School of Medicine, Yichun University, No. 576, Xuefu Road, Yichun, Jiangxi, China.
School of Medicine, Yichun University, No. 576, Xuefu Road, Yichun, Jiangxi, China.
Clin Chim Acta. 2018 Feb;477:7-12. doi: 10.1016/j.cca.2017.11.029. Epub 2017 Nov 23.
The neutrophil to lymphocyte ratio (NLR) is reported to be a prognostic factor in multiple malignancies. However, its prognostic value in patients with gastrointestinal stromal tumors (GISTs) remains controversial. This study aims to evaluate the prognostic value of preoperative NLR in GISTs.
MEDLINE, EMBASE, and, Cochrane databases were searched until February 2017. Eligible articles were defined as studies assessing the prognostic role of preoperative NLR in GISTs. The end points were overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS), and clinicopathological parameters. Pooled hazard ratios (HRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were calculated using fixed-effects/random-effects models.
A total of eight studies comprising 1676 patients with GISTs were included. Elevated NLR had an association with decreased DFS/RFS (HR: 2.18, 95% CI: 1.30-3.67, P=0.003), but not OS (HR: 1.74, 95% CI: 0.63-4.84, P=0.29). The findings from most subgroup analyses were consistent with those from the overall analysis. Moreover, high NLR was significantly correlated with male, stomach lesion, tumor size (>5cm), tumor rupture (+), tumor recurrence (+), mitotic index (>5/50HPF), and NIH risk category (high/intermediate).
Elevated preoperative NLR may be an unfavorable prognostic biomarker in patients with GISTs.
中性粒细胞与淋巴细胞比值（NLR）被报道为多种恶性肿瘤的预后因素。然而，其在胃肠道间质瘤（GIST）患者中的预后价值仍存在争议。本研究旨在评估术前 NLR 在 GIST 中的预后价值。
检索 MEDLINE、EMBASE 和 Cochrane 数据库，截至 2017 年 2 月。定义符合条件的文章为评估术前 NLR 在 GIST 中预后作用的研究。终点为总生存（OS）、无病生存（DFS）、无复发生存（RFS）和临床病理参数。使用固定效应/随机效应模型计算合并的风险比（HR）或比值比（OR）及其 95%置信区间（CI）。
共纳入 8 项包含 1676 例 GIST 患者的研究。升高的 NLR 与 DFS/RFS 降低相关（HR：2.18，95%CI：1.30-3.67，P=0.003），但与 OS 无关（HR：1.74，95%CI：0.63-4.84，P=0.29）。大多数亚组分析的结果与总体分析一致。此外，高 NLR 与男性、胃部病变、肿瘤大小（>5cm）、肿瘤破裂（+）、肿瘤复发（+）、有丝分裂指数（>5/50HPF）和 NIH 危险度分类（高/中）显著相关。
术前 NLR 升高可能是 GIST 患者的不利预后生物标志物。
