Publication

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

Journal Paper/Review - May 3, 2014

Units
PubMed
Doi

Citation
Templeton A, Tannock I, Ocana A, Seruga B, Hermanns T, Vera-Badillo F, Al-Mubarak M, McNamara M, Ace O, Amir E. Prognostic role of platelet to lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Cancer Epidemiol Biomarkers Prev 2014; 23:1204-12.
Type
Journal Paper/Review (English)
Journal
Cancer Epidemiol Biomarkers Prev 2014; 23
Publication Date
May 3, 2014
Issn Electronic
1538-7755
Pages
1204-12
Brief description/objective

BACKGROUND
Inflammation influences cancer development and progression. An elevated platelet to lymphocyte ratio (PLR), a marker of inflammation, has been linked to poor prognosis in several malignancies. Here, we quantify the prognostic impact of this biomarker.

METHODS
A systematic review of databases was conducted to identify publications exploring the association of blood PLR and overall survival (OS) in solid tumors. Data were pooled in a meta-analysis. Pooled HRs for OS by disease group and by PLR cutoff groups were computed and weighted using generic inverse-variance and random-effect modeling.

RESULTS
Twenty studies comprising 12,754 patients were assessed. Cutoffs for PLR defining risk groups ranged from 150 to 300 and were dichotomous (12 studies; group 1) or split into three groups (<150/150-300/>300, 8 studies; group 2). Higher PLR was associated with significantly worse OS in group 1 [HR = 1.87; 95% confidence interval (CI, 1.49-2.34); P < 0.001] and with a nonsignificant association in group 2 (HR per higher category = 1.21; 95%CI, 0.97-1.50; P = 0.10). The size of effect of PLR on OS was greater for metastatic disease (HR[group 1] = 2.0; 95% CI, 1.6-2.7; HR[group 2] = 1.6; 95% CI, 1.1-2.4) than for early-stage disease (HR[group 1] = 1.5; 95% CI, 1.0-2.2; HR[group 2] = 1.0; 95% CI, 0.8-1.3). A significant association was observed for colorectal, hepatocellular, gastroesophageal, ovarian, and pancreatic carcinoma in group 1 and for colorectal cancers in group 2.

CONCLUSION
A high PLR is associated with worse OS in various solid tumors. Further research of its regulation and relevance in daily practice is warranted.

IMPACT
PLR is a readily available and inexpensive biomarker with independent prognostic value in solid tumors.