title: Prognostic role of platelet to lymphocyte ratio in hepatocellular carcinoma: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Several studies were conducted to explore the prognostic significance of platelet to lymphocyte ratio (PLR) in hepatocellular carcinoma (HCC), however, contradictory results across most reports were documented. To this end, we present a systematic review that aims to summarize the prognostic significance of PLR in patients with HCC.
  
  
  RESULTS
  A total of 10 studies involving a total of 2,315 patients were identified. The Newcastle-Ottawa Quality Assessment Scale (NOS) of each included study was greater than or equal to 5. The results indicated that high PLR was significantly associated with a worse OS when compared to the low PLR (HR = 1.60, 95% CI = 1.23-2.08, p = 0.0005; I2 = 88%, p < 0.00001). Similar results were detected in the subgroup analysis of the analysis model, cut-off value, ethnicity, sample size and therapy. However, no obvious correlation between the PLR and DFS/RFS in patients with HCC was observed (HR = 1.21, 95% CI = 0.87-1.67, p = 0.26; I2 = 61%, p = 0.07).
  
  
  METHODS
  A complete literature search in the PubMed, Cochrane Library and Embase database was performed. Retrospective and prospective studies focusing on the role of PLR on the prognosis in HCC were all deemed as "suitable" for our scope. The endpoints determined were: the overall survival (OS), disease-free survival (DFS), recurrence-free survival (RFS) and the progress free survival (PFS).
  
  
  CONCLUSIONS
  The study revealed that high PLR is an unfavorable predictor of OS in patients with HCC, and high PLR is a promising prognostic biomarker for HCC, especially for patients in Asia.
authors.affiliation: School of Medicine, Tongji University, Shanghai, China.
authors.forename: Yongzhao
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Interventional Radiology, Affiliated Traditional Chinese Medicine Hospital, Southwest Medical University, Luzhou, China.
authors.forename: Guangyan
authors.initials: G
authors.lastname: Si
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji University, Shanghai, China.
authors.forename: Fengshang
authors.initials: F
authors.lastname: Zhu
authors.affiliation: Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Jialiang
authors.initials: J
authors.lastname: Hui
authors.affiliation: Mental Health Institute of the Second Xiangya Hospital, National Technology Institute of Psychiatry, Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Hunan, China.
authors.forename: Shangli
authors.initials: S
authors.lastname: Cai
authors.affiliation: School of Medicine, Tongji University, Shanghai, China.
authors.forename: Chenshen
authors.initials: C
authors.lastname: Huang
authors.affiliation: School of Medicine, Tongji University, Shanghai, China.
authors.forename: Sijin
authors.initials: S
authors.lastname: Cheng
authors.affiliation: School of Medicine, Tongji University, Shanghai, China.
authors.forename: Abdel Hamid
authors.initials: AH
authors.lastname: Fathy
authors.affiliation: Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Xiang
authors.affiliation: Department of Gastroenterology, Tongji Hospital, Tongji University, Shanghai, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Li
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology; D018655:Lymphocyte Count; D010976:Platelet Count; D011379:Prognosis; D016019:Survival Analysis
keywords: hepatocellular carcinoma; overall survival; platelet to lymphocyte ratio; prognostic