Mowbray Nicholas G, Griffith David, Hammoda Mohammed, Shingler Guy, Kambal Amir, Al-Sarireh Bilal
Swansea University, Singleton Park, Swansea SA2 8PP, UK.
Royal Devon & Exeter Hospital, Barrack Road, Exeter EX2 5DW, UK.
HPB (Oxford). 2018 May;20(5):379-384. doi: 10.1016/j.hpb.2017.12.009. Epub 2018 Jan 11.
The neutrophil-to-lymphocyte ratio (NLR) is thought to reflect cancer disease burden. To assess the prognostic ability of the NLR on overall survival in patients with resectable, pancreatic cancer a meta-analysis of published literature was undertaken.
A systematic review was performed independently by two authors using PubMed, Ovid MEDLINE and Embase databases. Included studies detailed the pre-operative NLR and overall survival of pancreatic cancer patients.
Of the 214 studies retrieved using the search strategy, 8 studies involving 1519 patients were included in the meta-analysis. Only one study did not find a statistically significant association between a high NLR and OS. The pooled Hazard Ratio was 1.77 (95% CI [1.45-2.15]; p < 0.01). The NLR cut-off values ranged from 2 to 5. There was low to moderate inter-study heterogeneity (I = 31%; p = 0.17), a low risk of intra-study bias, and potentially 3 unpublished (negative) studies.
A high pre-operative NLR indicates a worse prognosis than in patients with a low NLR. There is potential to use the NLR to direct therapies. A specific cut-off value has not been established from this study and so further research is required.
中性粒细胞与淋巴细胞比值（NLR）被认为可反映癌症疾病负担。为评估NLR对可切除胰腺癌患者总生存期的预后能力，我们对已发表文献进行了一项荟萃分析。
两位作者独立使用PubMed、Ovid MEDLINE和Embase数据库进行系统评价。纳入的研究详细说明了胰腺癌患者的术前NLR和总生存期。
使用检索策略检索到214项研究，其中8项研究涉及1519例患者被纳入荟萃分析。只有一项研究未发现高NLR与总生存期之间存在统计学显著关联。合并风险比为1.77（95%CI[1.45 - 2.15]；p<0.01）。NLR临界值范围为2至5。研究间存在低至中度异质性（I = 31%；p = 0.17），研究内偏倚风险较低，可能有3项未发表的（阴性）研究。
术前NLR高表明预后比NLR低的患者差。有可能利用NLR指导治疗。本研究未确定具体的临界值，因此需要进一步研究。
