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Meta-Analysis
. 2018 Apr 21;24(15):1658-1665.
doi: 10.3748/wjg.v24.i15.1658.

Platelet-to-lymphocyte ratio in the setting of liver transplantation for hepatocellular cancer: A systematic review and meta-analysis

Quirino Lai  1 , Fabio Melandro  2 , Zoe Larghi Laureiro  2 , Francesco Giovanardi  2 , Stefano Ginanni Corradini  3 , Flaminia Ferri  3 , Redan Hassan  2 , Massimo Rossi  2 , Gianluca Mennini  2
Affiliations
Meta-Analysis

Platelet-to-lymphocyte ratio in the setting of liver transplantation for hepatocellular cancer: A systematic review and meta-analysis

Quirino Lai et al. World J Gastroenterol. .

Abstract

Aim: To perform a systematic review and meta-analysis on platelet-to-lymphocyte ratio (PLR) as a risk factor for post-transplant hepatocellular cancer (HCC) recurrence.

Methods: A systematic literature search was performed using PubMed. Participants of any age and sex, who underwent liver transplantation for HCC were considered following these criteria: (1) studies comparing pre-transplant low vs high PLR values; (2) studies reporting post-transplant recurrence rates; and (3) if more than one study was reported by the same institute, only the most recent was included. The primary outcome measure was set for HCC recurrence after transplantation.

Results: A total of 5 articles, published between 2014 and 2017, fulfilled the selection criteria. As for the quality of the reported studies, all the investigated articles presented an overall high quality. A total of 899 cases were investigated: 718 cases (80.0%) were males. Three studies coming from European countries and one from Japan presented HCV as the main cause of cirrhosis. On the opposite, one Chinese study presented a greater incidence of HBV-related cirrhotic cases. In all the studies apart one, the PLR cut-off value of 150 was reported. At meta-analysis, high PLR value was associated with a significant increase in recurrence after transplantation (OR = 3.33; 95%CI: 1.78-6.25; P < 0.001). A moderate heterogeneity was observed among the identified studies according to the Higgins I2 statistic value.

Conclusion: Pre-transplant high PLR values are connected with an increased risk of post-operative recurrence of hepatocellular cancer. More studies are needed for better clarify the biological mechanisms of this results.

Keywords: Hepatocellular cancer; Inflammation; Liver transplantation; Platelet-to-lymphocyte ratio; Recurrence.

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Conflict of interest statement

Conflict-of-interest statement: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
PRISMA flowchart of the literature search and study selection.
Figure 2
Figure 2
Forest plot of odds ratios and 95% confidence intervals for the association between platelet-to-lymphocyte ratio and recurrence in hepatocellular cancer patients undergoing liver transplantation. Weights are from binary random-effect analysis.
See this image and copyright information in PMC

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