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Review
. 2015 Jul;70(7):524-30.
doi: 10.6061/clinics/2015(07)10. Epub 2015 Jul 1.

Prognostic value of the neutrophil to lymphocyte ratio in lung cancer: A meta-analysis

Yongmei Yin  1 , Jun Wang  2 , Xuedong Wang  1 , Lan Gu  1 , Hao Pei  2 , Shougang Kuai  2 , Yingying Zhang  2 , Zhongbo Shang  2
Affiliations
Review

Prognostic value of the neutrophil to lymphocyte ratio in lung cancer: A meta-analysis

Yongmei Yin et al. Clinics (Sao Paulo). 2015 Jul.

Abstract

Recently, a series of studies explored the correlation between the neutrophil to lymphocyte ratio and the prognosis of lung cancer. However, the current opinion regarding the prognostic role of the neutrophil to lymphocyte ratio in lung cancer is inconsistent. We performed a meta-analysis of published articles to investigate the prognostic value of the neutrophil to lymphocyte ratio in lung cancer. The hazard ratio (HR) and its 95% confidence interval (CI) were calculated. An elevated neutrophil to lymphocyte ratio predicted worse overall survival, with a pooled HR of 1.243 (95%CI: 1.106-1.397; P(heterogeneity)=0.001) from multivariate studies and 1.867 (95%CI: 1.487-2.344; P(heterogeneity)=0.047) from univariate studies. Subgroup analysis showed that a high neutrophil to lymphocyte ratio yielded worse overall survival in non-small cell lung cancer (NSCLC) (HR=1.192, 95%CI: 1.061-1.399; P(heterogeneity)=0.003) as well as small cell lung cancer (SCLC) (HR=1.550, 95% CI: 1.156-2.077; P(heterogeneity)=0.625) in multivariate studies. The synthesized evidence from this meta-analysis of published articles demonstrated that an elevated neutrophil to lymphocyte ratio was a predictor of poor overall survival in patients with lung cancer.

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Conflict of interest statement

No potential conflict of interest was reported.

Figures

Figure 1
Figure 1
Methodological flow diagram of the meta-analysis.
Figure 2
Figure 2
Forrest plots of studies evaluating HRs of the NLR for OS.
Figure 3
Figure 3
Effect of univariate studies on the pooled HR for the NLR and OS of patients.
Figure 4
Figure 4
Effect of multivariate studies on the pooled HR for the NLR and OS of patients.
Figure 5
Figure 5
Funnel plots adjusted with the trim and fill method for OS. Circles: included studies. Diamonds: presumed missing studies.
See this image and copyright information in PMC

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