Background
At present, several studies have reported that the pretreatment neutrophil‐lymphocyte ratio (NLR) may be associated with the prognosis of liver cancer. Nevertheless, their conclusions remain controversial. Thus, we performed a meta‐analysis of 54 studies to evaluate the prognostic value of NLR.
Method
Databases including PubMed, Embase, Cochrane Library, and Web of Science were searched to July 2017.
Result
A total of 54 studies including 12 979 patients were included in this meta‐analysis. Elevated NLR had a close relationship with the overall survival (OS) (HR 1.52; 95% CI 1.39‐1.67), recurrence‐free survival (RFS) (HR 1.84; 95% CI 1.48‐2.30), and disease‐free survival (DFS) (HR 1.71; 95% CI 1.39‐2.11) of liver cancer, respectively. In addition, elevated NLR was associated with the presence of tumor vascular invasion (OR 2.35; 95% CI 1.93‐2.86), multiple tumors (OR 1.38; 95% CI 1.15‐1.66), alpha‐fetoprotein ≥ 400 ng/mL (OR 1.51; 95% CI 1.15‐1.98), presence of HbsAg (+) (OR 0.68; 95% CI 0.51‐0.90), and cirrhosis (OR: 0.59; 95% CI 0.44‐0.80).
Conclusion
This meta‐analysis indicated that elevated NLR may be an effective and noninvasive indicator for prognosis of patients with liver cancer.