Prognostic significance of blood inflammatory biomarkers NLR, PLR, and LMR in cancer—A protocol for systematic review and meta-analysis

Abstract

Background: The neutrophil-lymphocyte-ratio, platelet-lymphocyte-ratio, and monocyte-lymphocyte-ratio have been explored as a simple, inexpensive, and effective method for cancer prognosis. However, there are no studies that have investigated the comparative utility of these markers, in multiple cancers. Methods: The preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) guidelines were used to design this meta-analysis protocol. The final study will also be conducted under the PRISMA guidelines for systematic reviews and meta-analyses. The core bibliographic database search will be carried out by 2 reviewers working individually, with each conducting an initial screening based on titles and abstracts. The shortlisted articles will be selected for review and quantitative analysis, based on predefined inclusion and exclusion criteria. Study characteristics, relevant clinicopathological characteristics, and statistical data required for meta-analysis (hazard ratios [HRs] and 95% confidence intervals [CIs]) will be extracted and compiled into a MS Excel datasheet. Meta-analysis will be performed, using a random-effects model, and the results (pooled HR and 95% CI) will be presented in the form of a forest plot. Publication bias will also be assessed by use of Egger bias indicator test and funnel plot symmetry. If statistical data from included studies is insufficient, a qualitative literature review will be pursued. PROSPERO registration: PROSPERO CRD42019121008.

The derived neutrophil‐to‐lymphocyte ratio is an independent prognostic factor in patients with angioimmunoblastic T‐cell lymphoma

“…The HPR was calculated as haemoglobin divided by the platelet count (Tang et al , ). The PLR was determined as the platelet count divided by the lymphocyte count (Kumarasamy et al , ). This study was carried out in accordance with the Helsinki Declaration and its amendments and endorsed by the institutional review board of each participating institution.…”

Combining the Fibrinogen/Albumin Ratio and Systemic Inflammation Response Index Predicts Survival in Resectable Gastric Cancer

“…Inflammation is closely related to tumour progression and prognosis. Over the past few decades, immune cell-related indices such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-tomonocyte ratio (LMR) have been used to predict prognosis and recurrence in various malignancies [2]. In recent years, a novel inflammatory marker, the systemic inflammation response index (SIRI), which is calculated using the levels of neutrophils, monocytes, and lymphocytes, has shown an ability to predict prognosis in pancreatic cancer [3], gastric cancer [4], and nasopharyngeal cancer [5].…”

Systemic inflammation-based predictors of pathological response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer patients: A propensity score matching analysis

“…The analysis of circulating leukocyte subsets has become the most convenient method, especially for the analysis of NLR, PLR and MLR. Numerous studies have con rmed that they link to the prognosis of different cancers such as gastric cancer, ovarian cancer and colorectal cancer (15,16,(23)(24)(25). NLR, PLR and MLR are known to be predictors of pathological response in LARC patients.…”

“…In recent years, several studies have paid more attention on systemic in ammatory response indicators for predicting the prognosis of rectal cancer after CRT (11)(12)(13). In particular, neutrophil-lymphocyte-ratio (NLR), monocytelymphocyte-ratio (MLR) and platelet-lymphocyte-ratio (PLR) are considered as prognostic biomarkers for patients with rectal cancer (13)(14)(15)(16). Some studies have suggested that pre-CRT NLR and PLR, or NLR alone are independently related to tumor response (17,18).…”