title: Prognostic role of neutrophil-to-lymphocyte ratio in colorectal cancer: a systematic review and meta-analysis.
abstract: The prognostic role of inflammation index like neutrophil-to-lymphocyte ratio (NLR) in colorectal cancer (CRC) remains controversial. We conduct a meta-analysis to determine the predictable value of NLR in the clinical outcome of CRC patients. The analysis was carried out based on the data from 16 studies (19 cohorts) to evaluate the association between NLR and overall survival (OS) and progression-free survival (PFS) in patients with CRC. In addition, the relationship between NLR and clinicopathological parameters was assessed. Hazard ratio (HR) or odds ratio (OR) with its 95% confidence interval (CI) was used as the effect size estimate. Our analysis results indicated that elevated pretreatment NLR predicted poorer OS (HR: 1.813, 95% CI: 1.499-2.193) and PFS (HR: 2.102, 95% CI: 1.554-2.843) in patients with CRC. Increased NLR is also significantly associated with the poorer differentiation of the tumor (OR: 1.574, 95% CI: 1.226-2.022) and higher carcino-embryonie antigen (CEA) level (OR: 1.493, 95% CI: 1.308-1.705). By these results, we conclude that NLR gains a prognostic value for patients with CRC. NLR should be monitored in CRC patients for rational stratification of the patients and adjusting the treatment strategy.
authors.affiliation: Research Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China; Department of Hepatobiliary Surgery, The First Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi Province, People's Republic of China.
authors.forename: Mu-Xing
authors.initials: MX
authors.lastname: Li
authors.forename: Xue-Min
authors.initials: XM
authors.lastname: Liu
authors.forename: Xu-Feng
authors.initials: XF
authors.lastname: Zhang
authors.forename: Jian-Fei
authors.initials: JF
authors.lastname: Zhang
authors.forename: Wan-Li
authors.initials: WL
authors.lastname: Wang
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhu
authors.forename: Jian
authors.initials: J
authors.lastname: Dong
authors.forename: Ji-Wen
authors.initials: JW
authors.lastname: Cheng
authors.forename: Zheng-Wen
authors.initials: ZW
authors.lastname: Liu
authors.forename: Le
authors.initials: L
authors.lastname: Ma
authors.forename: Yi
authors.initials: Y
authors.lastname: Lv
mesh_terms: D002272:Carcinoembryonic Antigen / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D018572:Disease-Free Survival; D006801:Humans; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000473:pathology*; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology*; D011379:Prognosis
chemical_list: D002272:Carcinoembryonic Antigen
keywords: colorectal cancer; meta-analysis; neutrophil-to-lymphocyte ratio; prognosis