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. 2015 Sep 29:8:2731-8.
doi: 10.2147/OTT.S90875. eCollection 2015.

Prognostic role of neutrophil to lymphocyte ratio in lung cancers: a meta-analysis including 7,054 patients

Qing-Tao Zhao  1 , Yong Yang  2 , Shun Xu  3 , Xiao-Peng Zhang  1 , Hui-En Wang  1 , Hua Zhang  1 , Zhi-Kang Wang  1 , Zheng Yuan  1 , Guo-Chen Duan  1
Affiliations

Prognostic role of neutrophil to lymphocyte ratio in lung cancers: a meta-analysis including 7,054 patients

Qing-Tao Zhao et al. Onco Targets Ther. .

Abstract

Background: Neutrophil to lymphocyte ratio (NLR) has recently been reported to be a poor prognostic indicator in lung cancer. However, the prognostic value of the NLR in patients with lung cancer still remains controversial. We performed a meta-analysis to evaluate the prognostic value of NLR in patients with lung cancer.

Methods: We performed a comprehensive literature search in PubMed, Ovid, the Cochrane Library, and Web of Science databases in May 2015. Studies were assessed for quality using the Newcastle-Ottawa Scale.

Results: Twenty-two studies with a total of 7,054 patients were included in this meta-analysis. The meta-analysis was performed to generate combined hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS). Our analysis results indicated that high NLR predicted poorer OS (HR, 1.51; 95% confidence interval [CI], 1.33-1.71; P<0.001) and PFS (HR, 1.33; 95% CI, 1.07-1.67; P=0.012) in patients with lung cancer. High NLR was also associated with poor OS in lung cancer treated by surgical resection (HR, 1.59; 95% CI, 1.26-1.99; P<0.001) and chemotherapy (HR, 1.15; 95% CI, 1.08-1.22; P<0.001). In addition, NLR cut-off value =5 (HR, 1.57; 95% CI, 1.16-2.12; P=0.003) and NLR cut-off value <5 (HR, 1.47; 95% CI, 1.28-1.69; P<0.001).

Conclusion: This meta-analysis result suggested that NLR should have significant predictive ability for estimating OS and PFS in patients with lung cancer and may be as a significant biomarker in the prognosis of lung cancer.

Keywords: NLR; lung cancer; meta-analysis; prognosis.

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Figures

Figure 1
Figure 1
Flow chart of the included studies. Abbreviations: HR, hazard ratio; CI, confidence interval; NLR, neutrophil to lymphocyte ratio; ESR, erythrocyte sedimentation rate.
Figure 2
Figure 2
Meta-analysis of the association between NLR and OS of lung cancer. Results are presented as individual and pooled hazard ratio (HR), and 95% confidence interval (CI). Note: Weights are from random-effects analysis. Abbreviations: NLR, neutrophil to lymphocyte ratio; OS, overall survival.
Figure 3
Figure 3
Meta-analysis of the association between NLR and PFS of lung cancer. Results are presented as individual and pooled hazard ratio (HR), and 95% confidence interval (CI). Note: Weights are from random-effects analysis. Abbreviations: NLR, neutrophil to lymphocyte ratio; PFS, progression-free survival.
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