Prognostic Role of Neutrophil-to-Lymphocyte Ratio in Solid Tumors: A Systematic Review and Meta-Analysis

Abstract

A high NLR is associated with an adverse OS in many solid tumors. The NLR is a readily available and inexpensive biomarker, and its addition to established prognostic scores for clinical decision making warrants further investigation.

Invasive breast cancer reprograms early myeloid differentiation in the bone marrow to generate immunosuppressive neutrophils

“…The role of neutrophils in human cancer has just begun to emerge, but a strong relationship between an increase in circulating neutrophils, referred to as a high neutrophil-to-lymphocyte ratio (NLR), and poor prognosis has been reported for decades; however, only recently were these reports compiled in a meta-analysis and shown to be an independent prognostic factor for poor survival in solid tumor cancers in more than 100 studies and 40,000 patients (54). In mice, tumor-associated neutrophils (TANs) and immunosuppressive neutrophils (PMN-MDSCs) promote tumor progression and metastasis by T cell-dependent and independent mechanisms, including promoting angiogenesis and remodeling of the extracellular matrix (55).…”

Utility of preoperative neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios to distinguish malignant from benign ovarian masses

“…However, neutrophilia involving immune cells as an inflammatory response against cancer will suppress the cytotoxic activities of lymphocytes and natural killer cells, thereby hindering the immune response (20). NLR reflects these inflammatory changes and therefore may be a useful prognostic marker for cancers with no reliable marker (21). NLR can help predict the prognosis of patients with ovarian cancer.…”

The Interplay Between Neutrophils and CD8+ T Cells Improves Survival in Human Colorectal Cancer

“…However, clinical and prognostic relevance of granulocyte infiltration in human cancers is debated (1)(2)(3). A number of studies suggest that high granulocyte/lymphocyte ratios in peripheral blood are associated with poor prognosis in different malignancies (4). Furthermore, myeloid cells of the granulocytic lineage at different maturation stages were shown to represent sizeable subsets of myeloid-derived suppressor cells (MDSC), promoting tumor growth and inhibiting cancer-specific adaptive responses (5).…”