Preoperative Neutrophil Lymphocyte Ratio Can Be Used as a Predictor of Prognosis in Patients With Adenocarcinoma of the Esophagogastric Junction: A Systematic Review and Meta Analysis

Abstract

Objective: Neutrophil lymphocyte ratio (NLR), Lymphocyte mononuclear cell ratio (LMR), and Platelet lymphocyte ratio (PLR) can be used as various prognostic factors for malignant tumors, but the value of prognosis for patients with adenocarcinoma of the esophagogastric junction (AEG) has not been determined. This study used meta-analysis to assess the value of these indicators in the evaluation of AEG prognosis. Methods: Relevant literatures on the prognostic relationship between NLR, LMR, PLR, and AEG was retrieved from PubMed, Web of Science, Embase, Cochrane Library, Cochrane Central Register of Controlled Trials, Wanfang data, and Chinese National Knowledge Infrastructure. The search time from database establishment to June 30, 2019. The language is limited to English and Chinese. Data was analyzed using Stata 15.0 software. Result: Six retrospective studies were included, five of them involved NLR and six of them involved PLR. No LMR literature that adequately satisfied the conditions was retrieved. Increased NLR was significantly associated with a significant reduction in overall survival (OS), cancer-specific survival (CSS), or disease specific survival (DSS) in patients with AEG [hazard ratio (HR) = 1.545, 95% CI: 1.096-2.179, P < 0.05]. Subgroup analysis showed that NLR had significant value in the prognosis of both Chinese and Non-Chinese patients (P = 0.009 vs. P = 0.000). NLR had significant prognostic value for ≥3 and <3 groups (P = 0.022 vs. P = 0.000). NLR has a significant prognostic value for samples ≥500 and <500 (P = 0.000 vs. P = 0.022). NLR and OS/CSS/DSS single factor meta-regression showed that regional NLR cutoff values and sample size may be the source of heterogeneity in AEG patients (all P < 0.05). There was no significant association between elevated PLR and OS in patients with AEG (HR = 1.117, 95% CI: 0.960-1.300, P > 0.05). PLR had no significant prognostic value for both Chinese and Liu et al. NLR Can Be Used as a Predictor of AEG UK patients (P = 0.282 vs. P = 0.429). PLR had no significant prognostic value for ≥150 group and <150 group (P = 0.141 and P = 0.724). No significant prognostic value was found in either the 300 group and <300 group (P = 0.282 vs. P = 0.429). Conclusion: Preoperative NLR rise was an adverse prognostic indicator of AEG. High-risk patients should be treated promptly. The results showed that PLR was not recommended as a prognostic indicator of AEG.

Model established based on blood markers predicts overall survival in patients after radical resection of types II and III adenocarcinoma of the esophagogastric junction

“…Among these, carcinoembryonic antigen (CEA) has been used for the early diagnosis of cancer[ 6 ]. Cancer-related systemic inflammatory responses, such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), play an important role in the progression and outcome of tumors[ 7 , 8 ]. Patients with a high NLR have a poor prognosis[ 9 ].…”

Preoperative BChE serves as prognostic marker in patients with resectable AEG after neoadjuvant chemotherapy

“…Furthermore, several serological biomarkers are potentially re ecting a state of in ammation and malnutrition and have been linked to the oncologic outcome of patients with esophageal cancer [14][15][16][17]. While the association of malnutrition and poor oncologic outcome can be evaluated by using the controlling nutritional status (CONUT) score [18], chronic in ammation and its impact on the prognosis in esophageal cancer patients was discussed by evaluating the preoperative Neutrophil-to-lymphocyte ratio (NLR) or the Albumin-to-Fibrinogen ratio, for instance [19,20]. Butyrylcholinesterase (BChE) is a non-speci c enzyme, produced and synthetized by the liver and found in most tissues, including the nervous system, small intestine and adipocytes [21].…”

Prognostic utility of preoperative inflammatory markers in patients with intrahepatic cholangiocarcinoma after hepatic resection: A systematic review and meta‐analysis

“…These blood biomarkers reflect the inflammatory status 10 and have been proved to be valuable in predicting the prognosis of many cancer types, including colorectal cancer, 11 breast cancer, 12 urinary neoplasm, 13 and esophagogastric junction cancer. 14 …”

“…These blood biomarkers reflect the inflammatory status 10 and have been proved to be valuable in predicting the prognosis of many cancer types, including colorectal cancer, 11 breast cancer, 12 urinary neoplasm, 13 and esophagogastric junction cancer. 14 The associations between NLR, LMR, PLR, and clinical outcomes in patients with ICC have been explored in various studies, but there is no consensus in results. [15][16][17][18][19][20][21][22][23][24][25][26][27][28][29] Two previous meta-analyses evaluated the role of inflammatory factors in predicting the prognosis of patients with cholangiocarcinoma.…”