4 years ago

Prognostic role of neutrophil–lymphocyte ratio in nasopharyngeal carcinoma: A meta-analysis

Yoshifumi Yamamoto, Yukinori Takenaka, Kazuya Takemura, Takahiro Kitamura, Atsuhiko Uno, Ryohei Oya, Kotaro Shimizu, Naoki Ashida

by Yukinori Takenaka, Takahiro Kitamura, Ryohei Oya, Naoki Ashida, Kotaro Shimizu, Kazuya Takemura, Yoshifumi Yamamoto, Atsuhiko Uno


Inflammatory markers are used to predict prognosis of nasopharyngeal carcinoma (NPC). Previous reports of neutrophil-to-lymphocyte ratio (NLR) and NPC mortality are inconsistent. This study aimed to quantify the prognostic impact of NLR on NPC.


The primary outcome was overall survival (OS), and the secondary outcomes were disease-specific survival (DSS), progression-free survival (PFS) and distant metastasis-free survival (DMFS). We systematically searched electronic databases, identified articles reporting an association between NLR and NPC prognosis. Hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted, and pooled HRs for each outcome were estimated using random effect models.


Nine studies enrolling 5397 patients were included in the analyses. NLR greater than the cutoff value was associated with poor overall survival (HR 1.51, 95% CI 1.27–1.78), disease-specific survival (HR 1.44, 95% CI 1.22–1.71), progression-free survival (HR 1.53, 95% CI 1.22–1.90), and distant metastasis-free survival (HR 1.83, 95% CI 1.14–2.95).


Elevated NLR predicts worse OS, DSS, PFS and DMFS in patients with NPC.

Publisher URL: http://journals.plos.org/plosone/article

DOI: 10.1371/journal.pone.0181478

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