Prognostic significance of peripheral blood‐derived neutrophil/lymphocyte ratio in patients with digestive cancer

Abstract

Accumulating studies reported the clinical value of derived neutrophil/lymphocyte ratio (dNLR) regarding the prediction of survival outcomes in digestive cancers, however, the prognostic significances of dNLR in these cancers were inconsistent. This study was carried out to clarify the relationship between circulating dNLR and prognosis in gastrointestinal (GI) cancers. Eligible publications were collected and extracted by searching Pubmed, Embase, Web of Science, and Google Scholar up to November 21, 2018. The prognostic impact of dNLR in subjects with GI cancers was assessed with the overall hazard ratios (HRs). A total of 26 studies with up to 13,945 participants were recruited. Our findings showed that peripheral blood dNLR before treatment could be a useful prognostic predictor in digestive cancers, an elevated dNLR indicated a shorter overall survival (OS) in GI tumors (HR, 1.44; 95% confidence interval [CI], 1.36-1.51).Furthermore, its significant prognostic value for OS was also confirmed in subgroup analyses stratified by disease type, publication year, type of research, detection method, geographic location, cut-off value, treatment, analysis type, follow-up time and disease stage. In addition, high dNLR was significantly associated with worse cancer-specific survival (HR, 1.25; 95% CI, 1.04-1.47) and inferior event-free survival (HR, 1.22; 95% CI, 1.11-1.33) in patients with digestive cancers. Our study showed elevated peripheral blood dNLR may indicate unfavorable outcomes in digestive cancer.

The Prognostic Value of a Derived Neutrophil-Lymphocyte Ratio in Patients With Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

“…Therefore, the WBC count minus the neutrophil count is primarily lymphocytes. 27 Neutrophils have a major role in the inflammatory process, and the lymphocyte count is a regulatory pathways marker. Classical and generally accepted proinflammatory cytokines, such as IL-6, IL-8, tumor necrosis factor-a (TNF-a), may trigger neutrophil extracellular traps (NET) formation.…”

“…Proctor et al initially defined dNLR as the neutrophil count divided by the (WBC count-neutrophil count). 26 Numerous studies regarded dNLR as an inflammation marker that reflected the severity of systematic inflammation in cancers, such as non-small cell lung cancer, 21 gastrointestinal cancer, 27 and breast cancer, 28 but the roles of dNLR in ACS have not yet been established. Interestingly, a possible association between an increased dNLR and high short-term mortality in heart failure patients with a reduced ejection fraction was reported.…”

Analysis of preoperative nutrition, immunity and inflammation correlation index on the prognosis of upper tract urothelial carcinoma surgical patients: a retrospective single center study

“…dNLR is a new indicator found in recent studies, and it simultaneously contains the most representative in ammatory immune cells, such as leukocytes, neutrophils, lymphocytes, and monocytes. It has been reported that it is related to the prognosis of various tumors, such as urinary tumors (Liu F et al 2019) and gastrointestinal tumors (Ou W, et al 2016). LDH is a key enzyme for the conversion of pyruvic acid into lactic acid during glycolysis and is also an enzyme necessary for maintaining anaerobic glycolysis in tumors (Faloppi L et al 2016).…”

The Optimal Cutoff Value of Neutrophil/Lymphocyte Ratio in Severe Grades of Diabetic Retinopathy Short Title: NLR in Diabetic Retinopathy

“…It has also been shown that an elevated NLR is an independent risk factor for coronary artery diseases in asymptomatic patients (15). Furthermore, it has been demonstrated that the NLR can be a potential prognostic indicator for many cancers, such as digestive cancer or malignant melanoma (16,17). Numerous studies in the literature have examined the relationship between the NLR and systemic inflammation-related diseases.…”