Prognostic value of the neutrophil to lymphocyte ratio in lung cancer: A meta-analysis

Yin, Yongmei; Wang, Jun; Wang, Xuedong; Gu, Liqun; Hao, Pei; Kuai, Shougang; Zhang, Yingying; Shang, Zhongbo

doi:10.6061/clinics/2015(07)10

Cited by 137 publications

(137 citation statements)

References 36 publications

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“…The optimal cutoff values for NLR and PLR were determined using time-dependent receiver operating curve (ROC) analysis with survival ROC package (17). NLR and PLR cutoff points of 4.5 (11,12) and 258 (11) were used to stratify the patients, respectively. In terms of survival analyses, Kaplan-Meier method with log-rank test was used to analyze the correlation between variables and OS.…”

Section: Resultsmentioning

confidence: 99%

“…Whilst, the 7 th TNM classification stratifies the patients according to the extent of the primary tumor (T-stage), lymph node involvement (N-stage) and distant metastasis (M-stage) (6)(7)(8). However, the survival of the SCLC patients in the same stage varied dramatically, previous studies showed that various clinical factors of SCLC patients were predictive factors (9)(10)(11)(12). Unfortunately, the predictive value of these factors remained unknown.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, it was inappropriate that SCLC and NSCLC shared the same or similar staging system. On the other hand, SCLC patients were divided into only two categories in VALSG, which might be not conclusive (9)(10)(11)(12). Nomograms are a pictorial representation of a complex mathematical formula.…”

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confidence: 99%

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Nomogram prediction for the survival of the patients with small cell lung cancer

et al. 2017

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Background: Small cell lung cancer (SCLC) is a subtype of lung cancer with poor prognosis. In this study, we aimed to build a nomogram to predict the survival of individual with SCLC by incorporating significant clinical parameters. Methods:The patients with SCLC were enrolled from the First Affiliated Hospital of Guangzhou Medical University (GMUFAH) between 2009 and 2013. We identified and incorporated the independent prognostic factors to build a nomogram to predict the survival of SCLC patients. The predictive accuracy and discriminative ability of the nomogram were evaluated by concordance index (C-index) and calibration curve.We also compared the accuracy of the built model with the 7 th AJCC TNM and VALSG staging system. The nomogram was further validated in an independent cohort of 80 patients with SCLC from Cancer Center of Guangzhou Medical University (GMUCC) between 2009 and 2013.Results: A total of 275 patients with SCLC were included in the primary cohort, and seven independent prognostic factors were identified including age, N stage, metastasis status, histology, platelets to lymphocyte ratio (PLR), neuron specific enolase (NSE) and CYFRA21-1 as independent prognostic factors after using Cox regression model. A nomogram incorporating these prognostic factors was subsequently built. The calibration curves for possibilities of 1-, 2-year overall survival (OS) revealed optimal agreement between nomogram prediction and actual observation. The C-index of this nomogram was higher than that of TNM Conclusions:In this study, we established and validated a novel nomogram for the prediction of OS for the patients with SCLC. This model could provide more accurate individual prediction of survival probability of SCLC than the existing staging systems.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Nomogram prediction for the survival of the patients with small cell lung cancer

et al. 2017

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“…In this context, a meta-analysis conducted by Yin Y and coll. reported that an elevated NLR predicted worse overall survival in lung cancer, with an adjusted HR of 1.2 in multivariate analysis (14). Similarly, in a narrative literature review, Faria SS and coll.…”

Section: Discussionmentioning

confidence: 87%

Could neutrophil to lymphocyte ratio be a prognostic predictor of relapse in patients with extra-pulmonary tuberculosis?

et al. 2018

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Background:We aimed to evaluate whether neutrophil to lymphocyte ratio (NLR) was associated with relapse occurrence during the follow-up of extra-pulmonary tuberculosis (EPTB). Material and Methods:We retrospectively collected data from 408 EPTB patients hospitalized between 1996 and 2015. We evaluated the performance of NLR in predicting relapse and to stratify patients into high and low level groups. Kaplan-Meier method was used to generate regression-free survival (RFS) curves, which were compared by Logrank test according to NLR categories. Results: Fourteen cases developed a relapse (3.4%). The median value of NLR was significantly higher in patients with relapse (3.8±1.4 vs 2.7±1.4; p=0.008). Receiving operating characteristics (ROC) curves analysis showed that NLR had an Area under the ROC (AUROC) of 0.73 in predicting relapse (p=0.003). At a cut-off of 3, NLR had a sensitivity of 64% and a specificity of 70% to predict relapse. Survival curves showed that patients with a high NLR (≥3) had shorter RFS compared with those with a low NLR (<3) (24.7 vs 44.2 months; p=0.04). High NLR was significantly associated with relapse both in univariate (HR=3.7; p=0.041) and multivariate Cox regression analysis (HR=5.24; p=0.027). Conclusion: NLR may have a prognostic value in the follow up of patients with EPTB.

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“…An imbalance of the immune system involving the NLR can be used as a biomarker for a systematic inflammatory response. In addition, it is used to predict the prognosis of patients with various cancers [10,11], cardiovascular diseases [12,13] and hemorrhagic stroke [14][15][16]. Recently, NLR was used to predict in-hospital mortality [17,18], 90-day mortality [19][20][21] and 90-day poor outcomes (mRS≥3) [4,[21][22][23] in patients with ischemic stroke.…”

Section: Introductionmentioning

confidence: 99%

The prediction of neutrophil to lymphocyte ratio for outcomes in ischemic stroke

Ye¹,

Ai²,

Fang³

et al. 2017

Oncotarget

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Objective: Neutrophil to lymphocyte ratio (NLR) is a prognostic inflammatory biomarker in patients with cardiovascular disease and hemorrhagic stroke. This metaanalysis aims to evaluate the prognostic values of NLR in predicting clinical outcomes in patients with ischemic stroke.Methods: A literature search was performed using the databases PubMed, EMBASE, Cochrane Central Register of Controlled Trials and China National Knowledge Infrastructure. Two reviewers independently retrieved papers that met the inclusion criteria. Subgroup analyses were performed using in-hospital mortality, 90-day mortality and 90-day poor outcomes (mRS>2) as the outcome measures.Results: Eight studies with 3855 patients were included in the analysis. An elevated NLR was a strong predictor for in-hospital mortality (OR: 1.05; 95% CI: 1.03-1.07, p<0.001) and for 90-day poor outcomes (OR: 2.28; 95% CI: 1.39-3.73, p<0.001), but not for 90-day mortality (OR: 3.04; 95% CI: 0.74-12.55, p=0.12). After performing subgroup analysis, the NLR was found to predict 90-day mortality with a high (>5) cut-off values (OR: 6.69; 95% CI: 1.70-26.33, p=0.007). The lower cut-off values had no significance (OR: 2.17; 95% CI: 0.43-10.86, p=0.35).Conclusions: A high NLR was significantly associated with higher rates of inhospital mortality and 90-day poor outcome in patients with ischemic stroke, especially with a high mean NLR or high cut-off values. With a high cut-off value (>5), NLR could predict the 90-day mortality after ischemic stroke.

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Prognostic value of the neutrophil to lymphocyte ratio in lung cancer: A meta-analysis

Cited by 137 publications

References 36 publications

Nomogram prediction for the survival of the patients with small cell lung cancer

Nomogram prediction for the survival of the patients with small cell lung cancer

Could neutrophil to lymphocyte ratio be a prognostic predictor of relapse in patients with extra-pulmonary tuberculosis?

The prediction of neutrophil to lymphocyte ratio for outcomes in ischemic stroke

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