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Guo G, Hu X, Gao T, Zhou H, Li B, Zhou C, Yu B, Wang G. Potential impact of platelet-to-lymphocyte ratio on prognosis in patients with colorectal cancer: A systematic review and meta-analysis. Front Surg 2023; 10:1139503. [PMID: 37051571 PMCID: PMC10083474 DOI: 10.3389/fsurg.2023.1139503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 03/06/2023] [Indexed: 03/29/2023] Open
Abstract
BackgroundNumerous studies have confirmed that inflammation promotes the occurrence, development and prognosis of colorectal cancer (CRC).ObjectiveThis study focuses on the potentially prognostic value of the platelet-to-lymphocyte ratio (PLR) in CRC patients.Data SourcesThis study was registered at PROSPERO (ID: CRD42020219215). Relative studies were searched on PubMed, Cochrane Library, Embase, Web of Science, and clinical trial databases by two back-to-back reviewers. Study Selection and Intervention: Studies were screened according to the predetermined inclusion and exclusion criteria, comparing prognosis differences between low PLR levels and high PLR levels for CRC patients. Main Outcome Measures: Studies were integrated and compared to analyze the value of PLR in predicting overall survival (OS), progression-free survival (PFS), cancer-specific survival (CSS), disease-free survival (DFS) and recurrence-free survival (RFS) of CRC. Results: Outcomes were compared using Review Manager (version 5.4) software from Cochrane Collaboration. A total of 27 literary works, including 13,330 patients, were incorporated into our study. The final results showed that higher PLR levels had worse OS (hazard ratio [HR] = 1.40, 95% confidence interval [CI] = 1.21–1.62, P < 0.00001), DFS (HR = 1.44, 95% CI = 1.09–1.90, P = 0.01) and RFS (HR = 1.48, 95% CI = 1.13–1.94, P = 0.005) than lower PLR levels, respectively. However, there was no evidence of significance for PFS (HR = 1.14, 95% CI = 0.84–1.54, P = 0.40) and CSS (HR = 1.16, 95% CI = 0.88–1.53, P = 0.28) in the final meta-analysis.LimitationsOur study has the following limitations. First of all, we only included literature published in English, which means that some publication bias may be inevitable. In addition, our study used aggregate data, not individual data; furthermore, we did not define the exact cut-off value representing the PLR level.ConclusionAn elevated PLR seems to be an adverse prognostic factor affecting survival outcomes in patients with CRC. Meanwhile, more prospective studies are required to confirm our conclusion.PROSPERO ID: CRD42020219215.
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Affiliation(s)
- Ganlin Guo
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Xuhua Hu
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Tianyi Gao
- The Third Hospital of Hebei Medical University, Shijiazhuang, China
| | - Huixian Zhou
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
| | - Baokun Li
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Chaoxi Zhou
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Bin Yu
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
| | - Guiying Wang
- The Second Hospital of Hebei Medical University, Shijiazhuang, China
- The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
- Correspondence: Guiying Wang
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Preoperative Platelet-to-Lymphocyte Ratio (PLR) for Predicting the Survival of Stage I-III Gastric Cancer Patients with a MGC Component. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9678363. [PMID: 33997045 PMCID: PMC8112911 DOI: 10.1155/2021/9678363] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 04/23/2021] [Indexed: 12/17/2022]
Abstract
Background The preoperative platelet-to-lymphocyte ratio (PLR) evaluates the prognosis of gastric cancer patients. However, whether preoperative PLR may be used to evaluate the prognosis of mucinous gastric carcinoma (MGC) patients is poorly investigated. The present study evaluated the effect of preoperative PLR on overall survival in gastric cancer patients with a mucinous component. Methods A total of 336 MGC were enrolled in this study, and the characteristics of the tumor, including pathological features and clinical data, were retrospectively analyzed. Results A high PLR was associated with larger tumor size, advanced tumor invasion, lymph node metastasis, advanced TNM stage, tumor location, total gastrectomy, low hemoglobin level, low albumin level, high fibrinogen level, high platelet level, and high neutrophil-to-lymphocyte ratio (NLR, all P's < 0.05). Multivariate analysis identified age (HR = 1.876; 95% CI 1.361-2.585, P < 0.001), TNM stage (HR = 2.350; 95% CI 1.216-4.542, P = 0.011), globulin (HR = 1.520; 95% CI 1.067-2.165, P = 0.020), total gastrectomy (HR = 0.537; 95% CI 0.373-0.772, P = 0.001), and PLR (HR = 1.582; 95% CI 1.066-2.348, P = 0.023) as independent prognostic factors for OS. Conclusion Preoperative PLR is related to pathological features and may independently evaluate the survival of MGC. Therefore, preoperative PLR may help physicians develop treatment plans and evaluate survival in these patients.
