Platelet-lymphocyte ratio is a prognostic marker in small cell lung cancer-A systemic review and meta-analysis

Hongbin Zhou; Jiuke Li; Yiting Zhang; Zhewen Chen; Ying Chen; Sa Ye

doi:10.3389/fonc.2022.1086742

Platelet-lymphocyte ratio is a prognostic marker in small cell lung cancer-A systemic review and meta-analysis

Front Oncol. 2023 Jan 13:12:1086742. doi: 10.3389/fonc.2022.1086742. eCollection 2022.

Authors

Hongbin Zhou¹, Jiuke Li², Yiting Zhang³, Zhewen Chen⁴, Ying Chen⁴, Sa Ye⁴

Affiliations

¹ Cancer Center, Department of Pulmonary and Critical Care Medicine, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.
² Department of Ophthalmology, Hangzhou Aier Eye Hospital, Hangzhou, Zhejiang, China.
³ Department of Pulmonary and Critical Care Medicine, Xianju People's Hospital, Taizhou, Zhejiang, China.
⁴ Center for General Practice Medicine, Department of Clinical Nutrition, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, China.

Abstract

Aim: The aim of this study was to evaluate the relationship between platelet-lymphocyte ratio (PLR) and prognosis in small cell lung cancer (SCLC) patients.

Method: A comprehensive search was carried out to collect related studies. Two independent investigators extracted the data of hazard ratio (HR) and 95% confidence interval (CI) for overall survival (OS) or progression-free survival (PFS). A random-effect model was applied to analyze the effect of different PLR levels on OS and PFS in SCLC patients. Moreover, subgroup analysis was conducted to seek out the source of heterogeneity.

Results: A total of 26 articles containing 5,592 SCLC patients were included for this meta-analysis. SCLC patients with a high PLR level had a shorter OS compared with patients with a low PLR level, in both univariate (HR = 1.56, 95% CI 1.28-1.90, p < 0.0001) and multivariate (HR = 1.31, 95% CI 1.08-1.59, p = 0.007) models. SCLC patients with a high PLR level had a shorter PFS compared with patients with a low PLR level, in the univariate model (HR = 1.71, 95% CI 1.35-2.16, p < 0.0001), but not in the multivariate model (HR = 1.17, 95% CI 0.95-1.45, p = 0.14). Subgroup analysis showed that a high level of PLR shortened OS in some subgroups, including the Asian subgroup, the younger subgroup, the mixed-stage subgroup, the chemotherapy-dominant subgroup, the high-cutoff-point subgroup, and the retrospective subgroup. PLR level did not affect OS in other subgroups.

Conclusion: PLR was a good predictor for prognosis of SCLC patients, especially in patients received chemotherapy dominant treatments and predicting OS.

Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42022383069.

Keywords: overall survival (OS); platelet–lymphocyte ratio (PLR); prognosis; progression-free survival (PFS); small cell lung cancer (SCLC).

Publication types

Systematic Review

Grants and funding

This work was supported by grants from the Medical Science and Technology Project of Zhejiang Province (Nos. 2019RC011 and 2020KY012), the Research Project of Zhejiang Province Public Welfare Technology Application (No. LGC21H160004), the Scientific Research Fund of Zhejiang Provincial Education Department (No. Y202146109), and Science and Technology Plan Project of Taizhou (No. 22ywb166).