Prognostic role of neutrophil-to-lymphocyte ratio (NLR) in urological tumors: an umbrella review of evidence from systematic reviews and meta-analyses

Mjaess, Georges; Chebel, Roy; Karam, Aya; Moussa, Ilan; Prétot, Dominique; Tayeh, Georges Abi; Sarkis, Julien; Semaan, Albert; Peltier, Alexandre; Aoun, Fouad; Albisinni, Simone; Roumeguère, Thierry

doi:10.1080/0284186x.2021.1886323

Cited by 33 publications

(20 citation statements)

References 60 publications

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“…Kinds of inflammatory and immune response factors have been reported as survival biomarkers for various cancers ( 6 ). Many other inflammatory biomarkers that were also prognostic in urologic tumors, such as neutrophil-to-lymphocyte ratio (NLR) ( 34 ), platelet-to-lymphocyte ratio (PLR) ( 35 ), lymphocyte-to-monocyte ratio (LMR) ( 36 ), etc. Based on published studies, similar meta-analyses about the prognostic role of these biomarkers in urological tumors also have been performed by many researchers.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Role of Pretreatment C-Reactive Protein to Albumin Ratio in Urological Cancers: A Systematic Review and Meta-Analysis

Zhou²,

Chen

et al. 2022

Front. Oncol.

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BackgroundTo investigate the potential prognostic role of C-reactive protein to albumin ratio (CAR) in patients with urinary cancers, including renal cell carcinoma (RCC), bladder cancer (BC), and prostate cancer (PC).MethodsWe searched and screened literatures with PubMed, Embase, Cochrane Library, and Web of Science in January 2022. We applied combined hazard ratios (HRs) and 95% confidence intervals (CIs) to assess the associations.ResultsThirteen studies including 2,941 cases were analyzed in our study. Merged results indicated that highly pretreated CAR was associated with inferior overall survival (HR 2.21, 95% CI 1.86-2.62, p < 0.001) and progression-free survival (HR 1.85, 95% CI 1.36-2.52, p < 0.001) for urinary cancers. In a subgroup analysis of OS by tumor type, CAR can be a predictor in RCC (HR 2.10, 95% CI 1.72-2.56), BC (HR 3.35, 95% CI 1.94-5.80), and PC (HR 2.20, 95% CI 1.43-3.37). In a subgroup analysis of PFS by tumor type, CAR can be a predictor in BC (HR 1.76, 95% CI 1.03-3.02), and RCC (HR 1.90, 95% CI 1.25-2.89). The reliability and robustness of results were confirmed.ConclusionsHigh pretreated CAR was effective predictor of poor survival in patients with urinary cancers and can act as prognostic factor for these cases.Systematic Review RegistrationPROSPERO (CRD42022306414).

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Section: Discussionmentioning

confidence: 99%

Prognostic Role of Pretreatment C-Reactive Protein to Albumin Ratio in Urological Cancers: A Systematic Review and Meta-Analysis

Zhou²,

Chen

et al. 2022

Front. Oncol.

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“…Nevertheless, they are not the unique, non-invasive biomarkers being currently studied. Others, such as neutrophil-to-lymphocyte ratio [53], DLX1, PCA3, and DUOX1 mRNA plasma expressions [54] or a 14-genes' panel urine test including PMP22, GOLM1, LMTK2, EZH2, GSTP1, PCA3, VEGFA, CST3, PTEN, PIP5K1A, CDK1, TMPRSS2, ANXA3, and CCND1 [55], are some of the most updated research in PC non-invasive biomarkers. However, as previously mentioned by several authors, such as H.P.…”

Section: Discussionmentioning

confidence: 99%

Identification of MicroRNAs as Viable Aggressiveness Biomarkers for Prostate Cancer

et al. 2021

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MiRNAs play a relevant role in PC (prostate cancer) by the regulation in the expression of several pathways’ AR (androgen receptor), cellular cycle, apoptosis, MET (mesenchymal epithelium transition), or metastasis. Here, we report the role of several miRNAs’ expression patterns, such as miR-miR-93-5p, miR-23c, miR-210-3p, miR-221-3p, miR-592, miR-141, miR-375, and miR-130b, with relevance in processes like cell proliferation and MET. Using Trizol® extraction protocol and TaqMan™ specific probes for amplification, we performed miRNAs’ analysis of 159 PC fresh tissues and 60 plasmas from peripheral blood samples. We had clinical data from all samples including PSA, Gleason, TNM, and D’Amico risk. Moreover, a bioinformatic analysis in TCGA (The Cancer Genome Atlas) was included to analyze the effect of the most relevant miRNAs according to aggressiveness in an extensive cohort (n = 531). We found that miR-210-3p, miR-23c, miR-592, and miR-93-5p are the most suitable biomarkers for PC aggressiveness and diagnosis, respectively. In fact, according with our results, miR93-5p seems the most promising non-invasive biomarker for PC. To sum up, miR-210-3p, miR-23c, miR-592, and miR93-5p miRNAs are suggested to be potential biomarkers for PC risk stratification that could be included in non-invasive strategies such as liquid biopsy in precision medicine for PC management.