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Novel Model to Predict the Prognosis of Patients with Stage II-III Colon Cancer. BIOMED RESEARCH INTERNATIONAL 2020; 2020:8812974. [PMID: 33299880 PMCID: PMC7704148 DOI: 10.1155/2020/8812974] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/25/2020] [Accepted: 11/10/2020] [Indexed: 12/24/2022]
Abstract
Different opinions exist on the relationship between the C-reactive protein-to-albumin ratio (CAR) and the prognosis of colon cancer. This study is aimed at evaluating the relationship between CAR and prognosis of stage II–III colon cancer and establishing a clinical prognosis model. Patients were randomised to a training set (566 cases) and validation set (110 cases). The relationship between CAR and clinicopathological variables was calculated, and the Kaplan-Meier method was used to analyse the overall survival (OS) rate of colon cancer. In the training set, colon cancer independent risk factors were included in the prognosis model and then tested in the validation set. The accuracy and discrimination of the model were assessed using the C-index and calibration curves. Compared with patients with low CAR, patients with high CAR showed significantly poorer survival (P = 0.020). In the multivariate analysis, CAR, carcinoembryonic antigen (CEA), lymph node metastasis, operation mode, and perineural invasion were identified as independent prognostic indicators and adopted to establish the prediction model. The C-index of the nomogram for predicting OS reached 0.751 in the training set and 0.719 in the validation set. The calibration curve exhibited good consistency. In the present study, the CAR may be an independent prognostic factor for stage II–III colon cancer, and the nomogram has a certain predictive value. However, further prospective large-sample research needs to be conducted to validate our findings.
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Ouyang G, Pan G, Wu Y, Liu Q, Lu W, Chen X. Prognostic Significance of Preoperative Gamma-Glutamyltransferase to Alkaline Phosphatase Ratio in Hepatocellular Carcinoma Patients with Curative Liver Resection: A Retrospective Cohort Study. Cancer Manag Res 2020; 12:8721-8732. [PMID: 33061570 PMCID: PMC7518788 DOI: 10.2147/cmar.s263370] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Accepted: 08/22/2020] [Indexed: 12/12/2022] Open
Abstract
Purpose Gamma-glutamyltransferase (GGT) and alkaline phosphatase (ALP) were involved in the development and progression of cancers. This study aimed to evaluate the prognostic value of a preoperative GGT:ALP ratio (GAR) in hepatocellular carcinoma (HCC) patients with curative liver resection. Patients and Methods A total of 380 HCC patients underwent curative liver resection before December 2017 and from January to December 2018 were included and stratified into training set and validation set, respectively. Prediction accuracy was evaluated by the area under the receiver operating characteristic curve (AUC). Factors determined to be significant for overall survival (OS) and tumor-free survival (TFS) by using Cox regression analysis. The Kaplan–Meier method and Log rank test were utilized for survival analysis. Results The AUC of GAR was 0.70 (P < 0.001). An optimal cut-off value of 0.91 yielded a sensitivity of 78.1% and a specificity of 60.4% for GAR (P < 0.001), which stratified the HCC patients into high-risk (>0.91) and low-risk (≤ 0.91) groups. Time-dependent ROC revealed that the AUCs for 1-, 3-, and 5-year OS predictions for GAR were 0.60, 0.69 and 0.62, respectively. In addition, GAR was identified as an independent risk factor for OS and TFS both in training and validation cohort by univariate and multivariate Cox regression analysis, as well as a good prognostic indicator for patients with Barcelona Clinic Liver Cancer stage C or without vascular invasion. Notably, the AUC of the GAR for survival was better than several potential prognostic indices (P < 0.05). Conclusion We identified the GAR as a prognostic indicator in two independent cohorts of HCC patients with curative liver resection. The patients with decreased GAR score were significantly associated with better OS and TFS.
