Abstract
Past evidence has shown that lymphocyte-to-monocyte ratio (LMR) could be considered as a potential prognostic factor in non-small cell lung cancer (NSCLC). We conducted the current meta-analysis based on published studies to elucidate the prognostic value of pretreatment LMR on survival outcomes in NSCLC. Comprehensive searches of available electronic databases were implemented to identify potentially related studies that focused on the role of pretreatment LMR in predicting the prognosis of NSCLC patients. The hazard ratios (HRs) with 95% confidence intervals (CIs) were combined to assess the association of pretreatment LMR with overall survival (OS) and progression-free survival (PFS). A total of 20 articles including 8,304 patients were analyzed. Compared with patients with higher LMR, patients with lower LMR had poorer OS (HR = 1.63, 95% CI: 1.44–1.85, p < 0.001) and PFS (HR = 1.49, 95% CI: 1.25–1.77, p < 0.001). The subgroup analysis outcomes were similar to the overall analysis. Pretreatment LMR may be a useful prognostic marker in patients with NSCLC. However, more well-designed studies are warranted to confirm our findings.
Journal Section:
Systematic Review
References
1.
Siegel
RL
, Miller
KD
, Jemal
A
. Cancer Statistics, 2017
. CA Cancer J Clin
. 2017
Jan
;67
(1
):7
–30
.
[PubMed]
0007-92352.
Hirsch
FR
, Scagliotti
GV
, Mulshine
JL
, Kwon
R
, Curran
WJ
Jr, Wu
YL
, et al. Lung cancer: current therapies and new targeted treatments
. Lancet
. 2017
Jan
;389
(10066
):299
–311
.
[PubMed]
0140-67363.
Ettinger
DS
, Wood
DE
, Aisner
DL
, Akerley
W
, Bauman
J
, Chirieac
LR
, et al. Non-Small Cell Lung Cancer, Version 5.2017, NCCN Clinical Practice Guidelines in Oncology
. J Natl Compr Canc Netw
. 2017
Apr
;15
(4
):504
–35
.
[PubMed]
1540-14054.
Blandin Knight
S
, Crosbie
PA
, Balata
H
, Chudziak
J
, Hussell
T
, Dive
C
. Progress and prospects of early detection in lung cancer
. Open Biol
. 2017
Sep
;7
(9
):170070
.
[PubMed]
2046-24415.
Azar
FE
, Azami-Aghdash
S
, Pournaghi-Azar
F
, Mazdaki
A
, Rezapour
A
, Ebrahimi
P
, et al. Cost-effectiveness of lung cancer screening and treatment methods: a systematic review of systematic reviews
. BMC Health Serv Res
. 2017
Jun
;17
(1
):413
.
[PubMed]
1472-69636.
Chassagnon
G
, Bennani
S
, Revel
MP
. [New TNM classification of non-small cell lung cancer]
. Rev Pneumol Clin
. 2017
Feb
;73
(1
):34
–9
.
[PubMed]
0761-84177.
Maru
GB
, Gandhi
K
, Ramchandani
A
, Kumar
G
. The role of inflammation in skin cancer
. Adv Exp Med Biol
. 2014
;816
:437
–69
.
[PubMed]
0065-25988.
Shinko
D
, Diakos
CI
, Clarke
SJ
, Charles
KA
. Cancer-Related Systemic Inflammation: The Challenges and Therapeutic Opportunities for Personalized Medicine
. Clin Pharmacol Ther
. 2017
Oct
;102
(4
):599
–610
.
[PubMed]
0009-92369.
Bremnes
RM
, Busund
LT
, Kilvær
TL
, Andersen
S
, Richardsen
E
, Paulsen
EE
, et al. The Role of Tumor-Infiltrating Lymphocytes in Development, Progression, and Prognosis of Non-Small Cell Lung Cancer
. J Thorac Oncol
. 2016
Jun
;11
(6
):789
–800
.
[PubMed]
1556-086410.
