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Authors Zhou Y, Cheng S, Fathy AH, Qian H, Zhao Y
Received 15 October 2017
Accepted for publication 9 January 2018
Published 5 April 2018 Volume 2018:11 Pages 1899—1908
DOI https://doi.org/10.2147/OTT.S154162
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Amy Norman
Peer reviewer comments 2
Editor who approved publication: Prof. Dr. Geoffrey Pietersz
Background and
aims: Several studies were conducted to explore
the prognostic value of platelet-to-lymphocyte ratio (PLR) in pancreatic cancer
and have reported contradictory results. This study aims to summarize the
prognostic role of PLR in pancreatic cancer.
Materials and
methods: Embase, PubMed and Cochrane Library
were completely searched. The cohort studies focusing on the prognostic role of
PLR in pancreatic cancer were eligible. The overall survival (OS) and
progression-free survival (PFS) were analyzed.
Results: Fifteen papers containing 17 cohort studies with pancreatic cancer
were identified. The results showed patients that with low PLR might have
longer OS when compared to the patients with high PLR (hazard ratio=1.28, 95%
CI=1.17–1.40, P <0.00001; I 2=42%). Similar results were observed in the subgroup analyses of OS,
which was based on the analysis model, ethnicity, sample size and cut-off
value. Further analyses based on the adjusted potential confounders were
conducted, including CA199, neutrophil-to-lymphocyte ratio, modified Glasgow
Prognostic Score, albumin, C-reactive protein, Eastern Cooperative Oncology
Group, stage, tumor size, nodal involvement, tumor differentiation, margin
status, age and gender, which confirmed that low PLR was a protective factor in
pancreatic cancer. In addition, low PLR was significantly associated with
longer PFS when compared to high PLR in pancreatic cancer (hazard ratio=1.27,
95% CI=1.03–1.57, P =0.03; I 2=33%).
Conclusion: In conclusion, it was found that high PLR is an unfavorable
predictor of OS and PFS in patients with pancreatic cancer, and PLR is a
promising prognostic biomarker for pancreatic cancer.
Keywords: platelet-to-lymphocyte ratio, pancreatic cancer, prognostic,
progression-free survival, overall survival, biomarker