Templeton Arnoud J, Ace Olga, McNamara Mairéad G, Al-Mubarak Mustafa, Vera-Badillo Francisco E, Hermanns Thomas, Seruga Boštjan, Ocaña Alberto, Tannock Ian F, Amir Eitan
Authors' Affiliations: Division of Medical Oncology and Hematology, Department of Medicine;
Department of Surgical Oncology, Department of Surgery, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada;
Cancer Epidemiol Biomarkers Prev. 2014 Jul;23(7):1204-12. doi: 10.1158/1055-9965.EPI-14-0146. Epub 2014 May 3.
Inflammation influences cancer development and progression. An elevated platelet to lymphocyte ratio (PLR), a marker of inflammation, has been linked to poor prognosis in several malignancies. Here, we quantify the prognostic impact of this biomarker.
A systematic review of databases was conducted to identify publications exploring the association of blood PLR and overall survival (OS) in solid tumors. Data were pooled in a meta-analysis. Pooled HRs for OS by disease group and by PLR cutoff groups were computed and weighted using generic inverse-variance and random-effect modeling.
Twenty studies comprising 12,754 patients were assessed. Cutoffs for PLR defining risk groups ranged from 150 to 300 and were dichotomous (12 studies; group 1) or split into three groups (<150/150-300/>300, 8 studies; group 2). Higher PLR was associated with significantly worse OS in group 1 [HR = 1.87; 95% confidence interval (CI, 1.49-2.34); P < 0.001] and with a nonsignificant association in group 2 (HR per higher category = 1.21; 95%CI, 0.97-1.50; P = 0.10). The size of effect of PLR on OS was greater for metastatic disease (HR[group 1] = 2.0; 95% CI, 1.6-2.7; HR[group 2] = 1.6; 95% CI, 1.1-2.4) than for early-stage disease (HR[group 1] = 1.5; 95% CI, 1.0-2.2; HR[group 2] = 1.0; 95% CI, 0.8-1.3). A significant association was observed for colorectal, hepatocellular, gastroesophageal, ovarian, and pancreatic carcinoma in group 1 and for colorectal cancers in group 2.
A high PLR is associated with worse OS in various solid tumors. Further research of its regulation and relevance in daily practice is warranted.
PLR is a readily available and inexpensive biomarker with independent prognostic value in solid tumors.
炎症影响癌症的发生和发展。血小板与淋巴细胞比值（PLR）升高作为一种炎症标志物，已与多种恶性肿瘤的不良预后相关。在此，我们量化了这一生物标志物的预后影响。
对数据库进行系统综述，以确定探索实体瘤中血液PLR与总生存期（OS）之间关联的出版物。数据汇总进行荟萃分析。通过疾病组和PLR临界值组计算OS的合并风险比（HR），并使用通用逆方差和随机效应模型进行加权。
评估了20项研究，共12754例患者。定义风险组的PLR临界值范围为150至300，分为二分法（12项研究；第1组）或分为三组（<150/150 - 300/>300，8项研究；第2组）。在第1组中，较高的PLR与显著更差的OS相关[HR = 1.87；95%置信区间（CI，1.49 - 2.34）；P < 0.001]，在第2组中关联不显著（每高一个类别HR = 1.21；95%CI，0.97 - 1.50；P = 0.10）。PLR对OS的影响大小在转移性疾病中（HR[第1组]= 2.0；95%CI，1.6 - 2.7；HR[第2组]= 1.6；95%CI，1.1 - 2.4）大于早期疾病（HR[第1组]= 1.5；95%CI，1.0 - 2.2；HR[第2组]= 1.0；95%CI，0.8 - 1.3）。在第1组中，结直肠癌、肝细胞癌、胃食管癌、卵巢癌和胰腺癌以及在第2组中的结直肠癌观察到显著关联。
高PLR与多种实体瘤中更差的OS相关。有必要进一步研究其在日常实践中的调节和相关性。
PLR是一种易于获得且廉价的生物标志物，在实体瘤中具有独立的预后价值。
