Relationship between preoperative platelet-to-lymphocyte ratio and prognosis in patients with pancreatic ductal adenocarcinoma: a meta-analysis_West China Medical Journal

Authors：

HE Dong , FAN Wanli , ZHANG Shuze , ZHAO Bin ,  CHENG Zhibin

Department of General Surgery, the Second Hospital of Lanzhou University, Lanzhou, Gansu 730030, P. R. China;

Corresponding?author：

CHENG Zhibin, Email: zhibin_cheng@hotmail.com

Keywords：

Pancreatic ductal adenocarcinoma; prognosis; platelet-to-lymphocyte ratio; meta-analysis

DOI：

10.7507/1002-0179.202312043

Video：

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Objective To systematically review the relationship between preoperative platelet-to-lymphocyte ratio (PLR) and prognosis in patients with pancreatic ductal adenocarcinoma (PDAC). Methods Studies on the relationship between preoperative PLR and prognosis of PDAC patients were retrieved from China National Knowledge Infrastructure, Chongqing VIP, SinoMed, Wanfang, PubMed, Embase, Web of Science, and Cochrane Library, with a search period from databases establishment to December 2023. A meta-analysis was conducted using RevMan 5.3 software. Results A total of 7 studies were included, including 1273 patients. The meta-analysis results showed that the postoperative overall survival [hazard ratio (HR)=1.69, 95% confidence interval (CI) (1.24, 2.30)] and disease-free survival [HR=1.83, 95%CI (1.49, 2.24)] of PDAC patients with high preoperative PLR were shortened (P<0.05). The results of subgroup analysis showed that when the cut off of PLR was<200, preoperative high PLR was associated with shortened overall survival (HR=1.91, P<0.05), but when the cut off of PLR was ≥200, there was no significant correlation between preoperative PLR and overall survival (P>0.05). When followed up for<3 years, preoperative high PLR was associated with shortened overall survival (HR=2.05, P<0.05), but when followed up for ≥3 years, there was no significant correlation between preoperative PLR and overall survival (P>0.05). Conclusion Current evidence suggests that preoperative high PLR may be a risk factor for poor prognosis in PDAC patients.

Citation： HE Dong, FAN Wanli, ZHANG Shuze, ZHAO Bin, CHENG Zhibin. Relationship between preoperative platelet-to-lymphocyte ratio and prognosis in patients with pancreatic ductal adenocarcinoma: a meta-analysis. West China Medical Journal, 2024, 39(5): 771-775. doi: 10.7507/1002-0179.202312043 Copy

