The clinical use of pretreatment NLR, PLR, and LMR in patients with esophageal squamous cell carcinoma: evidence from a meta-analysis

Background and purpose: The relationship between neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and lymphocyte to monocyte ratio (LMR) and the prognostic and clinicopathological significance in patients with esophageal squamous cell carcinoma (ESCC) has been reported by many studies. However, inconsistent results have been presented. The current study aimed to investigate the prognostic and clinicopathological role of NLR, PLR, and LMR in patients with ESCC by meta-analysis. Methods: Eligible studies were identified in databases and the relationship between NLR/PLR/LMR and the prognosis or clinicopathological features in patients with ESCC was evaluated. OR or HR with 95% CI was calculated to estimate the risk or hazard association. Result: Twenty-six studies including 8,586 ESCC patients were included for the analysis. We found that high NLR, PLR and low LMR were associated with poor overall survival/cancerspecific survival and event-free survival and malignant phenotypes such as deeper depth of invasion (T), positive lymph node metastasis (N), and advanced TNM stage. Conclusion: NLR, PLR, and LMR might serve as prognostic markers in patients with ESCC.