-
Medicine Oct 2015The relationship between inflammation and tumor development and progression has been recognized in recent decades. NLR is an easily reproducible and widely used... (Meta-Analysis)
Meta-Analysis Review
The relationship between inflammation and tumor development and progression has been recognized in recent decades. NLR is an easily reproducible and widely used inflammatory response marker. The prognostic value of NLR for urologic tumors has been reported in succession. Here, we perform a systematic review and meta-analysis to summarize the association between the NLR and prognosis of urologic tumors. We conducted a computerized search of PubMed, Embase, and ISI Web of Knowledge to identify clinical studies that had evaluated the association between the pretreatment NLR and prognosis in urologic tumors. Prognostic outcomes included overall survival (OS), cancer-specific survival (CSS), recurrence-free survival (RFS), progression-free survival (PFS), and metastasis-free survival (MFS). We extracted and synthesized corresponding hazard ratios (HRs) and confidence intervals (CIs) using Review Manager 5.3 and STATA 13. We identified 34 retrospective cohort studies and conducted the meta-analysis. The results showed that all OS, CSS, RFS, PFS, and MFS risks were significantly different between patients with an elevated NLR and those with a low NLR in various urologic tumors. A high NLR portended poor prognosis. However, no significance was observed for CSS in patients with renal cell carcinoma (HR = 1.38, 95% CI: 0.96-1.99). Our meta-analysis suggests that NLR could be a prognostic predictor for urologic tumors. Patients with a high NLR were deemed to have a poor prognosis.
Topics: Adult; Aged; Aged, 80 and over; Carcinoma, Renal Cell; Cohort Studies; Humans; Leukocyte Count; Lymphocytes; Middle Aged; Neutrophils; Prognosis; Retrospective Studies; Urologic Neoplasms
PubMed: 26448011
DOI: 10.1097/MD.0000000000001670 -
Medicine Sep 2022The neutrophil-to-lymphocyte ratio (NLR) has been suggested to be a potential biomarker for assessing the systemic inflammatory response in polycystic ovary syndrome... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The neutrophil-to-lymphocyte ratio (NLR) has been suggested to be a potential biomarker for assessing the systemic inflammatory response in polycystic ovary syndrome (PCOS). This meta-analysis is aimed at evaluating whether PCOS patients present with a higher NLR and whether obesity, metabolic, and hormonal indices have effects on the states.
METHODS
We performed a literature search on PubMed, Embase and Web of Science (last update: August 2, 2022). Pooled standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated by applying random-effects models. Meta-regression analyses were used to explore the sources of heterogeneity and assess the relationship between NLR and several clinical parameters. Sensitivity analysis and publication bias were also assessed.
RESULTS
Thirteen studies involving 826 PCOS patients and 780 healthy controls were eligible for the present meta-analysis. Generally, NLR significantly increased in PCOS women versus healthy women (SMD = 0.81, 95% CI = 0.30-1.33, P = .002). NLR disparity was subsequently investigated in obese and non-obese cohorts. Obese PCOS women exhibited a higher NLR than obese controls (SMD = 0.56, 95% CI = 0.24-0.87, P = .001), and a similar difference was shown between non-obese PCOS and non-obese controls (SMD = 0.36, 95% CI = 0.02-0.71, P = .038). No significant NLR disparity was observed between obese versus non-obese PCOS women (SMD = 0.50, 95% CI = -0.37 to 1.38, P = .259). Meta-regression analysis revealed that NLR was significantly positively associated with fasting blood glucose (P = .006) and total cholesterol levels (P = .021), but not correlated with body mass index and other parameters in PCOS patients. Sensitivity analysis indicated that no individual study significantly affected the overall pooled result, and no publishing bias was observed.
CONCLUSION
PCOS women typically present with an increased NLR. Such an increase is independent of obesity and may be associated with glycolipid metabolic disorders.
