Prognostic Value Of Pretreatment Neutrophil-to-Lymphocyte Ratio And Platelet-to-Lymphocyte Ratio In Gastroenteropancreatic Neuroendocrine Neoplasms:A Meta-analysis

Objective:To evaluate the prognostic value of pretreatment neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)in gastroenteropancreatic neuroendocrine neoplasms(GEP-NENs)through a meta-analysis.Methods:A computerized systematic search of Chinese National Knowledge Infrastructure,Wanfang,Pub Med,Embase,Web of Science and Cochrane Library was conducted up to February 5,2022 in Chinese and English.We independently screened all literature and evaluated the quality of evidence to finalize includied studies.The meta-analysis on NLR and PLR was carried out to determine the prognostic effectiveness of the GEP-NENs patients by using the Review Manager software(Version 5.4.1)and Stata statistical software(Version 12.0).Results:12 researches with 2040 GEP-NENs patients were included in total.The result show that:1.NLR was obviously related to shortening of progression free survival(PFS)/recurrence free survival(RFS)[HR=2.31,95%CI(1.65-3.24),P<0.01] and overall survival(OS)[HR=2.90,95%CI(1.67-5.05),P<0.01] among patients with GEP-NENs.Further subgroup analyses of OS,regardless of country,number of samples,treatment strategy,NLR cut-off,determination method of NLR cut-off and primary site of tumor,Among patients suffering from GEP-NENs,growing NLR was related to shortened OS.2.The results showed that high pretreatment PLR was associated with poor OS[HR=2.52,95%CI(1.71-3.72),P<0.01] among patients with GEP-NENs.3.An enhanced level of NLR was associated to lymph node metastasis[OR=2.61,95%CI(1.27-5.39),P<0.05],poor tumor grade [OR=0.31,95%CI(0.21-0.47),P<0.05],stage [OR=0.46,95%CI(0.28-0.76),P<0.05] and unfunctional GEP-NENs[OR=0.55,95%CI(0.34-0.88),P<0.05].Conclusion:The pretreatment NLR and PLR could be used as prognostic biomarkers to predict the survival outcome of GEP-NENs patients,These indictors played an important role in stratified management and prognosis assessment,they also assisted GEP-NENs patients to individualized management.