The Prognostic Role Of The Pre-operation Platelet-lymphocytes Ratio And Neutrophil-lymphocyte Ratio In Gastric Cancer:A Meta-analysis

Objective:The purpose of this meta-analysis was to evaluate the prognostic value of the pre-operation Platelet to Lymphocytes ratio(PLR)and Neutrophil to Lymphocyte ratio(NLR)in patients with gastric cancer.Methods:A systematic literature search including PubMed,Embase,the Cochrane Library CBM,CNKI,WANFANG databases was performed to assess the prognostic value of the pre-operation PLR and NLR in gastric cancer.The quality of each included study was evaluated using the Newcastle Ottawa Quality Assessment Scale(NOS).After data being extracted,RevMan(Version 5.2,Cochrane Library)was used for all statistical analysis.Pooled outcomes were calculated using a random effects model conservatively.Results:Eleven studies,comprising 5962 patients with gastric cancer,met the pre-setting inclusion criteria were analyzed.Compared with the normal pre-operation PLR,an elevated pre-operation PLR was correlated with a higher risk of lymph node metastasis with an OR of 1.54(95% Cl:1.34-1.78;I2=20 %)and serosal invasion(T3 +T4)risk with an OR of 2.42(95% Cl: 1.67-3.50;I2 = 74%),and an elevated pre-operation PLR also increased the advanced stage(III +IV)risk with an OR of 2.05(95% Cl: 1.56-2.70;I2 = 66%).In comparison with the normal pre-operation NLR,an elevated pre-operation NLR was correlated with a higher risk of lymph node metastasis with an OR of 2.36(95% Cl:1.63-3.44,I2 = 80%)and serosal invasion(T3 +T4)risk with an OR of 2.20(95% Cl: 1.49-3.25,I2 = 83%),and an elevated pre-operation NLR also increased the advanced stage(III +IV)risk with an OR of 3.44(95% Cl: 1.91-6.18,I2 =92%).Conclusion:Elevated pre-operation PLR and NLR were correlated with a higher risk of lymph node metastasis,serosal invasion(T3+T4)and advanced stage(III +IV)risk in gastric cancer.Elevated pre-operation PLR and NLR probably were both negative factors of prognosis of patients with gastric cancer.