Topics: Biomarkers; Blood Glucose; Cholesterol; Female; Glycolipids; Humans; Lymphocytes; Neutrophils; Obesity; Polycystic Ovary Syndrome
PubMed: 36197242
DOI: 10.1097/MD.0000000000030579 -
Journal of Translational Medicine Feb 2023The systemic immune-inflammation index (SII) is a novel biomarker to predict the prognosis of some malignant tumors based on neutrophil, platelet, and lymphocyte counts.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The systemic immune-inflammation index (SII) is a novel biomarker to predict the prognosis of some malignant tumors based on neutrophil, platelet, and lymphocyte counts. Evidence is scarce about the prognostic value of SII for prostate cancer patients. This systematic review and meta-analysis was conducted to explore the prognostic value of the SII in prostate cancer.
METHODS
The PubMed, Embase, Web of Science, and Cochrane Library (CENTRAL) databases were searched to determine eligible studies from inception to August 15, 2022. Hazard ratios (HRs) with 95% confidence intervals (CIs) were extracted to pool the results. Statistical analyses were conducted by using Stata 17.0 software.
RESULTS
A total of 12 studies with 8083 patients were included. The quantitative synthesis showed that a high SII was related to poor overall survival (OS) (HR = 1.44, 95% CI 1.23-1.69, p < 0.001). Furthermore, a subgroup analysis showed that a high SII was associated with poor OS in the groups of any ethnicity, tumor type, and cutoff value. An increased SII was also associated with inferior progression-free survival (PFS) (HR = 1.80, 95% CI 1.27-2.56, p = 0.001). In the subgroup analysis, a high SII value was related to poor PFS in Asian patients (HR = 4.03, 95% CI 1.07-15.17, p = 0.04) and a cutoff value > 580 (HR = 1.19, 95% CI 1.04-1.36, p = 0.01).
CONCLUSION
Based on the current evidence, a high pretreatment SII may be associated with poor OS and PFS. The SII may serve as an important prognostic indicator in patients with prostate cancer. More rigorously designed studies are needed to explore the SII and the prognosis of prostate cancer.
Topics: Male; Humans; Prognosis; Proportional Hazards Models; Biomarkers; Inflammation; Prostatic Neoplasms; Neutrophils
PubMed: 36739407
DOI: 10.1186/s12967-023-03924-y -
Mediators of Inflammation 2022The goal of this systematic review and meta-analysis was to consolidate the available data on the role of the neutrophil to lymphocyte ratio (NLR) in predicting adnexal... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
The goal of this systematic review and meta-analysis was to consolidate the available data on the role of the neutrophil to lymphocyte ratio (NLR) in predicting adnexal torsion (AT), to help guide clinical decision-making and outcomes.
METHODS
We used Web of Science, PubMed, and Scopus to conduct a systematic search for relevant publications published before June 26, 2022. We reported standardized mean difference (SMD) with a 95% confidence interval (CI). Because a significant level of heterogeneity was found, we used the random-effects model to calculate pooled effects. We used the Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) too for quality assessment.
RESULTS
Overall, 15 articles were included in the analysis. A random-effects model revealed that patients with AT had elevated levels of NLR compared to those with other adnexal masses (SMD = 1.06, 95%CI = 0.67 to 1.45, < 0.001). So, NLR had diagnostic value. In the subgroup analysis according to ethnicity, we found that Caucasian patients with AT had elevated levels of NLR compared to patients who were operated due to adnexal mass and reported as having a benign ovarian cyst, without torsion (SMD = 1.12, 95%CI = 0.71 to 1.54, < 0.001). However, in the case of East Asian patients, there was no difference between cases and controls (SMD = 0.86, 95%CI = -0.21 to 1.94, = 0.11). The pooled sensitivity of NLR was 0.79 (95%CI = 0.72-0.85), and the pooled specificity was 0.84 (95% CI, 0.74-0.91).
CONCLUSION
In conclusion, there has been an interest in the use of NLR as a diagnostic marker for AT.