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“…In recent years, many studies have confirmed that the occurrence and development of malignant tumors are closely related to inflammation, and the level of inflammation indicators can affect the prognosis of patients with malignant tumors. Among the common inflammatory indicators: neutrophil–lymphocyte ratio (NLR) has played a good predictive role in the prognosis of patients with colorectal cancer, gastric cancer, liver cancer, pancreatic cancer, ovarian cancer, breast cancer and urological tumors ( 5 – 7 ). Pretreatment thrombocytosis is related to the decreased survival rate of lung cancer, kidney cancer, ovarian cancer, vulvar cancer, and cervical cancer.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Pretreatment Neutrophil-to-Lymphocyte Ratio, Platelet−to−Lymphocyte Ratio, or Monocyte-to-Lymphocyte Ratio in Endometrial Neoplasms: A Systematic Review and Meta−analysis

Leng

Zhang

2022

Front. Oncol.

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AimNeutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), or monocyte–lymphocyte ratio (MLR) has been shown to be related to the poor prognosis of cervical cancer, ovarian cancer, breast cancer, and other malignant tumors, but their role in predicting the prognosis of endometrial cancer is still controversial. Therefore, we conducted this meta-analysis to evaluate the effectiveness of NLR more accurately, PLR, or MLR in predicting the prognosis of endometrial cancer (EC).MethodsThis review systematically searched for relevant publications in databases of the Cochrane Library, PubMed, EMBASE, CNKI, WanFang, VIP, and CBM. Pooled hazard ratios (HR) with 95% confidence intervals (95% CI) were determined and used to explore the association between inflammatory biomarkers (NLR, PLR, and MLR) and overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) in a random-effects model. We also conducted subgroup analysis and publication bias in this meta-analysis. Stata 12.0 was used for statistical analysis.ResultsThis meta-analysis contained 14 eligible studies including 5,274 patients. Our results showed that NLR or PLR was associated with OS [NLR: HR, 2.51; 95% CI, 1.70–3.71; p <0.001 in univariate analysis (Ua); HR, 1.87; 95% CI, 1.34–2.60; p <0.001 in multivariate analysis (Ma); PLR: HR, 2.50; 95% CI, 1.82–3.43; p <0.001 in Ua; HR, 1.86; 95% CI, 1.22–2.83; p = 0.004 in Ma], but MLR was not associated with OS (HR, 1.44; 95% CI, 0.70–2.95; p = 0.325 in Ua; HR, 1.01; 95% CI, 0.39–2.60; p =0.987 in Ma). A further subgroup analysis found that the correlations were not affected by race, cutoff value, sample size, or treatment. Our meta-analysis showed that NLR or PLR was associated with DFS (NLR: HR, 2.50; 95% CI, 1.38–4.56; p =0.003 in Ua; HR, 2.06; 95% CI, 1.26–3.37, P =0.004 in Ma; PLR: HR, 1.91; 95% CI, 1.30–2.81; p = 0.001 in Ua), and NLR was associated with PFS only in the univariate analysis (HR, 1.71; 95% CI, 1.04–2.81; p =0.035 in Ua; HR, 1.79; 95% CI, 0.65–4.89; P =0.257 in Ma), but MLR was not associated with DFS (HR, 0.36; 95% CI, 0.03–4.13; p =0.409 in Ua).ConclusionsOur results indicated that pretreatment NLR and PLR were biomarkers of poor prognosis in patients with endometrial cancer. The results indicated that NLR or PLR was associated with OS and disease-free survival DFS, and NLR was associated with PFS only in univariate analysis, but MLR was not associated with OS or DFS.

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Prognostic role of neutrophil-to-lymphocyte ratio (NLR) in urological tumors: an umbrella review of evidence from systematic reviews and meta-analyses

Cited by 33 publications

References 60 publications

Prognostic Role of Pretreatment C-Reactive Protein to Albumin Ratio in Urological Cancers: A Systematic Review and Meta-Analysis

Prognostic Role of Pretreatment C-Reactive Protein to Albumin Ratio in Urological Cancers: A Systematic Review and Meta-Analysis

Identification of MicroRNAs as Viable Aggressiveness Biomarkers for Prostate Cancer

Prognostic Significance of Pretreatment Neutrophil-to-Lymphocyte Ratio, Platelet−to−Lymphocyte Ratio, or Monocyte-to-Lymphocyte Ratio in Endometrial Neoplasms: A Systematic Review and Meta−analysis

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