Prognostic value of systemic inflammatory markers in ovarian Cancer: a PRISMA-compliant meta-analysis and systematic review

BMC Cancer. 2018 Apr 18;18(1):443. doi: 10.1186/s12885-018-4318-5.

Abstract

Background: The prognostic effect of elevated systemic inflammatory markers, including neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), remains controversial in cancer patients. This meta-analysis was conducted to evaluate the predictive values of these markers for prognoses in ovarian cancer patients.

Methods: Potentially relevant publications in PubMed, ISI Web of Science, and EBSCO were searched. Pooled hazard ratios (HRs) and corresponding 95% confidence intervals (95% CIs) for overall survival (OS) and progression-free survival (PFS) were determined using a fixed or random effects model.

Results: Ten studies involving 2919 patients were included in this meta-analysis. In multivariate analysis, the group with higher NLR had worse OS (HR = 1.34, 95% CI = 1.16-1.54) and shorter PFS (HR = 1.36, 95% CI = 1.17-1.57) than the control group. Furthermore, PLR values higher than the cut-off were associated with not only poorer OS (HR = 1.97, 95% CI = 1.61-2.40) but also more unfavorable PFS (HR = 1.79, 95% CI = 1.46-2.20). Univariate analysis also indicated the same results. Additionally, subgroup analysis showed that when the cut-off values for NLR and PLR were higher, their predictive effects became stronger.

Conclusion: This comprehensive meta-analysis suggested that the values of inflammatory markers such as NLR and PLR were associated with ovarian cancer survival. Therefore, inflammatory markers can potentially serve as prognostic biomarkers.

Keywords: Inflammatory markers; Neutrophil-lymphocyte ratio; Ovarian cancer; Platelet-lymphocyte ratio; Prognosis.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Biomarkers
  • Female
  • Humans
  • Inflammation Mediators / metabolism*
  • Leukocyte Count
  • Lymphocyte Count
  • Lymphocytes
  • Neutrophils
  • Ovarian Neoplasms / blood
  • Ovarian Neoplasms / metabolism*
  • Ovarian Neoplasms / mortality*
  • Platelet Count
  • Prognosis
  • Proportional Hazards Models
  • Publication Bias

Substances

  • Biomarkers
  • Inflammation Mediators