Prognostic role of neutrophil-to-lymphocyte ratio to laryngeal squamous cell carcinoma: a meta-analysis

Abstract Introduction New evidence suggests that the ratio of neutrophils to lymphocytes is associated with the prognosis of other carcinoma, but the ratio of neutrophils to lymphocytes in laryngeal squamous cell carcinoma remains controversial. Objective The objective of this meta-analysis was to clarify the prognostic effectiveness of the ratio of neutrophils to lymphocytes in laryngeal squamous cell carcinoma. Methods According to the meta-analysis of the free guide, we searched EMBASE, Pubmed, the Cochrane Library databases. The ratio of neutrophils to lymphocytes of laryngeal squamous cell carcinoma patients was evaluated using mean standard vehicle and confidence interval. The overall survival, disease-free survival and progression free survival of patients with laryngeal squamous cell carcinoma were expressed by standard mean carrier method and confidence interval. The risk ratio of 95% confidence interval was used as an evaluation index for patients with laryngeal squamous cell carcinoma. Results Eight studies, including 1780 patients, used a variety of different end values to classify the ratio of neutrophils to lymphocytes (range 1.78-4.0). Among the eight studies that reported risk ratio of the overall survival, the higher median value was 2.72, and 2 of 4 studies reported disease-free survival results. The critical value of ratio of neutrophils to lymphocytes and overall survival deterioration (risk ratio = 1.68, 95% confidence interval 1.43-1.99, p< 0.001), disease-free survival (risk ratio = 2.09, 95% confidence interval 1.62-2.6, p< 0.001) and progression free survival (risk ratio = 1.92, 95% confidence interval 1.75-2.10, p< 0.001) was associated with with laryngeal aquamous cell carcinoma. The ratio of neutrophils to lymphocytes had prognostic value for laryngeal squamous cell carcinoma. Conclusion The results of this meta-analysis showed that the increase of neutrophils to lymphocytes ratio was related to poor prognosis of laryngeal squamous cell carcinoma. The neutrophils to lymphocytes ratio may serve as a cost-effective prognostic biomarker of poor prognosis of laryngeal squamous cell carcinoma. More high-quality prospective trials are needed to assess the practicability of evaluating the ratio of neutrophils to lymphocytes in laryngeal squamous cell carcinoma.

摘要 引言
现有新证据表明，中性粒细胞与淋巴细胞比值（ratio of neutrophils to lymphocytes）与其他癌种的预后相关，但喉鳞状细胞癌（laryngeal squamous cell carcinoma）中该比值的预后价值仍存在争议。
目的 本荟萃分析旨在明确中性粒细胞与淋巴细胞比值对喉鳞状细胞癌的预后价值。
方法 按照荟萃分析的通用研究规范，我们检索了EMBASE、PubMed以及Cochrane Library数据库。采用均数标准差与置信区间对喉鳞状细胞癌患者的中性粒细胞与淋巴细胞比值进行评估，采用标准均数差与置信区间分析患者的总生存期（overall survival）、无病生存期（disease-free survival）与无进展生存期（progression-free survival），并以95%置信区间的风险比（risk ratio）作为喉鳞状细胞癌患者的预后评价指标。
结果 共纳入8项研究，涉及1780例患者，各项研究采用不同的截断值对中性粒细胞与淋巴细胞比值进行分组（截断值范围为1.78~4.0）。在报告总生存期风险比的8项研究中，中位截断值为2.72；其中4项研究报告了无病生存期结果。中性粒细胞与淋巴细胞比值的截断值与喉鳞状细胞癌患者的总生存期恶化相关（风险比=1.68，95%置信区间1.43~1.99，P<0.001）、无病生存期（风险比=2.09，95%置信区间1.62~2.60，P<0.001）以及无进展生存期（风险比=1.92，95%置信区间1.75~2.10，P<0.001）均存在显著关联。中性粒细胞与淋巴细胞比值对喉鳞状细胞癌具有预后评估价值。
结论 本荟萃分析结果显示，中性粒细胞与淋巴细胞比值升高与喉鳞状细胞癌的不良预后密切相关。该比值可作为喉鳞状细胞癌不良预后的低成本高效益预后生物标志物。未来仍需开展更多高质量前瞻性临床试验，以评估中性粒细胞与淋巴细胞比值在喉鳞状细胞癌中的临床应用可行性。