Topics: Female; Humans; Neutrophils; Ovarian Torsion; Lymphocytes
PubMed: 36387932
DOI: 10.1155/2022/9680591 -
Breast Cancer Research : BCR Jan 2017The presence of a high neutrophil-to-lymphocyte ratio (NLR) has been associated with increased mortality in several malignancies. Here, we quantify the effect of NLR on... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
The presence of a high neutrophil-to-lymphocyte ratio (NLR) has been associated with increased mortality in several malignancies. Here, we quantify the effect of NLR on survival in patients with breast cancer, and examine the effect of clinicopathologic factors on its prognostic value.
METHODS
A systematic search of electronic databases was conducted to identify publications exploring the association of blood NLR (measured pre treatment) and overall survival (OS) and disease-free survival (DFS) among patients with breast cancer. Data from studies reporting a hazard ratio (HR) and 95% confidence interval (CI) or a P value were pooled in a meta-analysis. Pooled HRs were computed and weighted using generic inverse variance. Meta-regression was performed to evaluate the influence of clinicopathologic factors such as age, disease stage, tumor grade, nodal involvement, receptor status, and NLR cutoff on the HR for OS and DFS. All statistical tests were two-sided.
RESULTS
Fifteen studies comprising a total of 8563 patients were included. The studies used different cutoff values to classify high NLR (range 1.9-5.0). The median cutoff value for high NLR used in these studies was 3.0 amongst 13 studies reporting a HR for OS, and 2.5 in 10 studies reporting DFS outcomes. NLR greater than the cutoff value was associated with worse OS (HR 2.56, 95% CI = 1.96-3.35; P < 0.001) and DFS (HR 1.74, 95% CI = 1.47-2.07; P < 0.001). This association was similar in studies including only early-stage disease and those comprising patients with both early-stage and metastatic disease. Estrogen receptor (ER) and HER-2 appeared to modify the effect of NLR on DFS, because NLR had greater prognostic value for DFS in ER-negative and HER2-negative breast cancer. No subgroup showed an influence on the association between NLR and OS.
CONCLUSIONS
High NLR is associated with an adverse OS and DFS in patients with breast cancer with a greater effect on disease-specific outcome in ER and HER2-negative disease. NLR is an easily accessible prognostic marker, and its addition to established risk prediction models warrants further investigation.
Topics: Breast Neoplasms; Female; Humans; Leukocyte Count; Lymphocyte Count; Lymphocytes; Neutrophils; Prognosis; Proportional Hazards Models; Publication Bias
PubMed: 28057046
DOI: 10.1186/s13058-016-0794-1 -
BMJ Open Sep 2021Accumulating literature has shown the predictive values of inflammation and nutrition-based biomarkers in the prognosis of oesophageal cancer but with inconsistent... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Accumulating literature has shown the predictive values of inflammation and nutrition-based biomarkers in the prognosis of oesophageal cancer but with inconsistent findings.
METHOD
We performed a meta-analysis to systematically evaluate the predictive value of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), C reactive protein-to-albumin ratio (CAR), systemic inflammation index (SII), prognostic nutritional index (PNI), Glasgow Prognostic Score (GPS) and modified Glasgow Prognostic Score (mGPS) in oesophageal cancer. The outcome indicators include the overall survival (OS), disease-free survival (DFS) and cancer-specific survival (CSS). We applied pooled HR, sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and area under the curve together with 95% CI to estimate the predictive accuracy.
RESULTS
A total of 72 studies, including 22 260 patients, were included in the meta-analysis. Elevated NLR, PLR CAR, SII, GPS, mGPS and decreased LMR and PNI were associated with poor OS of oesophageal cancer. A high level of NLR, PLR and GPS was related to poor DFS. A high level of NLR and GPS was related to poor CSS. The summarised AUC of CAR (0.72, 95% CI: 0.68 to 0.75) and mGPS (0.75, 95% CI: 0.71 to 0.78) surpassed any other indicators.
