Prognostic role of neutrophil to lymphocyte ratio in lung cancers: a meta-analysis including 7,054 patients

• Published in: OncoTargets and therapy Vol. 8; pp. 2731 - 2738
• Main Authors: Zhao, Qing-Tao, Yang, Yong, Xu, Shun, Zhang, Xiao-Peng, Wang, Hui-En, Zhang, Hua, Wang, Zhi-Kang, Yuan, Zheng, Duan, Guo-Chen
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2015; Taylor & Francis Ltd; Dove Medical Press
• Subjects: Cancer therapies; Chemotherapy; Clinical trials; Confidence intervals; Hospitals; Inflammation; Lung cancer; Lymphocytes; Management; Measurement; Medical prognosis; Meta-analysis; Methods; Neutrophils; Original Research; Prognosis; Studies; Surgery; Thoracic surgery; United States > US; China; Japan; lung cancer; meta-analysis; NLR; prognosis
• ISSN: 1178-6930; 1178-6930
• DOI: 10.2147/OTT.S90875

Neutrophil to lymphocyte ratio (NLR) has recently been reported to be a poor prognostic indicator in lung cancer. However, the prognostic value of the NLR in patients with lung cancer still remains controversial. We performed a meta-analysis to evaluate the prognostic value of NLR in patients with lung cancer. We performed a comprehensive literature search in PubMed, Ovid, the Cochrane Library, and Web of Science databases in May 2015. Studies were assessed for quality using the Newcastle-Ottawa Scale. Twenty-two studies with a total of 7,054 patients were included in this meta-analysis. The meta-analysis was performed to generate combined hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS). Our analysis results indicated that high NLR predicted poorer OS (HR, 1.51; 95% confidence interval [CI], 1.33-1.71; P<0.001) and PFS (HR, 1.33; 95% CI, 1.07-1.67; P=0.012) in patients with lung cancer. High NLR was also associated with poor OS in lung cancer treated by surgical resection (HR, 1.59; 95% CI, 1.26-1.99; P<0.001) and chemotherapy (HR, 1.15; 95% CI, 1.08-1.22; P<0.001). In addition, NLR cut-off value =5 (HR, 1.57; 95% CI, 1.16-2.12; P=0.003) and NLR cut-off value <5 (HR, 1.47; 95% CI, 1.28-1.69; P<0.001). This meta-analysis result suggested that NLR should have significant predictive ability for estimating OS and PFS in patients with lung cancer and may be as a significant biomarker in the prognosis of lung cancer.