Prognostic value of platelet-to-lymphocyte ratio in pancreatic cancer: a comprehensive meta-analysis of 17 cohort studies
Authors Zhou Y, Cheng S, Fathy AH, Qian H, Zhao Y
Received 15 October 2017
Accepted for publication 9 January 2018
Published 5 April 2018 Volume 2018:11 Pages 1899—1908
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Geoffrey Pietersz
Yongping Zhou,1 Sijin Cheng,2 Abdel Hamid Fathy,2 Haixin Qian,3 Yongzhao Zhao1,2
1Department of Hepatobiliary, Wuxi Second Hospital, Nanjing Medical University, Wuxi, China; 2Tongji University School of Medicine, Shanghai, China; 3Department of Hepatobiliary, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
Background and aims: Several studies were conducted to explore the prognostic value of platelet-to-lymphocyte ratio (PLR) in pancreatic cancer and have reported contradictory results. This study aims to summarize the prognostic role of PLR in pancreatic cancer.
Materials and methods: Embase, PubMed and Cochrane Library were completely searched. The cohort studies focusing on the prognostic role of PLR in pancreatic cancer were eligible. The overall survival (OS) and progression-free survival (PFS) were analyzed.
Results: Fifteen papers containing 17 cohort studies with pancreatic cancer were identified. The results showed patients that with low PLR might have longer OS when compared to the patients with high PLR (hazard ratio=1.28, 95% CI=1.17–1.40, P<0.00001; I2=42%). Similar results were observed in the subgroup analyses of OS, which was based on the analysis model, ethnicity, sample size and cut-off value. Further analyses based on the adjusted potential confounders were conducted, including CA199, neutrophil-to-lymphocyte ratio, modified Glasgow Prognostic Score, albumin, C-reactive protein, Eastern Cooperative Oncology Group, stage, tumor size, nodal involvement, tumor differentiation, margin status, age and gender, which confirmed that low PLR was a protective factor in pancreatic cancer. In addition, low PLR was significantly associated with longer PFS when compared to high PLR in pancreatic cancer (hazard ratio=1.27, 95% CI=1.03–1.57, P=0.03; I2=33%).
Conclusion: In conclusion, it was found that high PLR is an unfavorable predictor of OS and PFS in patients with pancreatic cancer, and PLR is a promising prognostic biomarker for pancreatic cancer.
Keywords: platelet-to-lymphocyte ratio, pancreatic cancer, prognostic, progression-free survival, overall survival, biomarker
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