Prognostic Impact of Neutrophil-to-lymphocyte Ratio in Gliomas: a Systematic Review and Meta-analysis

Overview

Journal World J Surg Oncol

Publisher Biomed Central

Specialties General Surgery
Oncology

Date 2019 Sep 2

PMID 31472673

Citations 29

Authors

Yu-Ying Lei

Yi-Tong Li

Qi-Lu Hu

Juan Wang

Ai-Xia Sui

Affiliations

Soon will be listed here.

Abstract

Background: In some malignant tumors, a high neutrophil-to-lymphocyte ratio (NLR) is connected with unfavorable prognosis. Nevertheless, the prognostic value of the NLR in gliomas remains disputed. The clinical significance of the NLR in gliomas was investigated in our study.

Methods: The databases, PubMed, Embase, and the Cochrane Library, were searched using words like "glioma," "glioblastoma," "neutrophil-to-lymphocyte ratio," and others through May 2019. We evaluated the significance of NLR on overall survival (OS) of patients with gliomas in our study.

Results: Finally, 16 cohorts with 2275 patients were analyzed. The pooled analysis revealed that an elevated NLR was connected with unfavorable OS (hazards ratio (HR): 1.43, 95% confidence interval (CI): 1.27-1.62) outcomes of patients with gliomas.

Conclusion: A high NLR can be considered a high-risk prognostic factor in gliomas, and more adjuvant chemotherapy should be recommended for high-risk patients.

Citing Articles

Rise in post-resection neutrophil-to-lymphocyte ratio correlates with decreased survival in glioblastoma patients.

Mohammad A, Sakalla R, Davalan W, Ruiz-Barerra M, Jatana S, Khalaf R Neurooncol Adv. 2025; 7(1):vdaf014.

PMID: 40051660 PMC: 11883344. DOI: 10.1093/noajnl/vdaf014.

Prognostic values of combined ratios of white blood cells in glioma: a systematic review and meta-analysis.

Zhou J, Tan B, Gao F Neurosurg Rev. 2024; 47(1):831.

PMID: 39477886 DOI: 10.1007/s10143-024-03064-x.

Serum beta2-microglobulin acts as a biomarker for severity and prognosis in glioma patients: a preliminary clinical study.

Liu Z, Tang F, Wang J, Yang J, Chen X, Wang Z BMC Cancer. 2024; 24(1):692.

PMID: 38844902 PMC: 11155066. DOI: 10.1186/s12885-024-12441-0.

The role of preoperative hematological inflammatory markers as a predictor of meningioma grade: A systematic review and meta-analysis.

Rusidi H, Rosyidi R, Wardhana D, Baskoro W, Ramadhana G Surg Neurol Int. 2024; 15:77.

PMID: 38628519 PMC: 11021116. DOI: 10.25259/SNI_849_2023.

Effect of Intraoperative Opioid Dose on Perioperative Neutrophil-to-Lymphocyte Ratio and Lymphocyte-to-Monocyte Ratio in Glioma.

Liu X, Teng L, Dai J, Shao H, Chen R, Li H J Inflamm Res. 2024; 17:2159-2167.

PMID: 38617385 PMC: 11016269. DOI: 10.2147/JIR.S451455.

References

Higgins J, Thompson S, Deeks J, Altman D . Measuring inconsistency in meta-analyses. BMJ. 2003; 327(7414):557-60. PMC: 192859. DOI: 10.1136/bmj.327.7414.557. View

Stupp R, Mason W, van den Bent M, Weller M, Fisher B, Taphoorn M . Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005; 352(10):987-96. DOI: 10.1056/NEJMoa043330. View

Aggarwal B, Vijayalekshmi R, Sung B . Targeting inflammatory pathways for prevention and therapy of cancer: short-term friend, long-term foe. Clin Cancer Res. 2009; 15(2):425-30. DOI: 10.1158/1078-0432.CCR-08-0149. View

Stang A . Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol. 2010; 25(9):603-5. DOI: 10.1007/s10654-010-9491-z. View

OCallaghan D, ODonnell D, OConnell F, OByrne K . The role of inflammation in the pathogenesis of non-small cell lung cancer. J Thorac Oncol. 2010; 5(12):2024-36. DOI: 10.1097/jto.0b013e3181f387e4. View

