Departments of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Hexi District, Tianjin 300211, China.
Departments of Urology, Tianjin Institute of Urology, The Second Hospital of Tianjin Medical University, No.23, Pingjiang Road, Hexi District, Tianjin 300211, China.
Clin Chim Acta. 2018 May;480:166-172. doi: 10.1016/j.cca.2018.02.014. Epub 2018 Feb 17.
The prognostic value of plated-lymphocyte ratio (PLR) in multiple malignancies had been investigated in previous studies; however, its prognostic value in renal cell carcinoma (RCC) remains controversial. This study was performed to assess the prognostic value of preoperative PLR in RCC patients.
Literature was searched from PubMed, Embase, Web of Science and Cochrane database, which evaluated the relationships between preoperative PLR and prognosis in RCC patients. Hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were extracted from eligible studies. Heterogeneity was assessed using the I value. The fixed-effects model was used if there was no evidence of heterogeneity; otherwise, the random-effects model was used. Publication bias was evaluated using Begg's funnel plots and Egger's regression test.
A total of 1528 patients from seven studies were included in the analysis. The pooled analysis showed that an elevated PLR was an effective prognostic marker of both OS (pooled HR = 2.10, 95%CI: 1.38-3.19, p = 0.001) and PFS (pooled HR = 3.45, 95%CI: 1.61-7.40, p = 0.001). Subgroup analysis revealed that a high PLR significantly predicted worse OS and PFS in Asian studies (OS, pooled HR = 2.72, 95%CI: 1.06-7.03, p = 0.038; PFS, pooled HR = 6.0, 95%CI: 3.12-11.54, p < 0.001), in metastatic RCC patients receiving mixed therapies (OS, pooled HR = 3.69, 95%CI: 1.93-11.42, p = 0.023; PFS, pooled HR = 6.05, 95%CI: 1.34-27.37, p = 0.019) and targeted therapy (OS, pooled HR = 1.59, 95%CI: 0.97-2.62, p = 0.067), in sample size >100 (OS, pooled HR = 1.83, 95%CI: 1.49-2.25, p < 0.001; PFS pooled HR = 6.05, 95%CI: 1.34-27.37, p < 0.019), and in cut-off value of PLR ≤ 195 (OS, pooled HR = 3.65, 95%CI: 1.06-12.60, p = 0.04; PFS pooled HR 4.46, 95%CI: 1.68-11.87, p = 0.003).
This study suggests that a high preoperative PLR is correlated with poor prognosis in RCC patients.
plated-lymphocyte ratio（PLR）在多种恶性肿瘤中的预后价值已在先前的研究中进行了探讨；然而，其在肾细胞癌（RCC）中的预后价值仍存在争议。本研究旨在评估术前 PLR 在 RCC 患者中的预后价值。
从 PubMed、Embase、Web of Science 和 Cochrane 数据库中检索文献，评估术前 PLR 与 RCC 患者预后之间的关系。从合格研究中提取总生存期（OS）和无进展生存期（PFS）的风险比（HR）。使用 I 值评估异质性。如果没有证据表明存在异质性，则使用固定效应模型；否则，使用随机效应模型。使用 Begg 漏斗图和 Egger 回归检验评估发表偏倚。
共有来自 7 项研究的 1528 名患者纳入分析。汇总分析表明，升高的 PLR 是 OS（汇总 HR=2.10，95%CI：1.38-3.19，p=0.001）和 PFS（汇总 HR=3.45，95%CI：1.61-7.40，p=0.001）的有效预后标志物。亚组分析显示，高 PLR 显著预示着亚洲研究中 OS（HR=2.72，95%CI：1.06-7.03，p=0.038）和 PFS（HR=6.0，95%CI：3.12-11.54，p<0.001）较差，转移性 RCC 患者接受混合治疗（OS，汇总 HR=3.69，95%CI：1.93-11.42，p=0.023；PFS，汇总 HR=6.05，95%CI：1.34-27.37，p=0.019）和靶向治疗（OS，汇总 HR=1.59，95%CI：0.97-2.62，p=0.067），样本量>100（OS，汇总 HR=1.83，95%CI：1.49-2.25，p<0.001；PFS 汇总 HR=6.05，95%CI：1.34-27.37，p<0.019）和 PLR 截断值≤195（OS，HR=3.65，95%CI：1.06-12.60，p=0.04；PFS 汇总 HR 4.46，95%CI：1.68-11.87，p=0.003）。
本研究表明，术前高 PLR 与 RCC 患者的不良预后相关。
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