Increased platelet-lymphocyte ratio closely relates to inferior clinical features and worse long-term survival in both resected and metastatic colorectal cancer: an updated systematic review and meta-analysis of 24 studies

Chen, Nan; Li, Wanling; Huang, Kexin; Yang, Wenhao; Huang, Lin; Cong, Tianxin; Li, Qingfang; Meng, Qingcai

doi:10.18632/oncotarget.16020

Cited by 40 publications

(37 citation statements)

References 54 publications

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“…Some pooled studies explored the prognostic role of PLR in CRC and reported that elevated PLR was significantly associated with poor prognosis [ 30 , 31 ]. Our study was based on the northern Chinese population and had some new findings.…”

Section: Discussionmentioning

confidence: 99%

Prognostic evaluation of platelet to lymphocyte ratio in patients with colorectal cancer

Gao

Yang

et al. 2017

Oncotarget

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Growing evidence indicates that inflammation plays an important role in cancer progression and prognosis; however, the prognostic role of platelet to lymphocyte ratio (PLR) in colorectal cancer (CRC) is unknown. A cohort of 1845 CRC patients from the Department of Surgical Oncology at The First Hospital of China Medical University (CMU-SO) was retrospectively analyzed. Harrell’s concordance index (c-index) was used to determine the optimal cut-off value of PLR and evaluate its predictive ability. Our results from CMU-SO indicated that the overall survival (OS) rate was significantly lower in the high-PLR group compared with the low-PLR group (P = 0.001). A similar result was observed for the cancer-specific survival (CSS) rate between these two groups (P = 0.001). The multivariate analysis indicated that high PLR was an independent prognostic indicator of poor OS (hazard ratio [HR] = 1.356, 95% confidence interval [CI] = 1.117–1.647, P = 0.002) and CSS (HR = 1.364, 95% CI = 1.111–1.675, P = 0.003). In addition, the c-indexes of TNM staging combined with PLR were greater than those of TNM staging alone (OS: 0.768 vs. 0.732; CSS: 0.785 vs. 0.746). In conclusion, elevated PLR is a negative prognostic indicator of CRC and may serve as an additional index of the current TNM staging system for predicting CRC.

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Section: Discussionmentioning

confidence: 99%

Prognostic evaluation of platelet to lymphocyte ratio in patients with colorectal cancer

Gao

Yang

et al. 2017

Oncotarget

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“…Using lymphocytes and monocytes as surrogate markers of tumor microenvironment and inflammatory responses, more and more studies have found that elevated absolute monocyte count (AMC), decreased absolute lymphocyte count (ALC), and the absolute lymphocyte to absolute monocyte count ratio (LMR) are predictors of various solid tumors, such as breast carcinoma, ovarian cancer, clonal cancer, and lung cancer, and similar findings have also been demonstrated in diffuse large B‐cell lymphoma (DLBCL) and classical Hodgkin's lymphoma (cHL) . In addition, parameters such as neutrophil‐lymphocyte ratio (NLR) and platelet‐lymphocyte ratio (PLR) have also exhibited prognostic activity in recent studies, although there were conflicting results . In the present study, the role of LMR, NLR, and PLR in the setting of adult T‐LBL was first discussed.…”

Section: Introductionmentioning

confidence: 87%

Complete Blood Count Score Model Integrating Reduced Lymphocyte-Monocyte Ratio, Elevated Neutrophil-Lymphocyte Ratio, and Elevated Platelet-Lymphocyte Ratio Predicts Inferior Clinical Outcomes in Adult T-Lymphoblastic Lymphoma

