Prognostic Value of Peripheral Whole Blood Cell Counts Derived Indexes in Gallbladder Carcinoma: A Systematic Review and Meta-Analysis

Abstract

BackgroundGallbladder carcinoma (GBC) is a rare gastrointestinal malignancy with poor prognosis. Adequate pre-treatment prediction of survival is essential for risk stratification and patient selection for aggressive surgery or adjuvant therapeutic strategy. Whole blood cell count (WBCC) derived indexes are broadly used as prognosticative biomarkers in various cancer types, but their utility in GBC needs to be validated.MethodsAn extensive literature review was conducted in line with PRISMA guideline until June 31 2020, to identify original studies concerning WBCC-derived indexes as prognostic indicators in GBC. All relative parameters were extracted and pooled for statistical analyses.ResultsFourteen studies incorporating 2,324 patients were included with a high quality and low risk of biases. All 14 studies evaluated the prognostic value of NLR showing a significant correlation with OS in GBC patients (HR = 1.94, P <0.001). Elevated NLR was revealed to correlate with TNM stage (stages III and IV, OR = 4.65, P <0.001), tumor differentiation (OR = 2.37, P <0.042), CA 19-9 (SMD = 0.47, P = 0.01), but no significance was found with age, sex and CEA. Positive indicative value of MLR and PLR were also confirmed with a HR of 2.06 (P <0.001) and 1.34 (P <0.001), respectively.ConclusionThe WBCC-derived indexes including NLR, MLR/LMR and PLR were validated to be useful prognostic parameters for predicting survival outcomes in GBC patients. These series of indexes, especially NLR, could improve risk stratification and facilitate better patient selection for surgical resection or aggressive chemotherapy in the decision making of GBC patients.

Haematologic biomarkers and survival in gallbladder cancer: a systematic review and meta-analysis

“…Our results are consistent with the previous meta-analysis showing the prognostic value of NLR on resected gallbladder cancer by Saqib et al [ 49 ] and the prognostic role of NLR, PLR and MLR among gallbladder cancer patients in the meta-analysis conducted by Xu et al [ 38 ]. We obtained lower I 2 values when Asian studies were analysed separately, which can partly explain the ethnicity and cut-off values as sources of heterogeneity.…”

“…To our knowledge, this is the first meta-analysis evaluating the prognostic significance of pretreatment PC and SII on gallbladder cancer. In addition, we updated the meta-analysis by Xu et al [ 38 ] on NLR, PLR and MLR.…”

Nomogram Based on Inflammatory Biomarkers to Predict the Recurrence of Hepatocellular Carcinoma—A Multicentre Experience

“…10,11 SIRI and ANRI are both comprehensive haematological indices of inflammation. 27 Their effective prediction capacities for survival and tumour recurrence have been extensively validated in many solid tumours, such as lung cancer, 28 gallbladder cancer 27 and pancreatic cancer. 21 In our research, the performance of these inflammatory indicators was indeed outstanding in predicting recurrence-free survival of HBV-HCC with curative resection.Cancer-associated inflammation plays a crucial role in the tumorigenesis, progression and survival of patients with HCC.…”

Whole blood microRNAs capture systemic reprogramming and have diagnostic potential in patients with biliary tract cancer

“…Elevation of whole blood counts, hepatobiliary function or general/inflammatory markers alone did not provide robust diagnostic information. However, incorporation of routine clinical features into combined nomograms has shown prognostic potential in BTC [13,32]. Further development of whole blood miRNA indexes as candidate diagnostic tools for BTC may benefit from machine learning approaches to incorporate them into nomograms alongside routine clinical and systemic features, as well as inflammatory markers (e.g.…”