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Affiliation(s)
- Guoqing Ouyang
- Department of Hepatobiliary Surgery, Liuzhou People's Hospital, Liuzhou, Guangxi, People's Republic of China
| | - Guangdong Pan
- Department of Hepatobiliary Surgery, Liuzhou People's Hospital, Liuzhou, Guangxi, People's Republic of China
| | - Yongrong Wu
- Department of Hepatobiliary Surgery, Liuzhou People's Hospital, Liuzhou, Guangxi, People's Republic of China
| | - Qiang Liu
- Department of Hepatobiliary Surgery, Liuzhou People's Hospital, Liuzhou, Guangxi, People's Republic of China
| | - Wuchang Lu
- Department of Hepatobiliary Surgery, Liuzhou People's Hospital, Liuzhou, Guangxi, People's Republic of China
| | - Xiang Chen
- Department of General Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China
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Rao J, Wu N, Qu X, Hu Y, Wu Y, Cheng Y, Yan L, Huang H, Li S, Shi L, Wu X. The Role of Serum Inflammation-Based Factors in Anti-Vascular Endothelial Growth Factor Treatment for Macular Edema Secondary to Retinal Vein Occlusion and Its Subtypes. Ophthalmic Res 2020; 64:237-245. [PMID: 32506058 DOI: 10.1159/000509171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 06/03/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aim of this work was to evaluate the association between pretreatment inflammation-based factors and outcomes in patients with macular edema (ME) secondary to retinal vein occlusion (RVO) and its subtypes after intravitreal ranibizumab or conbercept implant. METHODS This retrospective observational study included patients who were diagnosed with ME secondary to RVO at the First Affiliated Hospital of Nanchang University between January 2017 and January 2019, and who subsequently received intravitreal anti-vascular endothelial growth factor (VEGF) treatment. Blood-based parameters were measured before treatment, and correlations between best-corrected visual acuity (BCVA) and each of 3 parameters - neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) - were analyzed to identify predictors of effective intravitreal injection treatment outcomes. RESULTS A total of 315 treatment-naïve eyes treated with anti-VEGF drugs for RVO-ME were retrospectively analyzed in this study. The mean PLR value was significantly different in the effective and ineffective group for RVO-ME (138.03 ± 48.61 vs. 106.79 ± 27.28), branch RVO (BRVO)-ME (216.47 ± 53.04 vs. 185.94 ± 51.47), and central RVO (CRVO)-ME (231.07 ± 66.05 vs. 196.20 ± 60.44). The cutoff value of the PLR was 97.92, the area under the curve was 0.70, and the sensitivity and specificity were 81.5 and 44.3%, respectively. The mean NLR value was significantly different in the effective and ineffective groups for RVO-ME (2.20 ± 1.40 vs. 1.92 ± 0.89), and BRVO-ME (2.01 ± 0.80 vs. 1.82 ± 0.84), but not in patients with CRVO-ME (2.51 ± 2.02 vs. 2.12 ± 0.95). There are no significant differences between BRVO-ME and its subtype groups in MLR values. But the mean MLR value was significantly higher in the conbercept group than in the ranibizu-mab group among patients in the effective group (0.27 ± 0.11 vs. 0.25 ± 0.14). CONCLUSION Higher pretreatment PLR was associated with BCVA in patients with RVO-ME and its subtypes who were treated with anti-VEGF drugs. The PLR may be used as a predictive and prognostic tool for effective intravitreal injection treatment outcomes.
