Prognostic significance of thrombocytosis in lung cancer: a systematic review and meta-analysis

Abstract

A potential relationship between poor prognosis and thrombocytosis has been suggested by previous studies in lung cancer, but the conclusions continued to be controversial. Here, we performed a meta-analysis to explore the prognostic impact of thrombocytosis in lung cancer. The Cochrane Library, EMBASE and PubMed databases were comprehensively and systematically retrieved from establishment to May 5, 2020. Pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were applied to evaluate overall effects. Heterogeneity was assessed using I² statistics and Cochran’s Q test. Sensitivity and subgroup analyses were performed to analyze the sources of heterogeneity. Publication bias was examined using the Egger’s test and pooled HR was regulated using the trim-and-fill approach when publication bias was observed. A total of 37 studies including 14,833 patients were enrolled in the meta-analysis. Thrombocytosis was significantly correlated to poor overall survival (HR 1.033; 95% CI 1.017–1.050), disease-free survival (HR 1.568; 95% CI 1.276–1.928), and progression-free survival (HR 1.653; 95% CI 1.069–2.556). Although publication bias was identified, rectification for this bias using the trim-and-fill approach did not change the combined HR substantially. In conclusion, this meta-analysis result suggested that thrombocytosis is a predictor of poor prognosis in lung cancer.

Keywords:

• Lung neoplasms
• meta-analysis
• overall survival
• prognosis
• thrombocytosis

Author Contributions

Yunfei Ma and Xiaomin Wang conceived and devised this project. Yunfei Ma, Guangda Li, Yu Gao, Tongjing Ding and Xiaoxiao LI carried out search strategy, data collection and management. Yunfei Ma, Guangda Li, Xu Sun and Jiayun Nian contributed to the data analyses. Yunfei Ma, Mingwei Yu and Xiaomin Wang took part in writing and reviewing manuscript.

Statement Of Interest

There is no conflict of interest in this study.

Supplementary Material

Supplemental data for this article can be accessed on the publisher’s website.

Additional information

Funding

The research was supported through the National Natural Science Foundation of China [No.81473643; 81673924] and Beijing Natural Science Foundation [No.7202066; 7202065].