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Open Access 01-12-2021 | Lung Cancer | Research

Inflammation scores as prognostic biomarkers in small cell lung cancer: a systematic review and meta-analysis

Authors: Anne Winther-Larsen, Ninna Aggerholm-Pedersen, Birgitte Sandfeld-Paulsen

Published in: Systematic Reviews | Issue 1/2021

Abstract

Background

Inflammation scores based on general inflammation markers as leucocyte count or C-reactive protein have been evaluated as prognostic markers of inferior survival in several cancers. In small cell lung cancer (SCLC), however, inflammation scores are less studied. In the present study, we set out to perform a systematic review and meta-analysis investigating reported associations between inflammation scores and overall survival (OS) in SCLC.

Methods

A literature search was performed in PubMed, Embase, Scopus, and Web of Science following the Preferred Reporting Items for Systematic and Meta-Analyses (PRISMA) guidelines. Of the identified publications, only studies in English containing original data evaluating inflammation scores as a prognostic factor in SCLC patients were included. Hazard ratios (HRs) for OS were pooled in a random-effects model.

Results

In total, 33 articles were included evaluating eight different inflammation scores in 7762 SCLC patients. Seven of the identified scores were based on leucocyte count. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte (PLR) ratio were the most frequently evaluated scores (NLR: n = 23; PLR: n = 22). For NLR, a meta-analysis including 16 studies demonstrated that patients with a high NLR had a significantly shorter OS compared to patients with a low NLR (pooled HR = 1.39 (95% CI, 1.23–1.56)). For PLR, an association with survival could not be confirmed in a meta-analysis performed based on eight studies (pooled HR = 1.20 (95% CI, 0.96–1.51)).

Conclusions

This review identifies that inflammation scores based on general inflammation markers have some potential as prognostic biomarkers in SCLC. The meta-analyses indicated that NLR is associated with inferior OS, whereas an association between PLR and OS could not be confirmed. Thus, NLR could be a useful biomarker of OS in SCLC patients.

Systematic review registration

The protocol for the study was submitted to the PROSPERO database (registration number CRD42020188553).

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Title: Inflammation scores as prognostic biomarkers in small cell lung cancer: a systematic review and meta-analysis
Authors: Anne Winther-Larsen
Ninna Aggerholm-Pedersen
Birgitte Sandfeld-Paulsen
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Lung Cancer
Lung Cancer
SCLC
Lung Cancer
SCLC
Biomarkers
Published in: Systematic Reviews / Issue 1/2021
Electronic ISSN: 2046-4053
DOI: https://doi.org/10.1186/s13643-021-01585-w

At a glance: The STEP trials

Springer Medicine

Inflammation scores as prognostic biomarkers in small cell lung cancer: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusions

Systematic review registration

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Systematic review registration

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