Marchioni Michele, Primiceri Giulia, Ingrosso Manuela, Filograna Roberta, Castellan Pietro, De Francesco Piergustavo, Schips Luigi
Department of Urology, SS. Annunziata Hospital, "G.D'Annunzio" University of Chieti, Chieti, Italy.
Department of Urology, SS. Annunziata Hospital, "G.D'Annunzio" University of Chieti, Chieti, Italy.
Clin Genitourin Cancer. 2016 Dec;14(6):473-484. doi: 10.1016/j.clgc.2016.04.008. Epub 2016 Apr 22.
The neutrophil to lymphocyte ratio (NLR) is an inflammatory index that has been considered as a potential prognostic factor in human cancer. The aim of this study was to evaluate the available evidence regarding the NLR as a prognostic value in patients affected by urothelial cancer. This literature review, including papers on NLR in urothelial cancers, was done on PubMed/Medline and Cochrane libraries in November 2015. The selection of the articles followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses process. Twenty-three of 99 articles fulfilled all the inclusion criteria, including data on 6240 patients affected by urothelial cancers. Overall, cancer-specific, and recurrence-free survival were evaluated as the main oncological outcomes. There was significant heterogeneity among studies, and the majority of studies were of poor quality. Overall, NLR was considered as a prognostic marker in 87.5%, 80%, and 60% of the studies on upper tract urothelial cancer, urothelial bladder cancer, and metastatic and advanced disease, respectively. The NLR cut-off value ranged between 2 and 5. A high NLR was associated with worse overall, cancer-specific, and recurrence-free survival. NLR is a widely available, easy-to-collect, costless, prognostic marker in urothelial cancers. Its clinical use still remains under investigation, especially for the need for cut-off values, particularly in different subsets of patients.
中性粒细胞与淋巴细胞比值（NLR）是一种炎症指标，被认为是人类癌症潜在的预后因素。本研究的目的是评估有关NLR作为尿路上皮癌患者预后价值的现有证据。2015年11月，在PubMed/Medline和Cochrane图书馆对包括尿路上皮癌中NLR相关论文在内的文献进行了综述。文章的选择遵循系统评价和Meta分析的首选报告项目流程。99篇文章中有23篇符合所有纳入标准，包括6240例尿路上皮癌患者的数据。总体而言，将癌症特异性生存率和无复发生存率作为主要肿瘤学结局进行评估。各研究之间存在显著异质性，且大多数研究质量较差。总体而言，在上尿路尿路上皮癌、膀胱尿路上皮癌以及转移性和晚期疾病的研究中，分别有87.5%、80%和60%的研究将NLR视为预后标志物。NLR的临界值在2至5之间。高NLR与较差的总体生存率、癌症特异性生存率和无复发生存率相关。NLR是尿路上皮癌中一种广泛可用、易于收集、成本低廉的预后标志物。其临床应用仍在研究中，特别是对于临界值的需求，尤其是在不同亚组患者中。
