Table 1.
Predictive Role of Neutrophil-to-Lymphocyte Ratio (NLR) in Cancer.
| Cancer Type | Study | No of Patients | Results |
|---|---|---|---|
| Thyroid | Feng J et al.* (28) | 3081 | Subgroup analysis results indicated increase in pretreatment NLR is remarkably related to lower DFS. Overall, an elevated NLR was notably related to tumor size and metastasis. |
| Liu J-f et al.* (29) | 7349 | NLR of DTC patients was not significantly different from those with benign nodules. high NLR couldn’t be a valuable factor for developing DTC in goiter patients. | |
| Cho et al. (30) | 3870 | They observed advanced stages, cancer-related mortality, and the proportion of PDTC to ATC was notably more prevalent in the high NLR patients. | |
| Park J et al. (31) | 40 | An elevated NLR before and after RT is considerably correlated to poor OS in ATC patients who underwent RT | |
| Lee F et al. (27) | 151 | Incomplete response to therapy was correlated to gender, the largeness of mass, metastasis, and increased NLR in multivariate analysis. | |
| Breast | Zhou et al.* (34) | 5910 | Low NLR was linked to higher pCR. An elevated NLR was correlated to lower DFS and OS in BC patients who received NACT. |
| Fang Q et al. (35) | 1540 | The results indicated, in spite of menopausal status, in the whole population, a higher preoperative NLR could be associated with increases in BC. | |
| Ding N et al. (36) | 843 | HER2-positive BC individuals with advanced pretreatment NLR values may not respond to trastuzumab treatment or may respond weakly. | |
| Chen Y et al. (37) | 215 | Significant difference in pCR rate in individuals with low pretreatment NLR and those with advanced NLR in BC patients who underwent NACT | |
| Guo W et al.* (32) | 17079 | They discovered that high NLR was linked to poor DFS. | |
| Bae SJ et al. (38) | 1097 | NLR value ≥2.74 was recognized as a high NLR. They demonstrated high NLR could be an indicator for DFS and OS among HER2-negative patients who undertreated NACT. | |
| Lung | Kanzaki H et al. (45) | 111 | Average-NLR and post-radiotherapy NLR were notable predictive factors for the OS and DFS among NSCLC patients in stage 3 who received definitive chemoradiotherapy. |
| Winther-Larsen A et al.* (46) | 7762 | High NLR might be a predictive biomarker for adverse OS in SCLC patients. | |
| Jin J et al. (47) | 2068 | High NLR substantially related to adverse OS and PFS. | |
| Huang W et al. (48) | 589 | F-NLR could be an independent predictive parameter for DFS and OS. | |
| Lan H et al. (49) | 174 | Elevated PLR and NLR were significantly correlated to increased postoperative pulmonary complications. | |
| Esophageal | Sakin A et al. (57) | 80 | Increased pretreatment NLR correlated to decreased OS and DFS. |
| Li B et al.* (58) | 8431 | High NLR is significantly correlated to decreased OS, CSS, PFS and, DFS. | |
| Hoshino S et al. (60) | 586 | NLR is significantly related to survival in patients. | |
| Guo Q et al. (61) | 103 | Peripheral blood and pathological tissue NLR independently predict poor postoperative prognosis of the patients. | |
| Gastric | Namikawa T et al. (62) | 411 | High NLR and CAR substantially correlate to poor outcomes. |
| Liu Z et al. (63) | 111 | Decreased level of post-NACT is strongly associated with longer OS and DFS. | |
| Yasui S et al. (64) | 218 | Undifferentiated gastric adenocarcinoma patients have higher levels of NLR and PLR compared to patients with differentiated gastric adenocarcinoma. | |
| Fu L et al. (65) | 151 | R-NLR score is a favorable parameter in predicting OS in stage II-III gastric cancer patients. | |
| Pancreatic | Reddy AV et al. (74) | 156 | NLR level more than 2.6 is substantially associated with unfavorable OS and PFS. |
| Shusterman M et al. (75) | 226 | High NLR is an independent indicator of poor prognosis in individuals with PAC. | |
| Strong JS et al. (76) | 93 | No significant correlation was obtained between NLR and OS, DFS, and pathological response following the treatment. | |
| Cetin S et al. (77) | 118 | Using NLR and other biomarkers such as CA19-9 could be more powerful for predicting PAC outcomes. | |
| Shin K et al. (78) | 271 | Post-treatment NLR of less than 2.62 and 18% decline of CA19-9 combined is a useful predictive indicator. | |
| Hepatocellular | Qi X et al.* (80) | 20475 | With a lower NLR had a considerably better OS than those with a higher NLR. |
