The Clinical Use of the Platelet/lymphocyte Ratio and Lymphocyte/monocyte Ratio As Prognostic Predictors in Colorectal Cancer: a Meta-analysis

Overview

Journal Oncotarget

Specialty Oncology

Date 2017 Feb 18

PMID 28212553

Citations 33

Authors

Ya-Huan Guo

Hai-Feng Sun

Yan-Bing Zhang

Zi-Jun Liao

Lei Zhao

Jie Cui

Tao Wu

Jian-Rong Lu

Ke-Jun Nan

Shu-Hong Wang

Affiliations

Soon will be listed here.

Abstract

Background: Conflicting evidence exists regarding the effects of platelet/lymphocyte ratio (PLR) and lymphocyte/monocyte ratio(LMR) on the prognosis of colorectal cancer (CRC) patients. This study aimed to evaluate the roles of the PLR and LMR in predicting the prognosis of CRC patients via meta-analysis.

Methods: Eligible studies were retrieved from the PubMed, Embase,andChina National Knowledge Infrastructure (CNKI) databases, supplemented by a manual search of references from retrieved articles. Pooled hazard ratios (HR) with 95% confidence intervals (95% CI) were calculated using the generic inverse variance and random-effect model to evaluate the association of PLR and LMR with prognostic variables in CRC, including overall survival (OS), cancer-specific survival (CSS) and disease-free survival (DFS).

Results: Thirty-three studies containing 15,404 patients met criteria for inclusion. Pooled analysis suggested that elevated PLR was associated with poorer OS (pooled HR = 1.57, 95% CI: 1.41 - 1.75, p< 0.00001, I2=26%) and DFS (pooled HR = 1.58, 95% CI: 1.31 - 1.92, p< 0.00001, I2=66%). Conversely, high LMR correlated with more favorable OS (pooled HR = 0.59, 95% CI: 0.50 - 0.68, p< 0.00001, I2=44%), CSS (pooled HR = 0.54, 95% CI: 0.40 - 0.72, p< 0.00001, I2=11%) and DFS (pooled HR = 0.82, 95% CI: 0.71- 0.94,p=0.005, I2=29%).

Conclusions: Elevated PLR was associated with poor prognosis, while high LMR correlated with more favorable outcomes in CRC patients. Pretreatment PLR and LMR could serve as prognostic predictors in CRC patients.

Citing Articles

Effect of ultrasound-guided transverse abdominal plane block on neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and systemic immune inflammation index in patients undergoing radical resection of endometrial carcinoma.

Wang C, Fan S, Gu D, Deng J, Ma B, Xie L PLoS One. 2024; 19(12):e0315175.

PMID: 39637188 PMC: 11620674. DOI: 10.1371/journal.pone.0315175.

Lymphocyte-to-Monocyte Ratio Might Serve as a Prognostic Marker in Young Patients with Tongue Squamous Cell Carcinoma.

Kandathil S, Peter Truta I, Kadletz-Wanke L, Heiduschka G, Stoiber S, Kenner L J Pers Med. 2024; 14(2).

PMID: 38392590 PMC: 10890051. DOI: 10.3390/jpm14020159.

High pre-chemoradiotherapy pan-immune-inflammation value levels predict worse outcomes in patients with stage IIIB/C non-small-cell lung cancer.

Topkan E, Kucuk A, Ozkan E, Ozturk D, Besen A, Mertsoylu H Discov Oncol. 2023; 14(1):230.

PMID: 38091179 PMC: 10719443. DOI: 10.1007/s12672-023-00851-8.

Correlation between mismatch repair and survival of patients with gastric cancer after 5-FU-based adjuvant chemotherapy.

Zhao F, Li E, Shen G, Dong Q, Ren D, Wang M J Gastroenterol. 2023; 58(7):622-632.

PMID: 37036516 DOI: 10.1007/s00535-023-01990-z.

Correlation between Lymphocyte-to-Monocyte Ratio (LMR), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR) and Extramural Vascular Invasion (EMVI) in Locally Advanced Rectal Cancer.

Gawinski C, Holdakowska A, Wyrwicz L Curr Oncol. 2023; 30(1):545-558.

PMID: 36661692 PMC: 9857771. DOI: 10.3390/curroncol30010043.

References

Neofytou K, Smyth E, Giakoustidis A, Khan A, Cunningham D, Mudan S . Elevated platelet to lymphocyte ratio predicts poor prognosis after hepatectomy for liver-only colorectal metastases, and it is superior to neutrophil to lymphocyte ratio as an adverse prognostic factor. Med Oncol. 2014; 31(10):239. DOI: 10.1007/s12032-014-0239-6. View

Mori K, Toiyama Y, Saigusa S, Fujikawa H, Hiro J, Kobayashi M . Systemic Analysis of Predictive Biomarkers for Recurrence in Colorectal Cancer Patients Treated with Curative Surgery. Dig Dis Sci. 2015; 60(8):2477-87. DOI: 10.1007/s10620-015-3648-2. View

Liu H, Du X, Sun P, Xiao C, Xu Y, Li R . [Preoperative platelet-lymphocyte ratio is an independent prognostic factor for resectable colorectal cancer]. Nan Fang Yi Ke Da Xue Xue Bao. 2013; 33(1):70-3. View

Chan J, Chan D, Diakos C, Engel A, Pavlakis N, Gill A . The Lymphocyte-to-Monocyte Ratio is a Superior Predictor of Overall Survival in Comparison to Established Biomarkers of Resectable Colorectal Cancer. Ann Surg. 2016; 265(3):539-546. PMC: 5300029. DOI: 10.1097/SLA.0000000000001743. View

