• Xu Liu, Jing-Kun Qu, Jia Zhang, Yan Yan, Xi-Xi Zhao, Ji-Zhao Wang, Hang-Ying Qu, Lin Liu, Jian-Sheng Wang, and Xiao-Yi Duan.
• The Second Department of Thoracic Surgery, the First Affiliated Hospital of Xi'an Jiaotong University Department of Oncology, the Second Affiliated Hospital of Xi'an Jiaotong University The Department of Oncological Surgery, Shaanxi University of Chinese Medicine The Department of Radiology, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, P.R. China.
• Medicine (Baltimore). 2017 Nov 1; 96 (45): e8101.

BackgroundInflammation and cancer are closely related to each other. As a parameter that can reflect inflammation and host immune reaction, elevated blood neutrophil to lymphocyte ratio (NLR) has been confirmed to be correlated with poor prognosis in a variety of cancers. However, this remains controversial in breast cancer. Thus, we performed this updated meta-analysis to further clarify whether high NLR could be a predictor of survival in breast cancer patients.MethodsWe searched on PubMed Database and Cochrane Library. Overall survival (OS), disease-free survival (DFS), and cancer-specific survival were used as outcome events, and hazard ratio (HR) was chosen as the parameter to evaluate the correlation.ResultEighteen eligible studies were involved in this meta-analysis. The synthesized analysis demonstrated that elevated NLR was associated with poor DFS [HR = 1.72, 95% confidence interval (95% CI) = 1.30-2.27], OS (HR = 1.87, 95% CI = 1.41-2.48), and cancer-specific survival (HR = 2.09, 95% CI = 1.04-4.21). The correlation was stronger in triple-negative breast cancer (TNBC) (OS: HR = 2.58, 95% CI = 1.63-4.06; DFS: HR = 3.51, 95% CI = 1.97-6.24).ConclusionHigher NLR was correlated to poor prognosis of breast cancer patients. As a clinical parameter that we can easily obtain, NLR might be a potential predictor in patients' survival to assist with physicians' treatment decisions.

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