• Qingbin Wu, Tao Hu, Erliang Zheng, Xiangbing Deng, and Ziqiang Wang.
• Department of Gastrointestinal Surgery, West China Hospital West China School of Medicine, Sichuan University, Chengdu, China.
• Medicine (Baltimore). 2017 Jun 1; 96 (22): e7051.

BackgroundAlthough previous meta-analyses have proved that lymphocyte-to-monocyte ratio (LMR) is a prognostic factor in solid cancers, its prognostic role in colorectal cancer (CRC) remains controversial. We, therefore, conducted this up-to-date meta-analysis to evaluate the prognostic role of the LMR in CRC.MethodsA systematic search was performed in PubMed and Embase for relevant studies in November 2016. Article assessing the prognostic role of LMR in CRC was enrolled in this meta-analysis. Data and characteristics of each study were extracted. A meta-analysis was performed to generate pooled hazard ratio (HR) and 95% confidence intervals (95% CIs) for overall survival (OS) and disease-free survival. Begg funnel plot was used to evaluate publication bias.ResultsEleven studies published between 2014 and 2016 with a total of 9045 patients were enrolled in this meta-analysis. Our findings indicated that a low LMR predicted a worse OS (HR 1.57, 95% CI 1.30-1.90, P < .001) and disease-free survival. (HR 1.25, 95% CI 1.13-1.39, P < .001) for patients with CRC. Subgroup analyses according to stage (I-III and IV) and LMR cut-off value (<3.00 and ≥3.00) showed a significant prognostic value of LMR on OS. Begg funnel plot showed that publication bias existed in this meta-analysis.ConclusionsThis up-to-date meta-analysis shows that a low LMR is associated with poor survival in patients with CRC, although the publication bias is existed. Large-sample multicenter prospective cohort is needed to assess the role of the LMR in CRC patients.

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