Prognostic significance of neutrophil-to-lymphocyte ratio in diffuse large B-cell lymphoma: A meta-analysis (Publication with Expression of Concern)

被引:33
作者
Wang, Jin [1 ]
Zhou, Xu [1 ]
Liu, Yu [1 ]
Li, Zheng [1 ]
Li, Xiang [1 ]
机构
[1] Third Mil Med Univ, Daping Hosp, Dept Hematol, Inst Surg Res, Chongqing, Peoples R China
来源
PLOS ONE | 2017年 / 12卷 / 04期
关键词
HEPATOCELLULAR-CARCINOMA; PRETREATMENT NEUTROPHIL; STATISTICAL-METHODS; MONOCYTE RATIO; LUNG-CANCER; INFLAMMATION; PERFORMANCE; RITUXIMAB; PD-1;
D O I
10.1371/journal.pone.0176008
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background Neutrophil-to-lymphocyte ratio (NLR) has been investigated as a prognostic marker in patients with diffuse large B-cell lymphoma (DLBCL); however, the results remain controversial. This study aimed to explore the association between NLR and survival outcomes and clinicopathological factors in DLBCL. Methods Relevant studies were retrieved by searching PubMed, Embase, Web of Science, and China National Knowledge Infrastructure (CNKI) databases. The last search was updated on February 17, 2017. Hazard ratios (HRs) and odds ratios (ORs) and their 95% confidence intervals (CIs) were used as effective measures in the meta-analysis. Random-effects models and fixed-effects models were used for analyses. Meta-regression was performed. Publication bias was assessed using Begg's test. Stata version 12.0 was used for all analyses. Results A total of 9 studies with 2297 patients were included in the meta-analysis. The pooled results showed that NLR was a significant indicator for poor overall survival (OS) (HR = 1.84, 95% CI = 1.52-2.22, p<0.001) and poor progression-free survival (PFS) (HR = 1.64, 95% CI = 1.36-1.98, p<0.001). NLR remained a significant biomarker for OS and PFS regardless of location, sample size or cut-off value. In addition, high NLR was also associated with Ann Arbor stage (OR = 2.09, 95% CI = 1.14-3.81, p = 0.017), lactate dehydrogenase level (OR = 2.74, 95% CI = 1.16-6.46, p = 0.021), extranodal disease (OR = 1.63, 95% CI = 1.06-2.52, p = 0.027), and International Prognostic Index score (OR = 2.44, 95% CI = 1.03-5.08, p = 0.043). However, NLR was found to have no significant association with sex (OR = 0.89, 95% CI = 0.71-1.11, p = 0.29), age (OR = 1.18, 95% CI = 0.94-1.48, p = 0.152), European Cooperative Oncology Group performance status score (OR = 1.78, 95% CI = 0.71-4.46, p = 0.217), or presence of B symptoms (OR = 1.56, 95% CI = 0.7-3.48, p = 0.278). Conclusion In conclusion, our meta-analysis demonstrated that NLR has a strong association with worse OS and PFS in patients with DLBCL. NLR could be recommended as an inexpensive prognostic biomarker in DLBCL.
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页数:15
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