The prognostic role of neutrophils to lymphocytes ratio and platelet count in gastric cancer: A meta-analysis

Zhang, Xinji; Liu, Yonggang; Shi, Xiaojun; Chen, Xiaowu; Zhou, Dong; Zhu, Dajian

doi:10.1016/j.ijsu.2015.07.681

Cited by 90 publications

(60 citation statements)

References 34 publications

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“…Several clinical studies (7-10) have aimed to evaluate whether these interactions between white blood cells and platelets on one side and tumor cells on the other side may cause measurable alterations in blood parameters, as they are depicted in the complete blood count test. Furthermore, studies have attempted to detect any potential diagnostic and/or prognostic values of blood test parameters (7)(8)(9)(10). Parameters that have been examined regarding breast cancer include mean platelet volume, platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio.…”

Section: Discussionmentioning

confidence: 99%

“…White blood cells are key mediators in this response (2), in addition to platelets, which are involved in mechanisms promoting tumor growth and metastasis (4)(5)(6). Various white blood cell and platelet indices, including neutrophil-to-lymphocyte ratio, platelet count, mean platelet volume and platelet-to-lymphocyte ratio, have been reported as potential markers for predicting the progression or recurrence of disease and/or overall survival in several forms of cancer (7)(8)(9)(10). The present study aimed to investigate whether changes in white blood cell and platelet indices possess prognostic value regarding the development of distant metastases in patients with newly diagnosed breast cancer.…”

Section: Introductionmentioning

confidence: 99%

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White blood cell and platelet indices as prognostic markers in patients with invasive ductal breast carcinoma

et al. 2016

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Abstract.A growing body of evidence suggests that oncogenesis is associated with systemic inflammation. The present study investigated white blood cell and platelet indices, whose values change during the inflammatory response, in women with invasive ductal breast carcinoma. Preoperatively obtained white blood cell and platelet counts from 53 patients with early breast cancer, who developed systemic metastases over a mean follow-up period of 65 months, were analyzed and compared with those of a matching control group formed of 37 patients with the same characteristics, who remained recurrence-free during the same time period. Patients who developed distant metastasis had a significantly higher mean platelet volume and lower neutrophil count than patients who did not present with distant metastasis. Furthermore, time to distant metastasis development was longer in patients with a lower mean platelet volume, whilst patients with a lower neutrophil count had a shorter systemic disease-free time interval. However, receiver operating characteristic curve analysis demonstrated that these parameters provided moderate accuracy in predicting which patients may develop distant metastasis. No differences were detected between patient groups regarding additional parameters. Patients who developed systemic disease during a mean follow-up period of 65 months were observed to have an increased mean platelet volume and decreased neutrophil count preoperatively. These results indicate that such parameters may be of prognostic value in patients with breast cancer. Studies with a larger number of patients are required to further investigate this hypothesis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

White blood cell and platelet indices as prognostic markers in patients with invasive ductal breast carcinoma

et al. 2016

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“…The neutrophil-to-lymphocyte ratio (NLR), an index defined as the absolute neutrophil count divided by the absolute lymphocyte count, has attracted the interest of investigators as a potential systemic inflammatory marker [7, 8]. Moreover, the NLR has been identified as an independent prognostic factor in several cancers.…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis of the efficacy of the pretreatment neutrophil-to-lymphocyte ratio as a predictor of prognosis in renal carcinoma patients receiving tyrosine kinase inhibitors

