Prognostic role of platelet to lymphocyte ratio in hepatocellular carcinoma: a systematic review and meta-analysis
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Yongzhao Zhao1,*, Guangyan Si2,*, Fengshang Zhu3,*, Jialiang Hui4,*, Shangli Cai5, Chenshen Huang1, Sijin Cheng1, Abdel Hamid Fathy1, Yi Xiang4, Jing Li3
1School of Medicine, Tongji University, Shanghai, China
2Department of Interventional Radiology, Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China
3Department of Gastroenterology, Tongji Hospital, Tongji University, Shanghai, China
4Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
5Mental Health Institute of the Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Hunan, China
*These authors contributed equally to this work
Jing Li, email: [email protected]
Keywords: platelet to lymphocyte ratio, hepatocellular carcinoma, prognostic, overall survival
Received: September 09, 2016 Accepted: January 29, 2017 Published: February 11, 2017
Background and Aims: Several studies were conducted to explore the prognostic significance of platelet to lymphocyte ratio (PLR) in hepatocellular carcinoma (HCC), however, contradictory results across most reports were documented. To this end, we present a systematic review that aims to summarize the prognostic significance of PLR in patients with HCC.
Results: A total of 10 studies involving a total of 2,315 patients were identified. The Newcastle-Ottawa Quality Assessment Scale (NOS) of each included study was greater than or equal to 5. The results indicated that high PLR was significantly associated with a worse OS when compared to the low PLR (HR = 1.60, 95% CI = 1.23−2.08, p = 0.0005; I2 = 88%, p < 0.00001). Similar results were detected in the subgroup analysis of the analysis model, cut-off value, ethnicity, sample size and therapy. However, no obvious correlation between the PLR and DFS/RFS in patients with HCC was observed (HR = 1.21, 95% CI = 0.87−1.67, p = 0.26; I2 = 61%, p = 0.07).
Materials and Methods: A complete literature search in the PubMed, Cochrane Library and Embase database was performed. Retrospective and prospective studies focusing on the role of PLR on the prognosis in HCC were all deemed as “suitable” for our scope. The endpoints determined were: the overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS) and the progress free survival (PFS).
Conclusions: The study revealed that high PLR is an unfavorable predictor of OS in patients with HCC, and high PLR is a promising prognostic biomarker for HCC, especially for patients in Asia.
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