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The pretreatment neutrophil‐lymphocyte ratio may predict prognosis of patients with liver cancer: A systematic review and meta‐analysis
Author(s) -
Min GuangTao,
Li YuMin,
Yao Nan,
Wang Jun,
Wang HongPeng,
Chen Wei
Publication year - 2018
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.13151
Subject(s) - medicine , gastroenterology , meta analysis , neutrophil to lymphocyte ratio , confidence interval , lymphocyte , cancer , cochrane library , cirrhosis , liver cancer , hbsag , immunology , hepatitis b virus , virus
Background At present, several studies have reported that the pretreatment neutrophil‐lymphocyte ratio ( NLR ) may be associated with the prognosis of liver cancer. Nevertheless, their conclusions remain controversial. Thus, we performed a meta‐analysis of 54 studies to evaluate the prognostic value of NLR . Method Databases including PubMed, Embase, Cochrane Library, and Web of Science were searched to July 2017. Result A total of 54 studies including 12 979 patients were included in this meta‐analysis. Elevated NLR had a close relationship with the overall survival ( OS ) ( HR 1.52; 95% CI 1.39‐1.67), recurrence‐free survival ( RFS ) ( HR 1.84; 95% CI 1.48‐2.30), and disease‐free survival ( DFS ) ( HR 1.71; 95% CI 1.39‐2.11) of liver cancer, respectively. In addition, elevated NLR was associated with the presence of tumor vascular invasion ( OR 2.35; 95% CI 1.93‐2.86), multiple tumors ( OR 1.38; 95% CI 1.15‐1.66), alpha‐fetoprotein ≥ 400 ng/mL ( OR 1.51; 95% CI 1.15‐1.98), presence of HbsAg (+) ( OR 0.68; 95% CI 0.51‐0.90), and cirrhosis ( OR : 0.59; 95% CI 0.44‐0.80). Conclusion This meta‐analysis indicated that elevated NLR may be an effective and noninvasive indicator for prognosis of patients with liver cancer.