| Wu M et al. (83) | 70 | Preoperative NLR plus postoperative NLR was superior than other parameters as a predictive factor. They showed increasing in preoperative NLR plus postoperative NLR score could be correlated to poor differentiation and multiple tumors. | |
| Dai T et al. (81) | 195 | The results showed the NLRc (3–6 m) might be a predictive indicator for inferior DFS among HCC individuals. | |
| Colorectal | Gulben K et al. (91) | 219 | Multivariate analysis revealed that a preoperative NLR greater than 2.8 could indicate OS in CRC. However, DFS was not predicted favorably by preoperative NLR. |
| Yang Z et al. (92) | 88 | NLR and IL-6, when used together, are a more powerful predictor of DFS and OS in patients than NLR or IL-6 alone. | |
| Nemoto T et al. (93) | 71 | Change of NLR value in the pre-chemotherapy to 3 months post-chemotherapy period could be a good indicator in predicting OS in CRC. | |
| Cui M et al. (94) | 146 | They demonstrated the high-high group had the worst PFS, followed by the high-low, low-high and low-low, respectively. | |
| Renal | Shao Y et al.* (95) | 6461 | In general population, high pretreatment NLR was substantially correlated with unfavorable OS, DFS/PFS, and CSS. in patients with metastasis who received treatment with immune checkpoint inhibitors (ICIs), the elevated level of NLR was notably related to inferior OS and PFS. |
| Byun S-S et al. (97) | 1284 | Multivariate analysis suggested NLR could be a reliable predictor for both RFS and CSS. | |
| Zhao H et al. (98) | 384 | Elevated NLR is an independent indicator for OS. | |
| Prostate | Cao Z et al. (103) | 994 | Elevated NLR significantly correlated with better biochemical recurrence survival. |
| Bravi CA et al. (104) | 1258 | NLR significantly predicts adverse pathology and biochemical recurrence. | |
| Guan Y et al.* (105) | 3144 | The pooled data revealed that high NLR was remarkably correlated with poor OS in mCRPC individuals treated with abiraterone and enzalutamide, but no significant correlation was found for PFS. | |
| Masuda H et al. (106) | 633 | Their findings showed that NLR is an indicator of prognosis among these patients prior to prostate needle biopsy. | |
| Sun J et al. (107) | 335 | NLR, in combination with prostate imaging-reporting and data system version 2, can be a predictor of diagnosis of prostate cancer prior to biopsy. | |
| Ovarian | Henriksen JR et al. (110) | 72 | High NLR is a weak predictive indicator in these individuals. Also, high NLR was considerably related to poor treatment response. |
| Feng Z et al. (111) | 875 | High preoperative NLR level is related to an advanced international federation of gynecology and obstetrics stage, higher CA125 level, extensive ascites, inferior cytoreduction outcome, and resistance to chemotherapy. | |
| Li Z et al. (112) | 654 | High preoperative RDW and NLR predict poor OS in EOC (epithelial ovarian cancer) patients. Also, they suggested high RDW+NLR could be a parameter for stratifying HGSOC patients. Furthermore, the results revealed high NLR is correlated to adverse RFS, stage, preoperative CA125 level, and ascites. | |
| Zhu Y et al.* (113) | 2919 | They discovered that individuals with ovarian cancer who had a higher NLR have a considerably inferior OS and PFS than the control group. |
Studies indicated by an asterisk (*) represent meta-analyses. ATC, Anaplastic Thyroid Cancer; BC, Breast Cancer; CAR, C-Reactive Protein-to-Albumin Ratio; CRC, Colorectal Cancer; CSS, Cancer-Specific Survival; DFS, Disease-Free Survival; DTC, Differentiated Thyroid Carcinoma; F-NLR, Fibrinogen-Neutrophil-to-Lymphocyte Ratio; HCC, Hepatocellular Carcinoma; HER2, Human Epidermal Growth Factor Receptor 2;mCRPC, Metastatic Castration-Resistant Prostate Cancer; NACT, Neoadjuvant Chemotherapy; NSCLC, Non-Small Cell Lunger Carcinoma; NLR, Neutrophil-to-Lymphocyte Ratio; NLRc, Postoperative NLR/Preoperative NLR; OS, Overall Survival; PAC, Pancreatic Adenocarcinoma; pCR, Pathological Complete Response; PDTC, Poorly Differentiated Thyroid Cancer; PFS, Progression-Free Survival; PLR, Platelet-to-Lymphocyte Ratio; RFS, Relapse-Free Survival; RDW, Red Cell Distribution Width; R-NLR, Red Blood Cell Distribution Width-NLR; RT, Radiotherapy; SCLC, Small Cell Lung Carcinoma.