Prognostic value of platelet to lymphocyte ratio in patients with cervical cancer: an updated systematic review and meta-analysis

Abstract Background The identification of biomarkers that reliably forecast cervical cancer (CC) outcomes is a key area of research. Several studies have explored the link between the platelet-to-lymphocyte ratio (PLR) and cervical cancer prognosis, though the results are not entirely conclusive. Me...

Full description

Saved in:
Bibliographic Details
Main Authors: Tianyu Zhu, Zhaoying Chen, Beichen Zhang, Xianqing Wu
Format: Article
Language:English
Published: BMC 2025-05-01
Series:World Journal of Surgical Oncology
Subjects:
Online Access:https://doi.org/10.1186/s12957-025-03838-7
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849725122511896576
author Tianyu Zhu
Zhaoying Chen
Beichen Zhang
Xianqing Wu
author_facet Tianyu Zhu
Zhaoying Chen
Beichen Zhang
Xianqing Wu
author_sort Tianyu Zhu
collection DOAJ
description Abstract Background The identification of biomarkers that reliably forecast cervical cancer (CC) outcomes is a key area of research. Several studies have explored the link between the platelet-to-lymphocyte ratio (PLR) and cervical cancer prognosis, though the results are not entirely conclusive. Methods PubMed, Embase, Web of Science, and the Cochrane Library were used to search, with studies published up to May 30, 2024. The selection of studies followed predetermined inclusion and exclusion criteria. Overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) were primary outcomes. Hazard ratios (HR) and 95% confidence intervals (CIs) were calculated. Sensitivity and subgroup analyses were performed to evaluate the stability and investigate potential heterogeneity. Review Manager version 5.4.1 and STATA version 15.0 were conducted to analyze. Results Thirty cohort studies, involving 8,597 patients, were included. The pooled data showed that a higher PLR was associated with worse OS significantly (HR = 1.77, 95% CI: 1.43–2.19; p < 0.0001), PFS (HR = 1.69, 95% CI: 1.26–2.27; p = 0.0004), and DFS (HR = 1.57, 95% CI: 1.12–2.18; p = 0.008). Subgroup analysis indicated that the prognostic relevance of PLR was most prominent in patients who underwent both surgery and radiotherapy, as well as those from Asia and the America. Furthermore, a PLR threshold above 150 was associated with improved predictive accuracy. Conclusion Increased PLR among cervical cancer patients was significantly correlated with reduced OS, PFS, and DFS, pointing to its potential role as an independent prognostic marker. Nonetheless, additional prospective research is required to verify this finding.
format Article
id doaj-art-7d8fbb9d2e5c4a3fbccc5c2eb15d6228
institution DOAJ
issn 1477-7819
language English
publishDate 2025-05-01
publisher BMC
record_format Article
series World Journal of Surgical Oncology
spelling doaj-art-7d8fbb9d2e5c4a3fbccc5c2eb15d62282025-08-20T03:10:32ZengBMCWorld Journal of Surgical Oncology1477-78192025-05-0123111310.1186/s12957-025-03838-7Prognostic value of platelet to lymphocyte ratio in patients with cervical cancer: an updated systematic review and meta-analysisTianyu Zhu0Zhaoying Chen1Beichen Zhang2Xianqing Wu3Department of Obstetrics and Gynecology, The Second Xiangya Hospital of Central South UniversityDepartment of Obstetrics and Gynecology, Hunan Provincial People’s HospitalDepartment of Obstetrics and Gynecology, The Second Xiangya Hospital of Central South UniversityDepartment of Obstetrics and Gynecology, The Second Xiangya Hospital of Central South UniversityAbstract Background The identification of biomarkers that reliably forecast cervical cancer (CC) outcomes is a key area of research. Several studies have explored the link between the platelet-to-lymphocyte ratio (PLR) and cervical cancer prognosis, though the results are not entirely conclusive. Methods PubMed, Embase, Web of Science, and the Cochrane Library were used to search, with studies published up to May 30, 2024. The selection of studies followed predetermined inclusion and exclusion criteria. Overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS) were primary outcomes. Hazard ratios (HR) and 95% confidence intervals (CIs) were calculated. Sensitivity and subgroup analyses were performed to evaluate the stability and investigate potential heterogeneity. Review Manager version 5.4.1 and STATA version 15.0 were conducted to analyze. Results Thirty cohort studies, involving 8,597 patients, were included. The pooled data showed that a higher PLR was associated with worse OS significantly (HR = 1.77, 95% CI: 1.43–2.19; p < 0.0001), PFS (HR = 1.69, 95% CI: 1.26–2.27; p = 0.0004), and DFS (HR = 1.57, 95% CI: 1.12–2.18; p = 0.008). Subgroup analysis indicated that the prognostic relevance of PLR was most prominent in patients who underwent both surgery and radiotherapy, as well as those from Asia and the America. Furthermore, a PLR threshold above 150 was associated with improved predictive accuracy. Conclusion Increased PLR among cervical cancer patients was significantly correlated with reduced OS, PFS, and DFS, pointing to its potential role as an independent prognostic marker. Nonetheless, additional prospective research is required to verify this finding.https://doi.org/10.1186/s12957-025-03838-7Platelet-to-lymphocyte ratioCervical cancerPrognostic value of survivalMeta-analysis
spellingShingle Tianyu Zhu
Zhaoying Chen
Beichen Zhang
Xianqing Wu
Prognostic value of platelet to lymphocyte ratio in patients with cervical cancer: an updated systematic review and meta-analysis
World Journal of Surgical Oncology
Platelet-to-lymphocyte ratio
Cervical cancer
Prognostic value of survival
Meta-analysis
title Prognostic value of platelet to lymphocyte ratio in patients with cervical cancer: an updated systematic review and meta-analysis
title_full Prognostic value of platelet to lymphocyte ratio in patients with cervical cancer: an updated systematic review and meta-analysis
title_fullStr Prognostic value of platelet to lymphocyte ratio in patients with cervical cancer: an updated systematic review and meta-analysis
title_full_unstemmed Prognostic value of platelet to lymphocyte ratio in patients with cervical cancer: an updated systematic review and meta-analysis
title_short Prognostic value of platelet to lymphocyte ratio in patients with cervical cancer: an updated systematic review and meta-analysis
title_sort prognostic value of platelet to lymphocyte ratio in patients with cervical cancer an updated systematic review and meta analysis
topic Platelet-to-lymphocyte ratio
Cervical cancer
Prognostic value of survival
Meta-analysis
url https://doi.org/10.1186/s12957-025-03838-7
work_keys_str_mv AT tianyuzhu prognosticvalueofplatelettolymphocyteratioinpatientswithcervicalcanceranupdatedsystematicreviewandmetaanalysis
AT zhaoyingchen prognosticvalueofplatelettolymphocyteratioinpatientswithcervicalcanceranupdatedsystematicreviewandmetaanalysis
AT beichenzhang prognosticvalueofplatelettolymphocyteratioinpatientswithcervicalcanceranupdatedsystematicreviewandmetaanalysis
AT xianqingwu prognosticvalueofplatelettolymphocyteratioinpatientswithcervicalcanceranupdatedsystematicreviewandmetaanalysis