The clinical use of the platelet/lymphocyte ratio and lymphocyte/monocyte ratio as prognostic predictors in colorectal cancer: a meta-analysis

Abstract

BackgroundConflicting evidence exists regarding the effects of platelet/lymphocyte ratio (PLR) and lymphocyte/monocyte ratio(LMR) on the prognosis of colorectal cancer (CRC) patients. This study aimed to evaluate the roles of the PLR and LMR in predicting the prognosis of CRC patients via meta-analysis.MethodsEligible studies were retrieved from the PubMed, Embase,andChina National Knowledge Infrastructure (CNKI) databases, supplemented by a manual search of references from retrieved articles. Pooled hazard ratios (HR) with 95% confidence intervals (95% CI) were calculated using the generic inverse variance and random-effect model to evaluate the association of PLR and LMR with prognostic variables in CRC, including overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS).ResultsThirty-three studies containing 15,404 patients met criteria for inclusion. Pooled analysis suggested that elevated PLR was associated with poorer OS (pooled HR = 1.57, 95% CI: 1.41 – 1.75, p< 0.00001, I2=26%) and DFS (pooled HR = 1.58, 95% CI: 1.31 – 1.92, p< 0.00001, I2=66%). Conversely, high LMR correlated with more favorable OS (pooled HR = 0.59, 95% CI: 0.50 – 0.68, p< 0.00001, I2=44%), CSS (pooled HR = 0.54, 95% CI: 0.40 – 0.72, p< 0.00001, I2=11%) and DFS (pooled HR = 0.82, 95% CI: 0.71– 0.94,p=0.005, I2=29%).ConclusionsElevated PLR was associated with poor prognosis, while high LMR correlated with more favorable outcomes in CRC patients. Pretreatment PLR and LMR could serve as prognostic predictors in CRC patients.

The prognostic value of the systemic inflammatory score in patients with unresectable metastatic colorectal cancer

“…The AUC of the ROC curve for the LMR and the serum albumin concentration were relatively low, despite both markers having been reported to be useful prognostic markers in many previous reports (5,6,16). We thought that the small number of cases was the reason for the low AUC.…”

“…Inflammation is known to contribute to cancer progression (1,2), and several inflammatory markers, such as the neutrophil-to-lymphocyte ratio (NLR), the lymphocyte-to-monocyte ratio (LMR) and the Glasgow prognostic score (GPS) have been reported to be associated with clinical outcomes in patients with various types of cancer, including colorectal cancer (3)(4)(5)(6)(7)(8). Recently, a new inflammatory marker, the systemic inflammatory score (SIS), based on the combination of the LMR and the serum albumin concentration has been reported to be a useful prognostic marker in patients with clear-cell renal cell carcinoma, colorectal cancer and oral cavity squamous cell carcinoma (9)(10)(11).…”

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

“…Kim et al [18] declared the predictive power of the NLR and PLR in GC patients. Two other meta-analyses investigated the correlations of the PLR with clinicopathologic characteristics, morbidity, and mortality in colorectal cancer patients [19,20]. Growing data and studies about inflammatory markers and prognosis in GC patients indicate the use of these markers as predictors [3,[6][7][8].…”

Association between body composition measured by bioelectrical impedance analysis and platelet-to-lymphocyte ratio in colorectal cancer

“…The PLR was calculated as the absolute count of platelets divided by the absolute count of lymphocytes. Patients were divided into the low and high PLR groups using a cutoff value of 150 [9]. In addition, other inflammation-based prognostic scores were calculated (prognostic nutritional index [PNI]: 10 × serum albumin concentration (g/dL)+0.005 × absolute lymphocyte count; neutrophil lymphocyte ratio [NLR]: absolute neutrophil count/absolute lymphocyte count).…”