Paik K, Lee I, Lee Y, Sung N, Kwon T . Clinical implications of systemic inflammatory response markers as independent prognostic factors in colorectal cancer patients. Cancer Res Treat. 2014; 46(1):65-73. PMC: 3918529. DOI: 10.4143/crt.2014.46.1.65. View

Li Y, Jia H, Yu W, Xu Y, Li X, Li Q . Nomograms for predicting prognostic value of inflammatory biomarkers in colorectal cancer patients after radical resection. Int J Cancer. 2016; 139(1):220-31. DOI: 10.1002/ijc.30071. View

Lin G, Liu P, Liu D, Peng J, Xiao J, Xia Z . Prognostic significance of the pre-chemotherapy lymphocyte-to-monocyte ratio in patients with previously untreated metastatic colorectal cancer receiving FOLFOX chemotherapy. Chin J Cancer. 2016; 35:5. PMC: 4704261. DOI: 10.1186/s40880-015-0063-1. View

Templeton A, Ace O, McNamara M, Al-Mubarak M, Vera-Badillo F, Hermanns T . Prognostic role of platelet to lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev. 2014; 23(7):1204-12. DOI: 10.1158/1055-9965.EPI-14-0146. View

Minami T, Minami T, Shimizu N, Yamamoto Y, De Velasco M, Nozawa M . Identification of Programmed Death Ligand 1-derived Peptides Capable of Inducing Cancer-reactive Cytotoxic T Lymphocytes From HLA-A24+ Patients With Renal Cell Carcinoma. J Immunother. 2015; 38(7):285-91. DOI: 10.1097/CJI.0000000000000090. View

10.

Marech I, Ammendola M, Sacco R, Sammarco G, Zuccala V, Zizzo N . Tumour-associated macrophages correlate with microvascular bed extension in colorectal cancer patients. J Cell Mol Med. 2016; 20(7):1373-80. PMC: 4929299. DOI: 10.1111/jcmm.12826. View

11.

Song A, Eo W, Lee S . Comparison of selected inflammation-based prognostic markers in relapsed or refractory metastatic colorectal cancer patients. World J Gastroenterol. 2015; 21(43):12410-20. PMC: 4649124. DOI: 10.3748/wjg.v21.i43.12410. View

12.

Sun Z, Han X, Wang H, Tang Y, Zhao Z, Qu Y . Prognostic significance of preoperative fibrinogen in patients with colon cancer. World J Gastroenterol. 2014; 20(26):8583-91. PMC: 4093707. DOI: 10.3748/wjg.v20.i26.8583. View

13.

Baranyai Z, Krzystanek M, Josa V, Dede K, Agoston E, Szasz A . The comparison of thrombocytosis and platelet-lymphocyte ratio as potential prognostic markers in colorectal cancer. Thromb Haemost. 2013; 111(3):483-90. DOI: 10.1160/TH13-08-0632. View

14.

Zou Z, Liu H, Ning N, Li S, Du X, Li R . Clinical significance of pre-operative neutrophil lymphocyte ratio and platelet lymphocyte ratio as prognostic factors for patients with colorectal cancer. Oncol Lett. 2016; 11(3):2241-2248. PMC: 4774601. DOI: 10.3892/ol.2016.4216. View

15.

Cannon N, Meyer J, Iyengar P, Ahn C, Westover K, Choy H . Neutrophil-lymphocyte and platelet-lymphocyte ratios as prognostic factors after stereotactic radiation therapy for early-stage non-small-cell lung cancer. J Thorac Oncol. 2014; 10(2):280-5. DOI: 10.1097/JTO.0000000000000399. View

16.

Choi W, Cleghorn M, Jiang H, Jackson T, Okrainec A, Quereshy F . Preoperative Neutrophil-to-Lymphocyte Ratio is a Better Prognostic Serum Biomarker than Platelet-to-Lymphocyte Ratio in Patients Undergoing Resection for Nonmetastatic Colorectal Cancer. Ann Surg Oncol. 2015; 22 Suppl 3:S603-13. DOI: 10.1245/s10434-015-4571-7. View

17.

Ozawa T, Ishihara S, Nishikawa T, Tanaka T, Tanaka J, Kiyomatsu T . The preoperative platelet to lymphocyte ratio is a prognostic marker in patients with stage II colorectal cancer. Int J Colorectal Dis. 2015; 30(9):1165-71. DOI: 10.1007/s00384-015-2276-9. View

18.

Szkandera J, Pichler M, Absenger G, Stotz M, Arminger F, Weissmueller M . The elevated preoperative platelet to lymphocyte ratio predicts decreased time to recurrence in colon cancer patients. Am J Surg. 2014; 208(2):210-4. DOI: 10.1016/j.amjsurg.2013.10.030. View

19.

Neofytou K, Smyth E, Giakoustidis A, Khan A, Williams R, Cunningham D . The Preoperative Lymphocyte-to-Monocyte Ratio is Prognostic of Clinical Outcomes for Patients with Liver-Only Colorectal Metastases in the Neoadjuvant Setting. Ann Surg Oncol. 2015; 22(13):4353-62. DOI: 10.1245/s10434-015-4481-8. View

20.

Hanahan D, Weinberg R . Hallmarks of cancer: the next generation. Cell. 2011; 144(5):646-74. DOI: 10.1016/j.cell.2011.02.013. View