Deng
C
, Wu
S
, Zhang
L
, Yang
M
, Lin
Q
, Xie
Q
, et al. Role of monocyte tissue factor on patients with non-small cell lung cancer
. Clin Respir J
. 2018
Mar
;12
(3
):1125
–33
.
[PubMed]
1752-698111.
Hanna
RN
, Cekic
C
, Sag
D
, Tacke
R
, Thomas
GD
, Nowyhed
H
, et al. Patrolling monocytes control tumor metastasis to the lung
. Science
. 2015
Nov
;350
(6263
):985
–90
.
[PubMed]
0036-807512.
Tan
D
, Fu
Y
, Tong
W
, et al. Prognostic significance of lymphocyte to monocyte ratio in colorectal cancer: A meta-analysis.
International journal of surgery (London, England). 2018
;55:128-38. 13.
Sierzega
M
, Lenart
M
, Rutkowska
M
, Surman
M
, Mytar
B
, Matyja
A
, et al. Preoperative Neutrophil-Lymphocyte and Lymphocyte-Monocyte Ratios Reflect Immune Cell Population Rearrangement in Resectable Pancreatic Cancer
. Ann Surg Oncol
. 2017
Mar
;24
(3
):808
–15
.
[PubMed]
1068-926514.
Li
T
, Xu
H
, Yang
L
, Tan
P
, Wei
Q
. Predictive value of preoperative lymphocyte-to-monocyte ratio for patients with upper tract urothelial carcinoma
. Clin Chim Acta
. 2019
May
;492
:50
–6
.
[PubMed]
0009-898115.
Moher
D
, Liberati
A
, Tetzlaff
J
, Altman
DG
; PRISMA Group
. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement
. BMJ
. 2009
Jul
;339
jul21 1
:b2535
.
[PubMed]
0959-813816.
Tierney
JF
, Stewart
LA
, Ghersi
D
, Burdett
S
, Sydes
MR
. Practical methods for incorporating summary time-to-event data into meta-analysis
. Trials
. 2007
Jun
;8
(1
):16
.
[PubMed]
1745-621517.
Higgins
JP
, Thompson
SG
. Quantifying heterogeneity in a meta-analysis
. Stat Med
. 2002
Jun
;21
(11
):1539
–58
.
[PubMed]
0277-671518.
Begg
CB
, Mazumdar
M
. Operating characteristics of a rank correlation test for publication bias
. Biometrics
. 1994
Dec
;50
(4
):1088
–101
.
[PubMed]
0006-341X19.
Stang
A
. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses
. Eur J Epidemiol
. 2010
Sep
;25
(9
):603
–5
.
[PubMed]
0393-299020.
Hu
P
, Shen
H
, Wang
G
, Zhang
P
, Liu
Q
, Du
J
. Prognostic significance of systemic inflammation-based lymphocyte- monocyte ratio in patients with lung cancer: based on a large cohort study
. PLoS One
. 2014
Oct
;9
(9
):e108062
.
[PubMed]
1932-620321.
Lin
GN
, Peng
JW
, Xiao
JJ
, Liu
DY
, Xia
ZJ
. Prognostic impact of circulating monocytes and lymphocyte-to-monocyte ratio on previously untreated metastatic non-small cell lung cancer patients receiving platinum-based doublet
. Med Oncol
. 2014
Jul
;31
(7
):70
.
[PubMed]
1357-056022.
Chen
YM
, Lai
CH
, Chang
HC
, Chao
TY
, Tseng
CC
, Fang
WF
, et al. Baseline and Trend of Lymphocyte-to-Monocyte Ratio as Prognostic Factors in Epidermal Growth Factor Receptor Mutant Non-Small Cell Lung Cancer Patients Treated with First-Line Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitors
. PLoS One
. 2015
Aug
;10
(8
):e0136252
.
[PubMed]
1932-620323.
Wang
L
, Long
W
, Li
PF
, Lin
YB
, Liang
Y
. An Elevated Peripheral Blood Monocyte-to-Lymphocyte Ratio Predicts Poor Prognosis in Patients with Primary Pulmonary Lymphoepithelioma-Like Carcinoma
. PLoS One
. 2015
May
;10
(5
):e0126269
.