CONCLUSIONS
Clinical indicators such as NLR, PLR, LMR, PNI, SII, CAR, GPS and mGPS have the moderate predictive ability in OS, DFS and CSS of oesophageal cancer. The pretreatment level of CAR and mGPS showed an outstanding prediction value in 5-year OS for oesophageal cancer.
Topics: Biomarkers; Esophageal Neoplasms; Humans; Inflammation; Lymphocytes; Neutrophils; Prognosis; Retrospective Studies
PubMed: 34593492
DOI: 10.1136/bmjopen-2020-048324 -
Cancer Immunology, Immunotherapy : CII Mar 2023Neutrophils have recently gained recognition for their potential in the fight against cancer. Neutrophil plasticity between the N1 anti-tumor and N2 pro-tumor subtypes... (Review)
Review
Neutrophils have recently gained recognition for their potential in the fight against cancer. Neutrophil plasticity between the N1 anti-tumor and N2 pro-tumor subtypes is now apparent, as is the ability to polarize these individual subtypes by interventions such as intratumoral injection of various agents including bacterial products or pro-oxidants. Metabolic responses and the production of reactive oxygen species (ROS) such as hydrogen peroxide act as potent chemoattractants and activators of N1 neutrophils that facilitates their recruitment and ensuing activation of a toxic respiratory burst in tumors. Greater understanding of the precise mechanism of N1 neutrophil activation, recruitment and regulation is now needed to fully exploit their anti-tumor potential against cancers both locally and at distant sites. This systematic review critically analyzes these new developments in cancer immunotherapy.
Topics: Humans; Reactive Oxygen Species; Neutrophils; Respiratory Burst; Immunotherapy; Neoplasms
PubMed: 36066649
DOI: 10.1007/s00262-022-03248-8 -
Advances in Nutrition (Bethesda, Md.) May 2016Previous research on animals indicates flavonoid compounds have immunomodulatory properties; however, human research remains inconclusive. The aim of this systematic... (Meta-Analysis)
Meta-Analysis Review
Previous research on animals indicates flavonoid compounds have immunomodulatory properties; however, human research remains inconclusive. The aim of this systematic review was to assess the efficacy of dietary flavonoids on upper respiratory tract infections (URTIs) and immune function in healthy adults. A created search strategy was run against Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE and EMBASE classic, CINAHL, and AMED. The returned studies were initially screened, and 2 reviewers independently assessed the remaining studies for eligibility against prespecified criteria. Fourteen studies, of 387 initially identified, were included in this review, and the primary outcome measure was the effect of flavonoids on URTI incidence, duration, and severity. Of the included studies, flavonoid supplementation ranged from 0.2 to 1.2 g/d. Overall, flavonoid supplementation decreased URTI incidence by 33% (95% CI: 31%, 36%) compared with control, with no apparent adverse effects. Sick-day count was decreased by 40% with flavonoid supplementation, although unclear. Differences in bio-immune markers (e.g., interleukin-6, tumor necrosis factor-α, interferon-γ, neutrophils) were trivial between the intervention and control groups during the intervention and after exercise when a postintervention exercise bout was included. These findings suggest that flavonoids are a viable supplement to decrease URTI incidence in an otherwise healthy population.
Topics: Cytokines; Dietary Supplements; Female; Flavonoids; Humans; Immunity; Male; Neutrophils; Phytotherapy; Plant Extracts; Respiratory Tract Infections
PubMed: 27184276
DOI: 10.3945/an.115.010538 -
BMC Women's Health Nov 2023The purpose of this systematic review and meta-analysis was to compile existing evidence on the significance of the NLR in predicting endometriosis in order to aid... (Meta-Analysis)
Meta-Analysis
BACKGROUND
The purpose of this systematic review and meta-analysis was to compile existing evidence on the significance of the NLR in predicting endometriosis in order to aid clinical decision-making and outcomes.