Feng

et al. 2019

The Oncologist

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Background T‐lymphoblastic lymphoma (T‐LBL) is a highly aggressive neoplasm of lymphoblasts of T‐cell origin. Although promising improvements have been recently achieved, one third of patients experience relapse or refractory T‐LBL. Therefore, optimal strategies for identifying high‐risk patients are urgently needed. Materials and Methods In the present study, 75 newly diagnosed adult patients (aged ≥15 years) with T‐LBL were identified and the predictive value of complete blood count (CBC) abnormalities, including lymphocyte‐monocyte ratio (LMR), neutrophil‐lymphocyte ratio (NLR), and platelet‐lymphocyte ratio (PLR) on clinical outcomes, was analyzed. Results Using the receiver operating characteristic curve to determine the best cutoff values based on survival, it was found that patients with T‐LBL with LMR ≤2.8, NLR ≥3.3, and PLR ≥200 had both inferior progression‐free survival (PFS) and inferior overall survival (OS), in which the differences were much more remarkable in the international prognostic index score 0–2 subgroup. In the multivariable analysis, NLR ≥3.3 together with age >40 years and central nervous system (CNS) involvement were identified to be independently associated with shortened PFS, whereas PLR ≥200 and CNS involvement were identified to be independent risk factors for OS. LMR, NLR, and PLR were integrated to generate a “CBC score” model, which well separated adult patients with T‐LBL into three risk groups, and the 3‐year OS was 84%, 53%, and 30% for low‐, intermediate‐, and high‐risk patients, respectively. Conclusion Overall, a “CBC score” model was initially promoted for stratification in adult patients with T‐LBL using simple, widely available, and easy to interpret parameters in the largest adult T‐LBL cohort to date. Implications for Practice Optimal strategies for identifying high‐risk patients with T‐lymphoblastic lymphoma (T‐LBL) are urgently needed. In the largest adult T‐LBL cohort to date, simple, inexpensive, widely available parameters were applied and revealed that patients with lymphocyte‐monocyte ratio (LMR) ≤2.8, neutrophil‐lymphocyte ratio (NLR) ≥3.3, and platelet‐lymphocyte ratio (PLR) ≥200 had both inferior progression‐free survival and inferior overall survival (OS), in which the differences were much more remarkable in the international prognostic index score 0–2 subgroup. LMR, NLR, and PLR were integrated to generate a “complete blood count score” model, in which the 3‐year OS was 84%, 53%, and 30% for low‐, intermediate‐, and high‐risk patients, respectively.

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“…Another extensively studied marker of systemic inflammation is PLR. Several publications state an association between elevated PLR and worse prognosis in CRC patients, namely, OS, CSS, disease-free and recurrence-free survival (50)(51)(52) in both localized and metastatic disease. There are several known mechanisms for increased PLR in cancer patients.…”

Section: Systemic Inflammation Markers In Crcmentioning

confidence: 99%

Systemic and local inflammation in colorectal cancer

Rumba¹,

Cipkina²,

Cukure³

et al. 2019

AML

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Background. Colorectal cancer (CRC) is the third most common cancer in the world. The cornerstone of CRC treatment is surgical resection. However, patients in the same TNM stage show different recurrence rates and survival. Of patients with a local disease without lymph node or a distant metastasis, 20–25% still develop recurrence. There is evidence that inflammatory reaction is one of the key elements in tumour development. Materials and methods. We reviewed literature on colorectal cancer and its relationships with the immune system, with special focus on local and systemic inflammatory reaction. The Pubmed and ClinicalKey databases were searched using the key words colorectal cancer, local inflammation, systemic inflammation, markers of inflammation. The relevant literature was reviewed and included in the article. Results. The immune system has two-sided relationships with cancer, so it not only performs anti-tumour activities, but can also promote tumour growth and spread. Research has shown that signs of local inflammation are associated with a better prognosis in CRC. Systemic inflammation has been associated with more aggressive behaviour and a worse prognosis for patients with several cancers, including CRC. Conclusions. Recent findings in tumour biology have improved our understanding of colorectal cancer and of the natural course of this disease. Several markers of local and systemic inflammatory reaction have been identified. The next step is to find the most accurate and applicable marker, so that this promising tool can be used in clinical practice and aid in decision making.

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Increased platelet-lymphocyte ratio closely relates to inferior clinical features and worse long-term survival in both resected and metastatic colorectal cancer: an updated systematic review and meta-analysis of 24 studies

Cited by 40 publications

References 54 publications

Prognostic evaluation of platelet to lymphocyte ratio in patients with colorectal cancer

Prognostic evaluation of platelet to lymphocyte ratio in patients with colorectal cancer

Complete Blood Count Score Model Integrating Reduced Lymphocyte-Monocyte Ratio, Elevated Neutrophil-Lymphocyte Ratio, and Elevated Platelet-Lymphocyte Ratio Predicts Inferior Clinical Outcomes in Adult T-Lymphoblastic Lymphoma

Systemic and local inflammation in colorectal cancer

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