Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Department of Radiation Oncology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Clin Chim Acta. 2018 Aug;483:48-56. doi: 10.1016/j.cca.2018.04.023. Epub 2018 Apr 18.
Inflammation biomarkers have been introduced into clinical practice for risk-rating in treatment of patients with cancer. We aimed to confirm the prognostic role of platelet-to-lymphocyte ratio (PLR) as a powerful biomarker for patients with advanced cancer.
A systematic literature search was conducted through PubMed, Embase and Web of Science databases for studies on advanced tumors. Research articles that analyzed the PLR and hazard ratios (HR) in patients with overall survival (OS) or progression-free survival (PFS) data were involved. Two authors assessed the eligibility of trials and extracted data independently. Meta-analyses were performed with random-effect models. Data heterogeneity was calculated with the I method.
Thirty-three eligible cohort studies including 8215 patients were further analyzed. Elevated PLR was associated with reduced OS (HR = 1.45, 95% CI, 1.31-1.61, p < 0.001) and PFS (HR = 1.73, 95% CI, 1.31-2.29, p < 0.001) in patients with advanced cancer. A extreme result was observed in a subgroup analysis in metastatic renal cancer with the worst OS (HR = 2.47, 95% CI, 1.32-4.62, p = .005) and PFS (HR = 3.89, 95% CI, 1.23-12.28, p = 0.021).
Patients with high pretreatment blood PLR level have poor OS and PFS. Further investigations are needed to explore the underlying mechanisms.
炎症生物标志物已被引入临床实践，用于对癌症患者进行风险分层。我们旨在确认血小板与淋巴细胞比值（PLR）作为晚期癌症患者强有力的生物标志物的预后作用。
通过 PubMed、Embase 和 Web of Science 数据库进行系统文献检索，以获取有关晚期肿瘤的研究。纳入分析 PLR 与总生存（OS）或无进展生存（PFS）数据的风险比（HR）的研究文章。两位作者独立评估试验的纳入标准并提取数据。采用随机效应模型进行荟萃分析。采用 I ² 方法计算数据异质性。
进一步分析了 33 项符合条件的队列研究，共纳入 8215 例患者。升高的 PLR 与晚期癌症患者的 OS（HR=1.45，95%CI，1.31-1.61，p<0.001）和 PFS（HR=1.73，95%CI，1.31-2.29，p<0.001）降低相关。在转移性肾细胞癌亚组分析中观察到一个极端结果，OS 最差（HR=2.47，95%CI，1.32-4.62，p=0.005）和 PFS（HR=3.89，95%CI，1.23-12.28，p=0.021）。
治疗前血液 PLR 水平较高的患者 OS 和 PFS 较差。需要进一步研究以探讨潜在机制。
Zotero 插件