METHODS
We searched ProQuest, Web of Science, and PubMed for related studies published before January 2, 2023. Standardized mean difference (SMD) with a 95% confidence interval (CI) was reported for each outcome. Because a significant level of heterogeneity was found, we used the random-effects model to calculate pooled effects. We used Newcastle-Ottawa Scale (NOS) for quality assessment.
RESULTS
Overall, 18 article with were included in the analysis. A random-effect model revealed that patients with endometriosis had elevated levels of NLR compared to healthy controls (SMD = 0.79, 95% CI = 0.33 to 1.25, P < 0.001). Patients with endometriosis had elevated levels of NLR compared to those with other benign tumors (SMD = 0.85, 95% CI = 0.17 to 1.53, P = 0.014). In addition, NLR level of patients with stage III and IV endometriosis was not different from that of patients with stage I and II endometrioma (SMD = 0.30, 95% CI = -0.14 to 0.74, P = 0.18). However, NLR level was not different between endometriosis patients with and without peritoneal lesions (SMD = -0.12, 95% CI = -0.34to 0.10, P = 0.28), between patients with and without endometrioma (SMD = 0.20, 95% CI = -0.15 to 0.55, P = 0.26) and between endometriosis patients with and without deep lesions (SMD = 0.04, 95% CI = -0.20 to 0.28, P = 0.72). The pooled sensitivity of NLR was 0.67 (95% CI = 0.60-0.73), and the pooled specificity was 0.68 (95% CI, 0.62-0.73).
CONCLUSIONS
NLR might be utilized in clinics as a possible predictor to help clinicians diagnose endometriosis in affected women.
Topics: Humans; Female; Endometriosis; Neutrophils; Lymphocytes; Peritoneal Diseases
PubMed: 37936116
DOI: 10.1186/s12905-023-02692-7 -
Medicina (Kaunas, Lithuania) Sep 2022Background and objective: Among the broad variety of chemokines, monocyte chemoattractant protein-1 (MCP-1) is considered to be one of the most important chemokines.... (Meta-Analysis)
Meta-Analysis Review
Background and objective: Among the broad variety of chemokines, monocyte chemoattractant protein-1 (MCP-1) is considered to be one of the most important chemokines. Among others, MCP-1 activates monocytes and other immune cells highly involved in inflammation. In the present systematic review and meta-analysis, we evaluated the relationship between serum/plasma MCP-1 levels and the risk of obstructive sleep apnea (OSA) in adults as a disease related to inflammation. Materials and methods: Four databases were systematically investigated until 12 July 2022. We used the Review Manager 5.3 software (Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark) to extract and calculate the standardized mean difference (SMD) and its 95% confidence interval (CI) of plasma/serum levels of MCP-1 between adults with and without OSA. Results: Eight articles including eleven studies in adults were entered into the meta-analysis. The serum/plasma MCP-1 levels in adults with OSA were higher than that in the controls (SMD = 0.81; p = 0.0007) and as well as for adults with severe OSA compared to those with mild and moderate OSA (SMD = 0.42; p < 0.0001). The subgroup analysis showed that ethnicity was an effective factor in the pooled analysis of blood MCP-1 levels in adults with OSA compared to the controls (Asians: (p < 0.0001), mixed ethnicity: (p = 0.04), and Caucasians: (p = 0.89)). The meta-regression showed increasing serum/plasma MCP-1 levels in adults with OSA versus the controls, publication year, age of controls, body mass index (BMI) of controls, and sample size reduced, and also BMI and the apnea−hypopnea index of adults with OSA increased. Conclusions: The meta-analysis showed that compared to the controls, serum/plasma levels of MCP-1 in adults with OSA were significantly more, as well as adults with severe OSA having more serum/plasma MCP-1 levels compared to the adults with mild to moderate OSA. Therefore, MCP-1 can be used as a diagnostic and therapeutic factor in adults with OSA.
Topics: Adult; Chemokine CCL2; Humans; Inflammation; Monocytes; Sleep Apnea, Obstructive
PubMed: 36143943
DOI: 10.3390/medicina58091266