[PubMed]
1932-620324.
Xia
H
, Sun
Z
, Deng
L
, Zhu
D
, Wang
D
. Prognostic Significance of the Preoperative Lymphocyte to Monocyte Ratio in Patients With Stage I Non-Small Cell Lung Cancer Undergoing Complete Resection
. Cancer Invest
. 2016
Sep
;34
(8
):378
–84
.
[PubMed]
0735-790725.
Song
YJ
, Wang
LX
, Hong
YQ
, Lu
ZH
, Tong
Q
, Fang
XZ
, et al. Lymphocyte to monocyte ratio is associated with response to first-line platinum-based chemotherapy and prognosis of early-stage non-small cell lung cancer patients
. Tumour Biol
. 2016
Apr
;37
(4
):5285
–93
.
[PubMed]
1010-428326.
Gao
Y
, Zhang
H
, Li
Y
, Wang
D
, Ma
Y
, Chen
Q
. Preoperative pulmonary function correlates with systemic inflammatory response and prognosis in patients with non-small cell lung cancer: results of a single-institution retrospective study
. Oncotarget
. 2017
Apr
;8
(16
):27489
–501
.
[PubMed]
1949-255327.
Xiong
Y
, Zhao
N
, Zheng
Y
, Wang
J
, Wei
F
, Ren
X
. Prognostic value of pretreatment inflammatory biomarkers in advanced lung adenocarcinoma patients receiving first-line pemetrexed/platinum doublet
. Tumour Biol
. 2017
Jun
;39
(6
):1010428317701639
.
[PubMed]
1010-428328.
Ni
XF
, Wu
J
, Ji
M
, Shao
YJ
, Xu
B
, Jiang
JT
, et al. Effect of C-reactive protein/albumin ratio on prognosis in advanced non-small-cell lung cancer
. Asia Pac J Clin Oncol
. 2018
Dec
;14
(6
):402
–9
.
[PubMed]
1743-755529.
Liu
W
, Ha
M
, Yin
N
. Combination of platelet count and lymphocyte to monocyte ratio is a prognostic factor in patients undergoing surgery for non-small cell lung cancer
. Oncotarget
. 2017
Jun
;8
(42
):73198
–207
.
[PubMed]
1949-255330.
Zhang
Y
, Feng
YC
, Zhu
HG
, Xiong
TC
, Hou
YS
, Song
J
, et al. The peripheral blood neutrophil-to-lymphocyte ratio is a prognostic predictor for survival of EGFR-mutant nonsmall cell lung cancer patients treated with EGFR-TKIs
. Medicine (Baltimore)
. 2018
Jul
;97
(30
):e11648
.
[PubMed]
0025-797431.
Gao
Y
, Zhang
H
, Li
Y
, Wang
D
, Ma
Y
, Chen
Q
. Preoperative increased systemic immune-inflammation index predicts poor prognosis in patients with operable non-small cell lung cancer
. Clin Chim Acta
. 2018
Sep
;484
:272
–7
.
[PubMed]
0009-898132.
Chen
Y
, Wang
W
, Zhang
X
, Yu
X
, Xi
K
, Wen
Y
, et al. Prognostic significance of combined preoperative platelet-to-lymphocyte ratio and lymphocyte-to-monocyte ratio in patients undergoing surgery with stage IB non-small-cell lung cancer
. Cancer Manag Res
. 2018
Nov
;10
:5411
–22
.
[PubMed]
1179-132233.
Minami
S
, Ogata
Y
, Ihara
S
, Yamamoto
S
, Komuta
K
. Neutrophil-to-Lymphocyte Ratio Predicts Overall Survival of Advanced Non-Small Cell Lung Cancer Harboring Mutant Epidermal Growth Factor Receptor
. World J Oncol
. 2017
Dec
;8
(6
):180
–7
.
[PubMed]
1920-453134.
