title: Platelet-lymphocyte ratio acts as an indicator of poor prognosis in patients with breast cancer.
abstract: Platelet-lymphocyte ratio (PLR) is a hematological parameter which is investigated as a biomarker for prognosis in patients with breast cancer. Due to the controversial results from previous studies, we performed a meta-analysis. Databases of PubMed, Embase and Web of Science were searched to identify eligible studies. STATA version 12.0 was used for statistical analysis. Seven studies with 3,741 patients were ultimately included in this meta-analysis. High PLR was associated with poor overall survival (OS) (HR = 1.55, 95% CI = 1.07-2.25, p = 0.022) and disease-free survival (DFS) (HR = 1.73, 95% CI = 1.3-2.3, p < 0.001) in breast cancer patients. Subgroup analyses disclosed that elevated PLR could predict worse OS in Asian populations and poor DFS in both Asian and non-Asian patients. In addition, PLR remains a significant prognostic marker for OS in patients receiving systemic treatment (HR = 1.78, 95% CI = 1.06-2.99, p = 0.03) and patients receiving chemotherapy (HR = 2.82, 95% CI = 1.09-7.26, p = 0.032). High PLR also indicates poor DFS in patients who receive chemotherapy (HR = 2.6, 95% CI = 1.47-4.61, p = 0.001), surgery (HR = 1.8, 95% CI = 1.12-2.89, p = 0.016) and systemic treatment (HR = 2.03, 95% CI = 1.03-4.01, p = 0.042). Moreover, PLR was also in association with HER-2 positivity (OR = 1.48, 95% CI = 1.2-1.83, p < 0.001). In conclusion, this meta-analysis revealed that PLR could serve as an indicator of poor prognosis in patients with breast cancer.
authors.affiliation: Department of Medical Oncology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Yanyun
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Medical Oncology, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Si
authors.affiliation: Department of Medical Oncology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Qiong
authors.initials: Q
authors.lastname: Sun
authors.affiliation: Department of Medical Oncology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Boyu
authors.initials: B
authors.lastname: Qin
authors.affiliation: Department of Medical Oncology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Weihong
authors.initials: W
authors.lastname: Zhao
authors.affiliation: Department of Medical Oncology, Chinese PLA General Hospital, Beijing 100853, China.
authors.forename: Junlan
authors.initials: J
authors.lastname: Yang
mesh_terms: D015415:Biomarkers; D001792:Blood Platelets; D001943:Breast Neoplasms / Q000097:blood* / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D018655:Lymphocyte Count; D008214:Lymphocytes; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D010976:Platelet Count; D011379:Prognosis; D017594:Publication Bias
chemical_list: D015415:Biomarkers
keywords: PLR; biomarker; breast cancer; meta-analysis; prognosis