1.	王海靜, 秦芳. 外周血FAR聯合NLR在局部晚期或轉移性胰腺癌患者預后評估中的價值. 國際檢驗醫學雜志, 2022, 43(13): 1587-1592, 1597.
2.	Toledano-Fonseca M, Cano MT, Inga E, et al. The combination of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio with liquid biopsy biomarkers improves prognosis prediction in metastatic pancreatic cancer. Cancers (Basel), 2021, 13(6): 1210.
3.	Gleisner AL, Assumpcao L, Cameron JL, et al. Is resection of periampullary or pancreatic adenocarcinoma with synchronous hepatic metastasis justified?. Cancer, 2007, 110(11): 2484-2492.
4.	Klein F, Puhl G, Guckelberger O, et al. The impact of simultaneous liver resection for occult liver metastases of pancreatic adenocarcinoma. Gastroenterol Res Pract, 2012, 2012: 939350.
5.	Shrikhande SV, Kleeff J, Reiser C, et al. Pancreatic resection for M1 pancreatic ductal adenocarcinoma. Ann Surg Oncol, 2007, 14(1): 118-127.
6.	Chen X, Yi B, Liu Z, et al. Global, regional and national burden of pancreatic cancer, 1990 to 2017: results from the Global Burden of Disease Study 2017. Pancreatology, 2020, 20(3): 462-469.
7.	Singh N, Baby D, Rajguru JP, et al. Inflammation and cancer. Ann Afr Med, 2019, 18(3): 121-126.
8.	Sideras K, Braat H, Kwekkeboom J, et al. Role of the immune system in pancreatic cancer progression and immune modulating treatment strategies. Cancer Treat Rev, 2014, 40(4): 513-522.
9.	Templeton AJ, McNamara MG, ?eruga B, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst, 2014, 106(6): dju124.
10.	錢佳璐, 湯娜. 血小板與淋巴細胞比值聯合CA19-9預測胰腺癌預后. 現代消化及介入診療, 2022, 27(4): 512-515.
11.	謝小妹, 陳龍, 黃江瓊, 等. 術前血清CEA水平與非小細胞肺癌預后關系的Meta分析. 現代生物醫學進展, 2012, 12(19): 3689-3692.
12.	唐偉杰. NLR和PLR對根治性胰腺癌切除術術后生存期的預測價值. 蕪湖: 皖南醫學院, 2022.
13.	申鵬. 術前NLR、PLR對胰腺癌患者術后1年生存率的預測價值. 北京: 北京協和醫學院, 2017.
14.	Chawla A, Huang TL, Ibrahim AM, et al. Pretherapy neutrophil to lymphocyte ratio and platelet to lymphocyte ratio do not predict survival in resectable pancreatic cancer. HPB (Oxford), 2018, 20(5): 398-404.
15.	Shirai Y, Shiba H, Sakamoto T, et al. Preoperative platelet to lymphocyte ratio predicts outcome of patients with pancreatic ductal adenocarcinoma after pancreatic resection. Surgery, 2015, 158(2): 360-365.
16.	Wang Y, Cui C, Yu Q, et al. Development and validation of a nomogram for predicting survival in patients with pancreatic ductal adenocarcinoma after radical pancreatoduodenectomy. Oncologie, 2023, 25(1): 51-59.
17.	Giakoustidis A, Neofytou K, Costa Neves M, et al. Identifying the role of neutrophil-to-lymphocyte ratio and platelets-to-lymphocyte ratio as prognostic markers in patients undergoing resection of pancreatic ductal adenocarcinoma. Ann Hepatobiliary Pancreat Surg, 2018, 22(3): 197-207.
18.	Ye S, Bai L. Comparison and validation of the value of preoperative inflammation marker-based prognostic scores in resectable pancreatic ductal adenocarcinoma. Cancer Manag Res, 2018, 10: 3405-3417.
19.	孫婧, 史幼梧, 賈軍, 等. 血液炎癥相關指標在晚期胰腺癌中的預后價值. 首都醫科大學學報, 2022, 43(2): 299-304.
20.	徐雪君, 周天朔, 李志偉. 系統性炎癥指標對胰腺癌預后的價值研究. 癌癥進展, 2019, 17(23): 2774-2776.
21.	Miyashita T, Tajima H, Makino I, et al. Metastasis-promoting role of extravasated platelet activation in tumor. J Surg Res, 2015, 193(1): 289-294.
22.	劉榮華, 王婷, 張焜和. 外周血炎性指標對胰腺癌患者預后預測價值的研究進展. 癌癥進展, 2022, 20(10): 990-992, 1023.
23.	周雨, 林葉, 簡志祥. 治療前血小板水平與胰腺癌預后相關性的Meta分析. 循證醫學, 2017, 17(6): 343-349.
24.	Elaskalani O, Falasca M, Moran N, et al. The role of platelet-derived adp and atp in promoting pancreatic cancer cell survival and gemcitabine resistance. Cancers (Basel), 2017, 9(10): 142.
25.	孫彬, 李健. 血小板在惡性腫瘤轉移中的機制. 軍醫進修學院學報, 2011, 32(8): 871-873.
26.	程娟, 管世鶴, 陳禮文, 等. 胰腺癌患者手術前后外周血淋巴細胞亞群和血小板變化. 檢驗醫學, 2020, 35(7): 655-659.