Minami
S
, Ihara
S
, Komuta
K
. Pretreatment Lymphocyte to Monocyte Ratio as a Prognostic Marker for Advanced Pulmonary Squamous Cell Carcinoma Treated With Chemotherapy
. J Clin Med Res
. 2018
Aug
;10
(8
):657
–64
.
[PubMed]
1918-300335.
Minami
S
, Ihara
S
, Kim
SH
, Yamamoto
S
, Komuta
K
. Lymphocyte to Monocyte Ratio and Modified Glasgow Prognostic Score Predict Prognosis of Lung Adenocarcinoma Without Driver Mutation
. World J Oncol
. 2018
Feb
;9
(1
):13
–20
.
[PubMed]
1920-453136.
Watanabe
K
, Yasumoto
A
, Amano
Y
, Kage
H
, Goto
Y
, Yatomi
Y
, et al. Mean platelet volume and lymphocyte-to-monocyte ratio are associated with shorter progression-free survival in EGFR-mutant lung adenocarcinoma treated by EGFR tyrosine kinase inhibitor
. PLoS One
. 2018
Sep
;13
(9
):e0203625
.
[PubMed]
1932-620337.
Lim
JU
, Yeo
CD
, Kang
HS
, Park
CK
, Kim
JS
, Kim
JW
, et al. Prognostic value of platelet count and lymphocyte to monocyte ratio combination in stage IV non-small cell lung cancer with malignant pleural effusion
. PLoS One
. 2018
Jul
;13
(7
):e0200341
.
[PubMed]
1932-620338.
Luo
H
, Ge
H
, Cui
Y
, Zhang
J
, Fan
R
, Zheng
A
, et al. Systemic Inflammation Biomarkers Predict Survival in Patients of Early Stage Non-Small Cell Lung Cancer Treated With Stereotactic Ablative Radiotherapy - A Single Center Experience
. J Cancer
. 2018
Jan
;9
(1
):182
–8
.
[PubMed]
0378-236039.
Yuan
C
, Li
N
, Mao
X
, Liu
Z
, Ou
W
, Wang
SY
. Elevated pretreatment neutrophil/white blood cell ratio and monocyte/lymphocyte ratio predict poor survival in patients with curatively resected non-small cell lung cancer: results from a large cohort
. Thorac Cancer
. 2017
Jul
;8
(4
):350
–8
.
[PubMed]
1759-770640.
Li
W
, Ma
G
, Wu
Q
, Deng
Y
, Liu
Y
, Wang
J
. Prognostic value of lymphocyte-to-monocyte ratio among Asian lung cancer patients: a systematic review and meta-analysis
. Oncotarget
. 2017
Aug
;8
(66
):110606
–13
.
[PubMed]
1949-255341.
Geng
Y
, Shao
Y
, He
W
, et al. Prognostic Role of Tumor-Infiltrating Lymphocytes in Lung Cancer: a Meta-Analysis.
Cellular physiology and biochemistry : international journal of experimental cellular physiology, biochemistry, and pharmacology. 2015
;37(4):1560-71. 42.
Donnem
T
, Hald
SM
, Paulsen
EE
, Richardsen
E
, Al-Saad
S
, Kilvaer
TK
, et al. Stromal CD8+ T-cell Density—A Promising Supplement to TNM Staging in Non-Small Cell Lung Cancer
. Clin Cancer Res
. 2015
Jun
;21
(11
):2635
–43
.
[PubMed]
1078-043243.
Olingy
CE
, Dinh
HQ
, Hedrick
CC
. Monocyte heterogeneity and functions in cancer
. J Leukoc Biol
. 2019
Feb
;JLB.4RI0818-311R
.
[PubMed]
0741-540044.
Shibutani
M
, Maeda
K
, Nagahara
H
, Fukuoka
T
, Nakao
S
, Matsutani
S
, et al. The peripheral monocyte count is associated with the density of tumor-associated macrophages in the tumor microenvironment of colorectal cancer: a retrospective study
. BMC Cancer
. 2017
Jun
;17
(1
):404
.
[PubMed]
1471-2407© 2019 S. Karger AG, Basel
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
2019
You do not currently have access to this content.
