Prognostic significance of neutrophil-to-lymphocyte ratio in diffuse large B-cell lymphoma: A meta-analysisReport as inadecuate




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Background

Neutrophil-to-lymphocyte ratio NLR has been investigated as a prognostic marker in patients with diffuse large B-cell lymphoma DLBCL; however, the results remain controversial. This study aimed to explore the association between NLR and survival outcomes and clinicopathological factors in DLBCL.

Methods

Relevant studies were retrieved by searching PubMed, Embase, Web of Science, and China National Knowledge Infrastructure CNKI databases. The last search was updated on February 17, 2017. Hazard ratios HRs and odds ratios ORs and their 95% confidence intervals CIs were used as effective measures in the meta-analysis. Random-effects models and fixed-effects models were used for analyses. Meta-regression was performed. Publication bias was assessed using Begg’s test. Stata version 12.0 was used for all analyses.

Results

A total of 9 studies with 2297 patients were included in the meta-analysis. The pooled results showed that NLR was a significant indicator for poor overall survival OS HR = 1.84, 95% CI = 1.52–2.22, p<0.001 and poor progression-free survival PFS HR = 1.64, 95% CI = 1.36–1.98, p<0.001. NLR remained a significant biomarker for OS and PFS regardless of location, sample size or cut-off value. In addition, high NLR was also associated with Ann Arbor stage OR = 2.09, 95% CI = 1.14–3.81, p = 0.017, lactate dehydrogenase level OR = 2.74, 95% CI = 1.16–6.46, p = 0.021, extranodal disease OR = 1.63, 95% CI = 1.06–2.52, p = 0.027, and International Prognostic Index score OR = 2.44, 95% CI = 1.03–5.08, p = 0.043. However, NLR was found to have no significant association with sex OR = 0.89, 95% CI = 0.71–1.11, p = 0.29, age OR = 1.18, 95% CI = 0.94–1.48, p = 0.152, European Cooperative Oncology Group performance status score OR = 1.78, 95% CI = 0.71–4.46, p = 0.217, or presence of B symptoms OR = 1.56, 95% CI = 0.7–3.48, p = 0.278.

Conclusion

In conclusion, our meta-analysis demonstrated that NLR has a strong association with worse OS and PFS in patients with DLBCL. NLR could be recommended as an inexpensive prognostic biomarker in DLBCL.



Author: Jin Wang , Xu Zhou, Yu Liu, Zheng Li, Xiang Li

Source: http://plos.srce.hr/



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