Value of Preoperative Neutrophil-to-Lymphocyte Ratio in Predicting Prognosis of Surgically Resectable Urinary Cancers: Systematic Review and Meta-Analysis

Wang Zhan; Wang Xu; Wang Wenda; Zheng Guoyang; Guo Hao; Zhang Yushi

doi:10.24920/003668

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Value of Preoperative Neutrophil-to-Lymphocyte Ratio in Predicting Prognosis of Surgically Resectable Urinary Cancers: Systematic Review and Meta-Analysis

Chinese Medical Sciences Journal Vol. 35, Issue 3, Pages: 262-271(2020)

Original Article | Updated：2024-04-10

- Value of Preoperative Neutrophil-to-Lymphocyte Ratio in Predicting Prognosis of Surgically Resectable Urinary Cancers: Systematic Review and Meta-Analysis
- Affiliations：
  
  Department of Urology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
- Author bio：
  
  * E-mail: beijingzhangyushi@126.com
- Funds：
- DOI：10.24920/003668
  CLC：
- Received：08 January 2020，
  
  Published Online：30 September 2020，
  
  Published：30 September 2020
- Accepted：
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Wang Zhan, Wang Xu, Wang Wenda, et al. Value of Preoperative Neutrophil-to-Lymphocyte Ratio in Predicting Prognosis of Surgically Resectable Urinary Cancers: Systematic Review and Meta-Analysis[J]. Chinese medical sciences journal, 2020, 35(3): 262-271.
DOI：

Wang Zhan, Wang Xu, Wang Wenda, et al. Value of Preoperative Neutrophil-to-Lymphocyte Ratio in Predicting Prognosis of Surgically Resectable Urinary Cancers: Systematic Review and Meta-Analysis[J]. Chinese medical sciences journal, 2020, 35(3): 262-271. DOI： 10.24920/003668.

摘要

目的

术前中性粒细胞与淋巴细胞比值（NLR）与多种恶性肿瘤的预后密切相关

但是

NLR对可切除泌尿系肿瘤预后的影响尚不确定。因此

此系统综述和荟萃分析旨在探讨术前NLR在预测可切除泌尿系肿瘤预后方面的价值。

方法

我们通过检索Embase、PubMed/MEDLINE和Cochrane数据库

依据纳入和排除标准筛选文献

最终纳入25项研究

其中包括15950例受试对象。采用风险比（

s）及其95%可信区间（

s）评估术前NLR与可切除泌尿系肿瘤患者的总生存期（OS）及肿瘤特异性生存期（CSS）的关系。

结果

结果表明对于患有可切除泌尿系恶性肿瘤的患者

术前NLR能预测其预后。NLR越高

患者的OS（

=1.40

95%

：1.26~1.54

0.001）和CSS越短（

=1.43

95%

：1.27~1.59

0.001）。此外

不论患者种族或术前NLR阈值高低

术前NLR升高均能提示肾细胞癌（OS：

=2.06

95%

=1.54~2.76

=0.131;CSS：

=2.46

95%

=1.46~4.16

=0.178）、上尿路上皮癌（OS：

=1.91

95%

=1.50~2.42

=0.616;CSS：

=1.84

95%

=1.41~2.39

=0.001）、膀胱癌（OS：

=1.09

95%

=1.02~1.17

0.001;CSS：

=1.05

95%

=1.01~1.09

=0.163）和前列腺癌（OS：

=1.69

95%

=1.19~2.41

=0.714）预后较差。

结论

术前NLR升高能够作为预测泌尿系可切除恶性肿瘤不良预后的指标

包括肾癌、膀胱癌、前列腺癌和上尿路上皮癌。

Abstract

Objective

Accumulated evidence has suggested that there is a close association between preoperative neutrophil-to-lymphocyte ratio (NLR) and prognosis of various malignant tumors. However

the relationship between NLR and surgically resectable urinary cancers remains contradictory. Therefore

we performed this systematic review and meta-analysis to explore whether preoperative NLR could predict the prognosis of surgically resectable urinary cancers.

Methods

After searching the Embase

PubMed/MEDLINE and Cochrane databases and screening the articles

we finally included 25 studies involving 15950 patients. Hazard ratios (

s) and their 95% confidence intervals (

s) were extracted to assess the association between preoperative NLR and the overall survival (OS) and cancer-specific survival (CSS) of surgically resectable urinary cancers.

Results

The pooled results revealed that an elevated preoperative NLR could predict a worse OS (

=1.40

95%

: 1.26-1.54

0.001) and CSS (

=1.43

95%

: 1.27-1.59

0.001) in urinary cancers. In addition

our analyses also suggested that high preoperative NLR was associated with worse prognosis in renal cell carcinoma (OS:

=2.06

95%

: 1.54-2.76

=0.131; CSS:

=2.46

95%

: 1.46-4.16

=0.178)

upper tract urothelial carcinoma (OS:

=1.91

95%

: 1.50-2.42

=0.616; CSS:

=1.84

95%

: 1.41-2.39

=0.001)

bladder cancer (OS:

=1.09

95%

: 1.02-1.17

0.001; CSS:

=1.05

95%

: 1.01-1.09

=0.163) and prostate cancer (OS:

=1.69

95%

: 1.19-2.41

=0.714). Regardless of the participants’ race or the cutoff value of the preoperative NLR

the results remained valid.

Conclusion

Elevated preoperative NLR could predict a worse prognosis in surgically resectable urinary cancers

namely

renal cell carcinoma

bladder cancer

prostate cancer and upper tract urothelial carcinoma.

关键词

Keywords

references

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