1. 王海靜, 秦芳. 外周血FAR聯合NLR在局部晚期或轉移性胰腺癌患者預后評估中的價值. 國際檢驗醫學雜志, 2022, 43(13): 1587-1592, 1597.
2. Toledano-Fonseca M, Cano MT, Inga E, et al. The combination of neutrophil-lymphocyte ratio and platelet-lymphocyte ratio with liquid biopsy biomarkers improves prognosis prediction in metastatic pancreatic cancer. Cancers (Basel), 2021, 13(6): 1210.
3. Gleisner AL, Assumpcao L, Cameron JL, et al. Is resection of periampullary or pancreatic adenocarcinoma with synchronous hepatic metastasis justified?. Cancer, 2007, 110(11): 2484-2492.
4. Klein F, Puhl G, Guckelberger O, et al. The impact of simultaneous liver resection for occult liver metastases of pancreatic adenocarcinoma. Gastroenterol Res Pract, 2012, 2012: 939350.
5. Shrikhande SV, Kleeff J, Reiser C, et al. Pancreatic resection for M1 pancreatic ductal adenocarcinoma. Ann Surg Oncol, 2007, 14(1): 118-127.
6. Chen X, Yi B, Liu Z, et al. Global, regional and national burden of pancreatic cancer, 1990 to 2017: results from the Global Burden of Disease Study 2017. Pancreatology, 2020, 20(3): 462-469.
7. Singh N, Baby D, Rajguru JP, et al. Inflammation and cancer. Ann Afr Med, 2019, 18(3): 121-126.
8. Sideras K, Braat H, Kwekkeboom J, et al. Role of the immune system in pancreatic cancer progression and immune modulating treatment strategies. Cancer Treat Rev, 2014, 40(4): 513-522.
9. Templeton AJ, McNamara MG, ?eruga B, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst, 2014, 106(6): dju124.
10. 錢佳璐, 湯娜. 血小板與淋巴細胞比值聯合CA19-9預測胰腺癌預后. 現代消化及介入診療, 2022, 27(4): 512-515.
11. 謝小妹, 陳龍, 黃江瓊, 等. 術前血清CEA水平與非小細胞肺癌預后關系的Meta分析. 現代生物醫學進展, 2012, 12(19): 3689-3692.
12. 唐偉杰. NLR和PLR對根治性胰腺癌切除術術后生存期的預測價值. 蕪湖: 皖南醫學院, 2022.
13. 申鵬. 術前NLR、PLR對胰腺癌患者術后1年生存率的預測價值. 北京: 北京協和醫學院, 2017.
14. Chawla A, Huang TL, Ibrahim AM, et al. Pretherapy neutrophil to lymphocyte ratio and platelet to lymphocyte ratio do not predict survival in resectable pancreatic cancer. HPB (Oxford), 2018, 20(5): 398-404.
15. Shirai Y, Shiba H, Sakamoto T, et al. Preoperative platelet to lymphocyte ratio predicts outcome of patients with pancreatic ductal adenocarcinoma after pancreatic resection. Surgery, 2015, 158(2): 360-365.
16. Wang Y, Cui C, Yu Q, et al. Development and validation of a nomogram for predicting survival in patients with pancreatic ductal adenocarcinoma after radical pancreatoduodenectomy. Oncologie, 2023, 25(1): 51-59.
17. Giakoustidis A, Neofytou K, Costa Neves M, et al. Identifying the role of neutrophil-to-lymphocyte ratio and platelets-to-lymphocyte ratio as prognostic markers in patients undergoing resection of pancreatic ductal adenocarcinoma. Ann Hepatobiliary Pancreat Surg, 2018, 22(3): 197-207.
18. Ye S, Bai L. Comparison and validation of the value of preoperative inflammation marker-based prognostic scores in resectable pancreatic ductal adenocarcinoma. Cancer Manag Res, 2018, 10: 3405-3417.
19. 孫婧, 史幼梧, 賈軍, 等. 血液炎癥相關指標在晚期胰腺癌中的預后價值. 首都醫科大學學報, 2022, 43(2): 299-304.
20. 徐雪君, 周天朔, 李志偉. 系統性炎癥指標對胰腺癌預后的價值研究. 癌癥進展, 2019, 17(23): 2774-2776.
21. Miyashita T, Tajima H, Makino I, et al. Metastasis-promoting role of extravasated platelet activation in tumor. J Surg Res, 2015, 193(1): 289-294.
22. 劉榮華, 王婷, 張焜和. 外周血炎性指標對胰腺癌患者預后預測價值的研究進展. 癌癥進展, 2022, 20(10): 990-992, 1023.
23. 周雨, 林葉, 簡志祥. 治療前血小板水平與胰腺癌預后相關性的Meta分析. 循證醫學, 2017, 17(6): 343-349.
24. Elaskalani O, Falasca M, Moran N, et al. The role of platelet-derived adp and atp in promoting pancreatic cancer cell survival and gemcitabine resistance. Cancers (Basel), 2017, 9(10): 142.
25. 孫彬, 李健. 血小板在惡性腫瘤轉移中的機制. 軍醫進修學院學報, 2011, 32(8): 871-873.
26. 程娟, 管世鶴, 陳禮文, 等. 胰腺癌患者手術前后外周血淋巴細胞亞群和血小板變化. 檢驗醫學, 2020, 35(7): 655-659.

West China Medical Journal

Relationship between preoperative platelet-to-lymphocyte ratio and prognosis in patients with pancreatic ductal adenocarcinoma: a meta-analysis

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