BACKGROUND This study aimed to summarize the previously published literature on the role of platelet-to-lymphocyte ratio (PLR) on overall survival (OS) in patients with gastric cancer. METHODS We systematically searched PubMed, EmBase, and the Cochrane library to identify eligible studies to review. Pooled hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the random-effects model. Sensitivity and subgroup analyses were performed, and publication bias was assessed. RESULTS A total of 28 studies comprising 15,617 patients with gastric cancer were included in this meta-analysis. The pooled results indicated that elevated PLR was associated with poor OS (HR: 1.37; 95% CI: 1.24-1.51; P < 0.001). A significant publication bias was observed (Egger test, P = 0.036; Begg test, P = 0.017). After adjusting for publication bias using the trim and fill method, an adjusted pooled HR of 1.19 (95% CI: 1.08-1.33; P = 0.001) was observed. Subgroup analyses indicated an elevated PLR in retrospective studies. Studies conducted in Turkey, the UK, the USA, and Costa Rica; studies with a sample size of < 1000, with < 70% male patients, and with patients treated with chemotherapy; studies with PLR cutoff value of ≥200; and studies with lower quality as determined by the Newcastle-Ottawa Scale all showed greater harmful effects on OS than their corresponding subsets (P < 0.05). CONCLUSIONS An elevated PLR was associated with poor OS in patients with gastric cancer. These results might differ between studies due to differences in design, country of origin, sample size, sex proportion, treatment strategy, PLR cutoff value, and study quality.

中文翻译：

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血小板与淋巴细胞比例对胃癌总体生存的预后作用：系统评价和荟萃分析。

背景技术本研究旨在总结先前发表的有关胃癌患者血小板与淋巴细胞比例（PLR）对总生存期（OS）的作用的文献。方法我们系统地搜索了PubMed，EmBase和Cochrane库，以确定要审查的合格研究。使用随机效应模型计算合并风险比（HRs）和95％置信区间（CIs）。进行敏感性和亚组分析，并评估出版偏倚。结果这项荟萃分析共纳入28项研究，包括15617例胃癌患者。汇总结果表明，PLR升高与OS差有关（HR：1.37； 95％CI：1.24-1.51； P <0.001）。观察到显着的出版偏差（Egger测试，P = 0.036； Begg测试，P = 0.017）。使用修整和填充方法调整出版偏差后，观察到调整后的合并HR为1.19（95％CI：1.08-1.33； P = 0.001）。亚组分析表明，回顾性研究显示PLR升高。在土耳其，英国，美国和哥斯达黎加进行的研究；样本量小于1000，男性患者小于70％以及接受化疗的患者的研究；PLR截止值≥200的研究；纽卡斯尔-渥太华量表确定的较低质量的研究均显示，对OS的有害影响大于其相应的亚组（P <0.05）。结论胃癌患者的PLR升高与OS差有关。由于设计，原产国，样本量，性别比例，治疗策略，PLR临界值，