Systematic review and metanalysis of neutrophil to lymphocyte ratio and prognosis in patients with nasopharyngeal carcinoma

Author:

Zhao Wanying1ORCID,Li Xiaofeng2ORCID,Lv Li3ORCID,Sun Xiance2ORCID,Xue Juan1ORCID,Yang Ping1ORCID,Tang Jinhai1ORCID,Lv Xiupeng1ORCID

Affiliation:

1. Department of Radiotherapy First Affiliated Hospital of Dalian Medical University Dalian City Liaoning Province China

2. School of Basic Medicine and Public Health Dalian Medical University Dalian City Liaoning Province China

3. Department of Pathology Second Affiliated Hospital of Dalian Medical University Dalian City Liaoning Province China

Abstract

AbstractBackgroundHematological parameters have been associated with prognosis in patients with nasopharyngeal carcinoma (NPC). The present meta‐analysis investigated the utility of neutrophil‐lymphocyte ratio (NLR) in the prognosis of patients with NPC.MethodsMultiple electronic databases, including PubMed, Embase, the Cochrane Library, and the Web of Science, were systematically searched for studies assessing the association between NLR and NPC from 2011 to 2021. The primary outcomes were overall survival (OS) and progression‐free survival (PFS). Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were utilized to estimate effect size. Use of a fixed effect or random effect model was based on heterogeneity stability was tested by sensitivity analysis, and the risk of bias was assessed by funnel plots. Random effects models were used based on the actual results. Because the NLR grouping criteria for the included studies differed, subgroup analyses were performed.ResultsA search of the electronic databases identified 14 studies, encompassing 6693 patients, that met the selection criteria. NLR higher than the cutoff value was significantly associated with poorer OS [HR 1.760, 95% CI 1.470–2.120, p <0.00001] and PFS [HR 1.850, 95% CI 1.430–2.390, p = .006]. Sensitivity analysis showed that the results of the meta‐analysis were relatively stable, and funnel plots were used to exclude the risk of bias.ConclusionsElevated pretreatment NLR in peripheral blood is predictive of poorer OS and PFS in patients with NPC. NLR is an easily measured and important prognostic factor in patients with NPC.

Funder

Natural Science Foundation of Liaoning Province

Publisher

Wiley

Subject

General Medicine

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