生存期（disease-free survival, DFS）之间关联的文献。提取每个符合条件的研究数据，使用风险比率（hazard risk, HR）和95%置信区间（95% confidence interval, 95%CI）进行系统评价分析以评估PLR的预后价值，检索时限为建库至2018年11月。结果 我们共纳入15篇研究文献涉及5524名患者进行系统评价分析。Meta分析结果显示：较高PLR组的OS明显低于较低PLR组的OS（HR=1.69, 95%CI: 1.45-1.97, P<0.000,01, I²=46.2%, P异质性=0.026）；较高PLR组的DFS明显低于较低PLR组的DFS（HR=1.41, 95%CI: 1.14-1.74, P=0.001, I²=46.2%, P异质性=0.026）。亚组分析显示，按种族、样本大小、PLR临界值和治疗方法分组后，PLR较高组的OS仍明显低于PLR较低组（P<0.05）。结论 PLR增高与NSCLC患者预后不良有关，因此PLR可能作为NSCLC患者重要的生物预测标记，但其临床应用仍需要未来通过更多的研究来验证。】 【中文关键词：肺肿瘤；血小板与淋巴细胞比值；Meta分析；总生存期；无病生存期】.
Keywords: Disease-free survival; Lung neoplasms; Meta-analysis; Overall survival; Platelet to lymphocyte ratio.