Gooden M, de Bock G, Leffers N, Daemen T, Nijman H . The prognostic influence of tumour-infiltrating lymphocytes in cancer: a systematic review with meta-analysis. Br J Cancer. 2011; 105(1):93-103. PMC: 3137407. DOI: 10.1038/bjc.2011.189. View

McMillan D . The systemic inflammation-based Glasgow Prognostic Score: a decade of experience in patients with cancer. Cancer Treat Rev. 2012; 39(5):534-40. DOI: 10.1016/j.ctrv.2012.08.003. View

Bambury R, Teo M, Power D, Yusuf A, Murray S, Battley J . The association of pre-treatment neutrophil to lymphocyte ratio with overall survival in patients with glioblastoma multiforme. J Neurooncol. 2013; 114(1):149-54. DOI: 10.1007/s11060-013-1164-9. View

Templeton A, McNamara M, Seruga B, Vera-Badillo F, Aneja P, Ocana A . Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014; 106(6):dju124. DOI: 10.1093/jnci/dju124. View

10.

Kawano H, Hirano H, Yonezawa H, Yunoue S, Yatsushiro K, Ogita M . Improvement in treatment results of glioblastoma over the last three decades and beneficial factors. Br J Neurosurg. 2014; 29(2):206-12. DOI: 10.3109/02688697.2014.967750. View

11.

Ostrom Q, Gittleman H, Stetson L, Virk S, Barnholtz-Sloan J . Epidemiology of gliomas. Cancer Treat Res. 2014; 163:1-14. DOI: 10.1007/978-3-319-12048-5_1. View

12.

Han S, Liu Y, Li Q, Li Z, Hou H, Wu A . Pre-treatment neutrophil-to-lymphocyte ratio is associated with neutrophil and T-cell infiltration and predicts clinical outcome in patients with glioblastoma. BMC Cancer. 2015; 15:617. PMC: 4559944. DOI: 10.1186/s12885-015-1629-7. View

13.

Auezova R, Ryskeldiev N, Doskaliyev A, Kuanyshev Y, Zhetpisbaev B, Aldiyarova N . Association of preoperative levels of selected blood inflammatory markers with prognosis in gliomas. Onco Targets Ther. 2016; 9:6111-6117. PMC: 5067007. DOI: 10.2147/OTT.S113606. View

14.

Wiencke J, Koestler D, Salas L, Wiemels J, Roy R, Hansen H . Immunomethylomic approach to explore the blood neutrophil lymphocyte ratio (NLR) in glioma survival. Clin Epigenetics. 2017; 9:10. PMC: 5288996. DOI: 10.1186/s13148-017-0316-8. View

15.

Clark R . Immunosuppression by activated human neutrophils. Dependence on the myeloperoxidase system. J Immunol. 1987; 139(7):2406-13. View

16.

Wang P, Song H, Cai H, Kong L, Yao K, Jiang T . Preoperative inflammation markers and IDH mutation status predict glioblastoma patient survival. Oncotarget. 2017; 8(30):50117-50123. PMC: 5564834. DOI: 10.18632/oncotarget.15235. View

17.

Mason M, Maurice C, McNamara M, Tieu M, Lwin Z, Millar B . Neutrophil-lymphocyte ratio dynamics during concurrent chemo-radiotherapy for glioblastoma is an independent predictor for overall survival. J Neurooncol. 2017; 132(3):463-471. DOI: 10.1007/s11060-017-2395-y. View

18.

Zhang J, Zhang H, Li J, Shao X, Zhang C . The elevated NLR, PLR and PLT may predict the prognosis of patients with colorectal cancer: a systematic review and meta-analysis. Oncotarget. 2017; 8(40):68837-68846. PMC: 5620300. DOI: 10.18632/oncotarget.18575. View

19.

Zhou Q, Hong L, Zuo M, He Z . Prognostic significance of neutrophil to lymphocyte ratio in ovarian cancer: evidence from 4,910 patients. Oncotarget. 2017; 8(40):68938-68949. PMC: 5620309. DOI: 10.18632/oncotarget.20196. View

20.

Lopes M, Carvalho B, Vaz R, Linhares P . Influence of neutrophil-lymphocyte ratio in prognosis of glioblastoma multiforme. J Neurooncol. 2017; 136(1):173-180. DOI: 10.1007/s11060-017-2641-3. View