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Prognostic roles of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in ovarian cancer: a meta-analysis of retrospective studies

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Abstract

Purpose

The systemic inflammatory response markers have been reported to be associated with the prognosis of various cancers. We conducted this meta-analysis of retrospective studies to evaluate and identify the prognostic impact of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) on ovarian cancer.

Methods

PubMed, EMBASE, and China National Knowledge Infrastructure databases were included to search for eligible studies. The following terms were used: “neutrophil to lymphocyte ratio”, “NLR”, “platelet to lymphocyte ratio”, “PLR”, “ovarian cancer”, “ovary cancer”, “ovarian carcinoma”, “ovary carcinoma”, “ovarian neoplasm”, “ovary neoplasm”, “ovarian tumor”, and “ovary tumor”. The random-effects model was chosen to estimate the pooled HR with 95% CI. Heterogeneity between studies was assessed by Higgins I2 value. The stability and heterogeneity of studies were analyzed by sensitivity analysis. Publication bias was examined by Egger’s test and Begg’s test with the funnel plots.

Results

13 studies consisting of 3467 patients were considered for meta-analysis. We found that the high NLR had a poor prognostic impact on OS and PFS in ovarian cancer, with a pooled HR 1.70, 95% CI 1.35–2.15 and HR 1.77, 95% CI 1.48–2.12, respectively. Similarly, the results showed the high PLR adversely affected OS and PFS in ovarian cancer, with a pooled HR 2.05, 95% CI 1.70–2.48 and HR 1.85, 95% CI 1.53–2.25, respectively.

Conclusion

In conclusion, we found that both NLR and PLR had an unfavorable impact on PFS and OS of patients with ovarian cancer. Our meta-analysis supported that NLR/PLR could be effective prognostic predictors of ovarian cancer.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, 107 Wenhua Xi Road, Jinan, 250012, Shandong, People’s Republic of China

    Zhe Zhao, Xinrui Zhao, Jingjing Lu, Jing Xue, Peishu Liu & Hongluan Mao

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  1. Zhe Zhao
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  2. Xinrui Zhao
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  3. Jingjing Lu
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  4. Jing Xue
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  5. Peishu Liu
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  6. Hongluan Mao
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ZZ: Project development, Data collection, Manuscript writing. XZ: Data collection, Data analysis. JX: Data analysis. JL: Data collection, Data analysis. PL: Manuscript writing.

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Correspondence to Peishu Liu or Hongluan Mao.

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404_2018_4678_MOESM1_ESM.tif

Publication bias of meta analysis between included studies. A: NLR and OS; B: NLR and PFS; C: PLR and OS; D: PLR and PFS (TIFF 14038 kb)

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Zhao, Z., Zhao, X., Lu, J. et al. Prognostic roles of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in ovarian cancer: a meta-analysis of retrospective studies. Arch Gynecol Obstet 297, 849–857 (2018). https://doi.org/10.1007/s00404-018-4678-8

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