Prognostic Significance of Neutrophil Lymphocyte Ratio in Patients with Gastric Cancer: A Meta-Analysis

Abstract

BackgroundSeveral studies have shown that neutrophil lymphocyte ratio (NLR) may be associated with the prognosis of gastric cancer (GC), but the results are controversial.MethodsThis study was performed to evaluate the prognostic implications of neutrophil lymphocyte ratio of GC in all available studies. We surveyed 2 medical databases, PubMed and EMBASE, to identifyall relevant studies. Data were collected from studies comparing overall survival (OS), disease-free survival (DFS) and progression-free survival (PFS) in patients with GC.ResultsTen studies (n = 2,952) evaluated the role of NLR as a predictor of outcome were involved for this meta-analysis (10 for OS, 3 for DFS, and 2 for PFS). Overall and disease-free survival were significantly better in patients with low NLR value and the pooled HRs was significant at 1.83 ([95% CI], 1.62–2.07) and 1.58 ([95% CI], 1.12–2.21), respectively. For progression-free survival, the pooled hazard ratio of NLR was significant at 1.54 ([95% CI], 1.22–1.95). No evidence of significant heterogeneity or publication bias for OS and DFS was seen in any of the included studies.ConclusionThis meta-analysis indicated that elevated NLR may be associated with a worse prognosis for patients with GC.

The Neutrophil-to-Lymphocyte Ratio Predicts Malignant Potential in Intraductal Papillary Mucinous Neoplasms

“…[19][20][21][22][23][24] Because some patients with IPMA had high NLR (>2.074), we assessed whether NLR was also associated with the degree of dysplasia. However, there was no correlation between degree of dysplasia and NLR.…”

“…12 Host inflammatory responses to various cancers have been shown to be associated with tumor progression, 13,14 and increasing systemic inflammation correlating with poorer cancer-specific survival. [15][16][17] Neutrophil-to-lymphocyte ratio (NLR) is a simple index of systemic inflammation, 18 with elevated preoperative NLR associated with poor prognosis in patients with various types of malignant tumor, [19][20][21][22][23][24] However, the association between NLR and the biological characteristics of pancreatic IPMN has not been determined. This study therefore assessed whether NLR is a predictive biomarker for tumor initiation and/or progression in patients with pancreatic IPMN.…”

Prognostic implication of antitumor immunity measured by the neutrophil–lymphocyte ratio and serum cytokines and angiogenic factors in gastric cancer

“…The neutrophil-lymphocyte ratio (NLR) has been shown to be a well-validated prognostic factor in solid tumors such as those of the lung and breast, as well as hepatocellular and renal cell carcinomas [8][9][10][11][12]. The NLR is a well-known biomarker of cancer-associated inflammation.…”

Systemic Inflammatory Reaction in Gastric Cancer: Biology and Practical Implications of Neutrophil to Lymphocyte Ratio, Glasgow Prognostic Score and Related Parameters

“…Except the prognostic value to NLR, many aspects as the correlation with tumour morphology, type by Lauren classification, invasive properties of cancer, grade, intensity of angiogenesis and microvascular density have been targeted by low number of studies. Only few meta-analyses have been conducted [21,[35][36][37]. Few data are available on SIR parameters after treatment although it is known that post-chemotherapy NLR correlates with the response in patients with unresectable gastric cancer [38].…”