Department of Urology, the Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen, Guangdong, 518107, China.
Prostate Cancer Prostatic Dis. 2020 Jun;23(2):220-231. doi: 10.1038/s41391-020-0209-3. Epub 2020 Feb 7.
The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR), as markers of systematic inflammation response, have been reported to be indicators in metastatic castration-resistant prostate cancer (mCRPC), whereas their prognostic values remain conflict. This study was to assess the prognostic value of NLR and PLR in mCRPC patients and to assess the response of abiraterone or enzalutamide through using NLR and PLR.
Databases searching was conducted in the PubMed, EMBASE, Google Scholar, and the Cochrane Library for relevant published literature up to October 2019. Data extraction and quality evaluation were performed on the eligible studies. STATA 14.0 software was used to pooled hazard ratios (HRs) and their 95% confidence intervals (CIs) for overall survival (OS) and progression-free survival (PFS).
A total of 3144 mCRPC patients were enrolled from 15 cohort studies in this meta-analysis. The pooled results demonstrated that elevated NLR had a significant association with inferior OS in mCRPC patients treated with abiraterone (HR = 1.63, 95% CI: 1.43-1.85, P < 0.001) and enzalutamide (HR = 1.48, 95% CI: 1.27-1.72, P < 0.001), whereas elevated NLR had no significant association with unfavorable PFS treated with abiraterone and enzalutamide, respectively. Elevated PLR had a significant association with an inferior OS (HR = 1.52, 95% CI: 1.16-1.98, P < 0.001) in mCRPC patients treated with abiraterone.
NLR and PLR were effective biomarkers for predicting prognosis in mCRPC patients and served as indicators of the efficacy of personalized treatment of mCRPC using abiraterone or enzalutamide. Future, more randomized control trials (RCTs) are needed to investigate the promising value of hematologic parameters.
中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）作为全身炎症反应的标志物，已被报道为转移性去势抵抗性前列腺癌（mCRPC）的指标，但其预后价值仍存在争议。本研究旨在评估 NLR 和 PLR 在 mCRPC 患者中的预后价值，并通过 NLR 和 PLR 评估阿比特龙或恩扎卢胺的反应。
在 PubMed、EMBASE、Google Scholar 和 Cochrane Library 中进行数据库检索，以获取截至 2019 年 10 月的相关文献。对合格研究进行数据提取和质量评估。使用 STATA 14.0 软件对总生存期（OS）和无进展生存期（PFS）的风险比（HRs）及其 95%置信区间（CIs）进行汇总。
本荟萃分析共纳入了 15 项队列研究的 3144 名 mCRPC 患者。汇总结果表明，在接受阿比特龙治疗的 mCRPC 患者中，升高的 NLR 与 OS 不良显著相关（HR=1.63，95%CI：1.43-1.85，P<0.001），在接受恩扎卢胺治疗的 mCRPC 患者中，升高的 NLR 与 OS 不良也显著相关（HR=1.48，95%CI：1.27-1.72，P<0.001），而升高的 NLR 与接受阿比特龙和恩扎卢胺治疗的患者的无进展生存期无显著相关性。升高的 PLR 与接受阿比特龙治疗的 mCRPC 患者的 OS 不良显著相关（HR=1.52，95%CI：1.16-1.98，P<0.001）。
NLR 和 PLR 是预测 mCRPC 患者预后的有效生物标志物，可作为使用阿比特龙或恩扎卢胺治疗 mCRPC 个体化治疗疗效的指标。未来需要更多的随机对照试验（RCTs）来研究血液学参数的潜在价值。
