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

Abstract

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.

The Association between a Decrease in On-Treatment Neutrophil-to-Eosinophil Ratio (NER) at Week 6 after Ipilimumab Plus Nivolumab Initiation and Improved Clinical Outcomes in Metastatic Renal Cell Carcinoma

“…There are several limitations in the current study. First, several peripheral blood count-based biomarkers have been previously investigated in various cancers, before and after the advent of ICIs, such as the neutrophil-to-lymphocyte ratio [ 52 , 53 , 54 , 55 , 56 ], lymphocyte-to-monocyte ratio [ 52 , 55 , 57 ], and platelet-to-lymphocyte ratio [ 52 , 54 , 58 , 59 , 60 ]. The current study chose to investigate NER (instead of other indices) based on our clinical observation of eosinophil count elevation and the established prognostic role of neutrophilia in mRCC in the IMDC model [ 27 ].…”

Are blood parameters assessed before taking frozen sections useful in gynecological oncology?

“…Mean corpuscular volume, mean platelet volume, neutrophil percentage, lymphocyte percentage, and neutrophil/lymphocyte ratios in whole blood were significantly correlated with frozen results. As there are many examples in the literature [15][16][17][18][19], these parameters, which play a role in the inflammatory process, had data that could provide clues in the differentiation of benignborderline-malignant during surgery. We found that blood lymphocyte ratio, Ca-125, and neutrophil/lymphocyte ratio values have the most significant findings regarding the parameters that are the most predictive feature of the malignancy indicator.…”

Association of White Blood Cell Subtypes and Derived Ratios with a Mortality Outcome in Adult Patients with Polytrauma

“…The subtypes of WBCs may undergo relative changes under stress or systemic inflammation; thus, the derived ratios may also reflect the patients’ immune-inflammatory status and indicate their outcomes [ 9 , 10 ]. NLR, MLR, and PLR have been widely investigated as new inflammatory markers in many inflammatory, cardiovascular, and malignant diseases [ 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ], and have been thought to be simple, inexpensive, and easily assessed predictors.…”