Can the Neutrophil to Lymphocyte Ratio Be Used to Determine Gastric Cancer Treatment Outcomes? A Systematic Review and Meta-Analysis

Table 3

Summary of the meta analysis results.

Analysis		References	Fixed-effect model		Random-effect model		Heterogeneity		Meta regression
			HR (95% CI)		HR (95% CI)
Subgroup analysis for OS
Subgroup: treatments
Surgery	12	[13, 14, 18, 19, 21, 22, 24, 25, 28, 30–32]	2.01 (1.71–2.37)	<0.001	2.11 (1.72–2.57)	<0.001	26%	0.19	0.207
Chemotherapy	4	[20, 23, 29, 34]	1.95 (1.83–2.08)	<0.001	1.84 (1.48–2.28)	<0.001	86%	<0.001
Mutlitherapy	3	[26, 27, 33]	2.39 (1.84–3.11)	<0.001	2.39 (1.84–3.11)	<0.001	1%	0.37
Subgroup: region
Western	3	[19, 21, 26]	2.26 (1.74–2.94)	<0.001	2.10 (1.42–3.10)	<0.001	44%	0.17	0.543
Eastern	16	[13, 14, 18, 20, 22–25, 27–34]	1.96 (1.85–2.08)	<0.001	1.96 (1.71–2.24)	<0.001	56%	0.004
Subgroup: sample size
Sample size ≥ 200	9	[13, 14, 20, 24, 26, 30, 32–34]	1.69 (1.53–1.86)	<0.001	1.82 (1.55–2.13)	<0.001	45%	0.07	0.034
Sample size < 200	10	[18, 19, 21–23, 25, 27–29, 31]	2.15 (2.00–2.31)	<0.001	2.15 (2.00–2.31)	<0.001	0%	0.43
Subgroup: cutoff value
(1) Cutoff ≤ 2.2	5	[13, 24, 28, 30, 33]	1.80 (1.43–2.26)	<0.001	1.80 (1.43–2.26)	<0.001	0%	0.43	0.112
(2) 2.2 < cutoff ≤ 3	7	[19, 20, 22, 23, 25, 29, 34]	1.96 (1.84–2.08)	<0.001	1.88 (1.56–2.26)	<0.001	0%	0.47
(3) 3 < cutoff ≤ 4	3	[18, 26, 32]	2.32 (1.85–2.89)	<0.001	2.31 (1.81–2.94)	<0.001	41%	0.13
(4) 4 < cutoff ≤ 5	4	[14, 21, 27, 31]	2.27 (1.59–3.26)	<0.001	2.36 (1.38–4.03)	0.002	54%	0.09
Subgroup: stage IV
Resection	2	[30, 32]	1.75 (1.30–2.36)	<0.001	1.73 (0.85–3.54)	0.13	83%	0.02
Chemotherapy	3	[18, 20, 26, 29, 34]	1.94 (1.81–2.07)	<0.001	1.83 (1.49–2.24)	<0.001	90%	<0.001
Clinicopathological parameters			OR (95% CI)		OR (95% CI)
TNM stage (I + II vs. III + IV)	4	[13, 19, 24, 31]	2.59 (1.91–3.50)	<0.001	2.76 (1.36–5.61)	0.005	80%	0.002
Tumor differentiation; (well versus poor)	3	[13, 20, 30]	1.05 (0.77–1.43)	0.75	1.05 (0.77–1.44)	0.74	0%	0.38
CEA (<5 ng mL^−1 versus ≥5 ng mL^−1)	2	[23, 24]	1.43 (0.64–3.21)	0.38	1.31 (0.77–2.25)	0.32	52%	0.15