OncoTargets and Therapy (Sep 2015)

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

  • Zhao QT,
  • Yang Y,
  • Xu S,
  • Zhang XP,
  • Wang HE,
  • Zhang H,
  • Wang ZK,
  • Yuan Z,
  • Duan GC

Journal volume & issue
Vol. 2015, no. default
pp. 2731 – 2738

Abstract

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Qing-Tao Zhao,1 Yong Yang,2 Shun Xu,3 Xiao-Peng Zhang,1 Hui-En Wang,1 Hua Zhang,1 Zhi-Kang Wang,1 Zheng Yuan,1 Guo-Chen Duan11Department of Thoracic Surgery, Hebei General Hospital, Shijiazhuang, Hebei, 2Department of General Surgery, Sujiatun Central Hospital, 3Department of Thoracic Surgery, The First Affiliated Hospital, China Medical University, Shenyang, Liaoning, People’s Republic of ChinaBackground: 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.Methods: 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.Results: 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).Conclusion: 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.Keywords: NLR, lung cancer, prognosis, meta-analysis