Associations between peripheral whole blood cell counts derived indexes and cancer prognosis: An umbrella review of meta-analyses of cohort studies.
Level 3 - non-randomized controlled study
Umbrella review synthesizing meta-analyses of observational cohort studies
PubMed 39370059 · doi:10.1016/j.critrevonc.2024.104525
What was done
This umbrella review graded evidence from published meta-analyses of cohort studies evaluating associations between whole blood cell count-derived indexes (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], and lymphocyte-to-monocyte ratio [LMR]) and cancer prognosis. Quality of included meta-analyses was assessed using the AMSTAR tool.
What was found
A total of 694 associations from 224 articles were analyzed. AMSTAR rated 219 articles (97.8%) as moderate-to-high quality. Only 4 associations were supported by convincing evidence, while 165 were supported by highly suggestive evidence and 164 by suggestive evidence. The abstract reports no numerical effect sizes or risk ratios for specific cancer outcomes.
Why it matters
Despite hundreds of published meta-analyses investigating blood cell count ratios as cancer prognostic markers, robust and convincing evidence supporting their utility remains exceedingly scarce.
Limits
The underlying literature consists exclusively of observational cohort studies subject to confounding. The abstract notes inconsistent directions of effect sizes across studies and lacks details on specific cancer types, individual effect estimates, and total human participant numbers.
Cited by
- supports A low lymphocyte-to-monocyte ratio on a standard complete blood count is associated with worse clinical outcomes across cardiovascular disease, cancer, and diabetes.