Yao

Cheng

et al. 2016

Oncotarget

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The data on the impact of the neutrophil-to-lymphocyte ratio (NLR) in metastatic renal cell carcinoma (mRCC) patients receiving tyrosine kinase inhibitors (TKIs) are inconsistent. We therefore performed a meta-analysis to assess the prognostic value of pretreatment NLR in patients treated with TKIs for mRCC. We searched the Embase, Medline, PubMed, Cochrane and ISI Web of Knowledge to identify clinical studies that had evaluated the association between the pretreatment NLR and prognosis in mRCC patients. Prognostic outcomes included overall survival (OS) and progression-free survival (PFS). Nine studies encompassing a total of 1091 participants were included. We found that a high NLR was an effective prognostic marker of both OS (pooled HR: 1.93, 95% CI: 1.35-2.77; P = 0.0003) and PFS (pooled HR: 2.12, 95% CI: 1.42-3.17; P = 0.0002). Subgroup analysis revealed that studies reporting a NLR ≥ 3 showed a more significant effect of NLR on both OS (pooled HR: 2.50, 95% CI: 1.99-3.14; P = 0.0003) and PFS (pooled HR: 2.17, 95% CI: 1.26-3.75). This meta-analysis suggests that high pretreatment NLR is associated with a poor prognosis in mRCC patients receiving TKI treatment.

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“…The predictive role was lost for stage IV patients who received palliative surgery only [21]. Nineteen studies were subjected to meta-analysis by Xin-Ji et al [37]. Elevated NLR was associated with shorter overall (odds ratio (OR) …”

Section: Meta-analyses Of Nlr In Gastric Cancermentioning

confidence: 99%

“…Except the prognostic value to NLR, many aspects as the correlation with tumour morphology, type by Lauren classification, invasive properties of cancer, grade, intensity of angiogenesis and microvascular density have been targeted by low number of studies. Only few meta-analyses have been conducted [21,[35][36][37]. Few data are available on SIR parameters after treatment although it is known that post-chemotherapy NLR correlates with the response in patients with unresectable gastric cancer [38].…”

Section: Introductionmentioning

confidence: 99%

Systemic Inflammatory Reaction in Gastric Cancer: Biology and Practical Implications of Neutrophil to Lymphocyte Ratio, Glasgow Prognostic Score and Related Parameters

Štrumfa¹,

Bogdanova²,

Kalva³

et al. 2017

Gastric Cancer

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Gastric cancer induces systemic inflammatory reaction (SIR) manifesting with changes in counts of white blood cell fractions and concentrations of acute phase proteins, clotting factors and albumins. Thus, protein-based scores or blood cell ratios (neutrophil to lymphocyte ratio (NLR); platelet to lymphocyte ratio (PLR)) are used to evaluate SIR. SIR tests are biologically justified by multiple clinically important and fascinating events including bone marrow activation, development of immune-suppressing immature myeloid cells, generation of pre-metastatic niches and neutrophil extracellular trap formation from externalised DNA network in bidirectional association with platelet activation. Despite biological complexity, clinical SIR assessment is widely available, patient-friendly and economically feasible. Here we present concise review on NLR, PLR, Glasgow prognostic score and fibrinogen -parameters that have prognostic role regarding overall, cancer-free and cancer-specific survival in early and advanced cases. Tumour burden can be predicted helping in preoperative detection of serosal or lymph node involvement. Practical consequences abound, including selection of surgical approach in respect to tumour burden, adjustments in treatment intensity by prognosis or evaluation of chemotherapy response. The chapter also scrutinises main controversies including different cut-off levels. Future developments should include elaboration of complex scores as described here. SIR parameters should be wisely incorporated in patients' treatment.

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The prognostic role of neutrophils to lymphocytes ratio and platelet count in gastric cancer: A meta-analysis

Abstract: This meta-analysis suggests that elevated NLR and platelet count predict poor survival in patients with gastric cancer, and may provides some useful evidence for the clinical application of the two prognostic indicators in gastric cancer.

Cited by 90 publications

References 34 publications

White blood cell and platelet indices as prognostic markers in patients with invasive ductal breast carcinoma

White blood cell and platelet indices as prognostic markers in patients with invasive ductal breast carcinoma

Meta-analysis of the efficacy of the pretreatment neutrophil-to-lymphocyte ratio as a predictor of prognosis in renal carcinoma patients receiving tyrosine kinase inhibitors

Systemic Inflammatory Reaction in Gastric Cancer: Biology and Practical Implications of Neutrophil to Lymphocyte Ratio, Glasgow Prognostic Score and Related Parameters

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