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Affiliation(s)
- Jie Rao
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Na Wu
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaoyong Qu
- Department of Ophthalmology, Jiuiang No. 1 People's Hospital, Jiujiang, China
| | - Yuxiang Hu
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yajun Wu
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yi Cheng
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Li Yan
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Hui Huang
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Siyu Li
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Ling Shi
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaorong Wu
- Department of Ophthalmology, the First Affiliated Hospital of Nanchang University, Nanchang, China,
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Hu Z, Tan S, Chen S, Qin S, Chen H, Qin S, Huang Z, Zhou F, Qin X. Diagnostic value of hematological parameters platelet to lymphocyte ratio and hemoglobin to platelet ratio in patients with colon cancer. Clin Chim Acta 2019; 501:48-52. [PMID: 31809747 DOI: 10.1016/j.cca.2019.11.036] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 11/17/2019] [Accepted: 11/27/2019] [Indexed: 12/09/2022]
Abstract
OBJECTIVE This study was designed to retrospectively analyze the value of the hematological parameter platelet to lymphocyte ratio (PLR) and hemoglobin to platelet ratio (HPR) in patients with colon cancer. METHODS The hematological parameters and clinical data of 354 cases patients with colon cancer, 108 cases patients with benign colon tumors and 123 healthy controls were collected from our hospital electronic medical records. RESULTS Compared with the colon benign tumor group and the healthy control group, the colon cancer group had an increased PLR value and a decreased HPR value. The correlation between the clinicopathological features and the laboratory parameters of colon cancer patients was analyzed, and the results showed that both PLR and HPR were associated with tumor invasion and tumor size. Compared with PLR (AUC = 0.725, 95%CI: 0.682-0.765), HPR (AUC = 0.752, 95%CI: 0.710-0.790) or carcinoembryonic antigen (CEA) (AUC = 0.710, 95%CI: 0.666-0.751) used alone, the combination with PLR and CEA (AUC = 0.790, 95%CI: 0.750-0.826) or with HPR and CEA (AUC = 0.814, 95%CI: 0.775-0.848) can improve specificity and produce greater AUC in differentiating colon cancer from benign colon cancer. CONCLUSION Combined application of PLR, HPR, and CEA may improve the diagnostic efficacy of distinguishing between colon cancer and benign colon tumors.
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Affiliation(s)
- Zuojian Hu
- Department of Laboratory Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Shaolin Tan
- Department of Orthopaedic Surgery, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Siyuan Chen
- Department of Laboratory Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Shanzi Qin
- Department of Laboratory Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Huaping Chen
- Department of Laboratory Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Simeng Qin
- Department of Laboratory Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Zhili Huang
- Department of Blood Transfusion, Second Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Fengyuan Zhou
- Department of Laboratory Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China
| | - Xue Qin
- Department of Laboratory Medicine, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China.
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Li Z, Xu Z, Huang Y, Zhao R, Cui Y, Zhou Y, Wu X. Prognostic values of preoperative platelet-to-lymphocyte ratio, albumin and hemoglobin in patients with non-metastatic colon cancer. Cancer Manag Res 2019; 11:3265-3274. [PMID: 31114364 PMCID: PMC6489677 DOI: 10.2147/cmar.s191432] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 03/12/2019] [Indexed: 02/05/2023] Open
Abstract
Purpose: Preoperative platelet-to-monocyte ratio (PLR), albumin and hemoglobin are suggested prognostic indicators in various malignancies. However, the prognostic values of PLR, albumin and hemoglobin remain elusive. The objective of the present study was to evaluate the prognostic values of PLR, albumin and hemoglobin in stage I-III colon cancer. Patients and methods: A total of 312 patients with non-metastatic colon cancer undergoing curative resection were enrolled in this study. The prognostic values of PLR, albumin and hemoglobin were identified by receiver operating characteristics, and univariate and multivariate analyses. Results: Univariate analysis revealed that preoperative PLR, albumin and hemoglobin were significantly associated with overall survival (OS) and that preoperative PLR and albumin were significantly associated with progression-free survival (PFS). Multivariate analysis revealed that preoperative PLR was significantly associated with OS. Conclusion: Reduced preoperative PLR was significantly associated with better OS in patients with stage I-III colon cancer. Preoperative PLR was an independent prognostic indictor for OS in patients with colon cancer undergoing curative resection.
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Affiliation(s)
- Zhigui Li
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Zhaofen Xu
- Department of Pathology, The Second People's Hospital, Neijiang, Sichuan 641000, People's Republic of China
| | - Yuqian Huang
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Rui Zhao
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Yaping Cui
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Yong Zhou
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
| | - Xiaoting Wu
- Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, People's Republic of China
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