Prognostic Roles of Inflammatory Markers in Pancreatic Cancer: Comparison between the Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio

Abstract

Background/Objectives This meta-analysis is aimed at investigating the prognostic roles of the inflammatory markers neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in patients with pancreatic cancer. Methods The correlations between high inflammatory marker expression levels and prognosis in 7105 patients with pancreatic cancer from 34 eligible studies were investigated. Additionally, subgroup analyses based on study location, tumor stage, treatment, and value cutoffs were performed. Results High NLR and PLR values were considered to be 2.0–5.0 and 150–200, respectively. Using a random-effects model, the estimated rates of high NLR and PLR were 0.379 (95% confidence interval [CI] 0.310–0.454) and 0.490 (95% CI 0.438–0.543), respectively. High NLRs were frequently found in patients with lower tumor stages and in those who underwent surgery. There were significant correlations between high NLR and PLR and poor survival rates (hazard ratio [HR] 1.737, 95% CI 1.502–2.009 and HR 1.143, 95% CI 1.037–1.259, resp.). Interestingly, the NLR and PLR had no prognostic value in patients who underwent chemoradiotherapy. Conclusion Taken together, our results showed that inflammatory markers are useful for predicting prognosis in patients with pancreatic cancer. The NLR is a more suitable parameter for predicting prognosis regardless of the patient's condition.

Platelet-to-lymphocyte ratio and CA19-9 are simple and informative prognostic factors in patients with resected pancreatic cancer

“…C-reactive protein) [1,19]. A meta-analysis of 34 studies including 7105 patients with pancreatic cancer revealed that high PLR and NLR were defined as values from 150 to 200, and 2 to 5, respectively [20]. They found a significant correlation between high PLR (HR=1.143, 95% CI: 1.037 to 1.259) and NLR (HR=1.737, 95% CI: 1.502 to 2.009) and poor survival.…”

“…They found a significant correlation between high PLR (HR=1.143, 95% CI: 1.037 to 1.259) and NLR (HR=1.737, 95% CI: 1.502 to 2.009) and poor survival. Both parameters had no prognostic role in patients who underwent chemoradiotherapy [20]. Song et al conducted a meta-analysis of 8 studies including 1904 patients with pancreatic cancer [21], and found that the PLR was associated with decreased OS (HR=1.22, 95% CI: 1.04 to 1.43, P = 0.02), especially in Asian studies, patients with metastatic disease and for values of PLR over 150.…”

Prognostic value of neutrophil-to-lymphocyte ratio in early-stage ovarian clear-cell carcinoma

“…SIR markers such as neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are simple, easily available, and inexpensive to evaluate. Recent studies have shown that elevated NLR or PLR is associated with poor prognosis among patients with several types of cancers [678910].…”

Does the preoperative platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio predict morbidity after gastrectomy for gastric cancer?

“…Inflammation and tumor growth are dependent factors, and increasing numbers of studies have elucidated the role of systemic inflammatory response mediators in various solid cancers [13,14]. Among them, GC is one of the popular foci of these investigations that evaluated cancerrelated inflammation and possible predictors in the preoperative period [6][7][8].…”