Prognostic significance of neutrophil lymphocyte ratio in patients with gastric cancer: a meta-analysis

PLoS One. 2014 Nov 17;9(11):e111906. doi: 10.1371/journal.pone.0111906. eCollection 2014.

Abstract

Background: Several studies have shown that neutrophil lymphocyte ratio (NLR) may be associated with the prognosis of gastric cancer (GC), but the results are controversial.

Methods: This study was performed to evaluate the prognostic implications of neutrophil lymphocyte ratio of GC in all available studies. We surveyed 2 medical databases, PubMed and EMBASE, to identify all relevant studies. Data were collected from studies comparing overall survival (OS), disease-free survival (DFS) and progression-free survival (PFS) in patients with GC.

Results: Ten studies (n = 2,952) evaluated the role of NLR as a predictor of outcome were involved for this meta-analysis (10 for OS, 3 for DFS, and 2 for PFS). Overall and disease-free survival were significantly better in patients with low NLR value and the pooled HRs was significant at 1.83 ([95% CI], 1.62-2.07) and 1.58 ([95% CI], 1.12-2.21), respectively. For progression-free survival, the pooled hazard ratio of NLR was significant at 1.54 ([95% CI], 1.22-1.95). No evidence of significant heterogeneity or publication bias for OS and DFS was seen in any of the included studies.

Conclusion: This meta-analysis indicated that elevated NLR may be associated with a worse prognosis for patients with GC.

Publication types

  • Meta-Analysis

MeSH terms

  • Humans
  • Leukocyte Count*
  • Lymphocytes*
  • Neutrophils*
  • Patient Outcome Assessment
  • Prognosis
  • Publication Bias
  • Stomach Neoplasms / blood*
  • Stomach Neoplasms / mortality*

Grants and funding

The authors have no support or funding to report.