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Meta-Analysis
. 2017 Apr 4;8(14):22854-22862.
doi: 10.18632/oncotarget.15281.

Prognostic role of platelet to lymphocyte ratio in hepatocellular carcinoma: a systematic review and meta-analysis

Yongzhao Zhao  1 , Guangyan Si  2 , Fengshang Zhu  3 , Jialiang Hui  4 , Shangli Cai  5 , Chenshen Huang  1 , Sijin Cheng  1 , Abdel Hamid Fathy  1 , Yi Xiang  4 , Jing Li  3
Affiliations
Meta-Analysis

Prognostic role of platelet to lymphocyte ratio in hepatocellular carcinoma: a systematic review and meta-analysis

Yongzhao Zhao et al. Oncotarget. .

Abstract

Background and aims: Several studies were conducted to explore the prognostic significance of platelet to lymphocyte ratio (PLR) in hepatocellular carcinoma (HCC), however, contradictory results across most reports were documented. To this end, we present a systematic review that aims to summarize the prognostic significance of PLR in patients with HCC.

Results: A total of 10 studies involving a total of 2,315 patients were identified. The Newcastle-Ottawa Quality Assessment Scale (NOS) of each included study was greater than or equal to 5. The results indicated that high PLR was significantly associated with a worse OS when compared to the low PLR (HR = 1.60, 95% CI = 1.23-2.08, p = 0.0005; I2 = 88%, p < 0.00001). Similar results were detected in the subgroup analysis of the analysis model, cut-off value, ethnicity, sample size and therapy. However, no obvious correlation between the PLR and DFS/RFS in patients with HCC was observed (HR = 1.21, 95% CI = 0.87-1.67, p = 0.26; I2 = 61%, p = 0.07).

Materials and methods: A complete literature search in the PubMed, Cochrane Library and Embase database was performed. Retrospective and prospective studies focusing on the role of PLR on the prognosis in HCC were all deemed as "suitable" for our scope. The endpoints determined were: the overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS) and the progress free survival (PFS).

Conclusions: The study revealed that high PLR is an unfavorable predictor of OS in patients with HCC, and high PLR is a promising prognostic biomarker for HCC, especially for patients in Asia.

Keywords: hepatocellular carcinoma; overall survival; platelet to lymphocyte ratio; prognostic.

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Conflict of interest statement

CONFLICTS OF INTEREST

The authors have declared no conflicts of interest

Figures

Figure 1
Figure 1. Flow diagram of study selection process
Figure 2
Figure 2. Meta-analysis of overall survival
Figure 3
Figure 3. Meta-analysis of recurrence-free survival / disease free survival
See this image and copyright information in PMC

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