Are neutrophil/lymphocyte and platelet/lymphocyte rates in patients with non-small cell lung cancer associated with treatment response and prognosis? (original) (raw)
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Significance of neutrophil lymphocyte ratio and platelet lymphocyte ratio in lung cancer
Tropical Journal of Pathology and Microbiology, 2019
Background: An underlying inflammatory state is an important contributor to carcinogenesis and progression of tumors. Many of the etiological factors in development of lung cancer are linked to persistent inflammation. Neutrophil lymphocyte ratio (NLR) and Platelet lymphocyte ratio (PLR) are markers of systemic inflammatory response that have shown clinical significance in cancer, according to recent research. Objective: To evaluate NLR and PLR in lung cancer and compare these parameters in healthy controls. Materials and Methods: Clinicopathological details and hematological parameters of complete blood counts were recorded for 106 patients of lung cancer and 106 healthy controls retrospectively. NLR and PLR values were evaluated and compared in the two groups. Results: NLR and PLR were significantly elevated in lung cancer patients (NLR 4.44±2.98; PLR 162.72±96.15) as compared to control group (NLR 1.90±0.67, PLR 115.15±29.15) with p value <0.05. NLR showed a sensitivity of 74.5% and specificity 85.8% at optimal cut off value (2.5), as per Receiver operating characteristics (ROC) curve analysis. ROC curve analysis for PLR showed sensitivity 48.1% and specificity 87.8% at optimal cut off value (148.7). Conclusion: NLR and PLR are significantly raised in lung cancer. This reflects an underlying inflammatory state that may contribute to development and progression of neoplastic disease in lung. NLR a more sensitive than PLR and may provide useful diagnostic and prognostic information in a country like India that bears a high load of lung cancer cases.
Asian Pacific journal of cancer prevention : APJCP, 2014
Lung cancer (LC) is still the primary cause of cancer deaths worldwide, and late diagnosis is a major obstacle to improving lung cancer outcomes. Recently, elevated preoperative or pretreatment neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and mean platelet volume (MPV) detected in peripheral blood were identified as independent prognostic factors associated with poor survival with various cancers, including colon cancer, esophageal cancer, gastric cancer and breast cancer. The aim of this study was to examine whether MPV, NLR and PLR could be useful inflammatory markers to differentiate lung cancer patients from healthy controls. An investigation was also made of the relationship between these markers and other prognostic factors and histopathological subgroups. Retrospectively eighty-one lung cancer patients and 81 age-sexes matched healthy subjects included into the study. Patients with hypertension, hematological and renal disease, heart failure, chron...
Frontiers in Oncology, 2020
Objectives: Neutrophil-lymphocyte ratio (NLR) has been associated with mortality in non-small cell lung cancer (NSCLC), but its association with recurrence in locally advanced NSCLC (LA-NSCLC), specifically, is less established. We hypothesized preand posttreatment NLR would be associated with recurrence and mortality. Methods: We studied the association of pretreatment NLR (pre-NLR) and posttreatment NLR at 1 (post-NLR 1) and 3 months (post-NLR 3) with outcomes in patients with LA-NSCLC treated with chemoradiation. Pre-NLR was dichotomized by 5, an a priori cutoff previously shown to be prognostic in LA-NSCLC. Post-NLR 1 and post-NLR 3 were dichotomized by their medians. Results: We identified 135 patients treated with chemoradiation for LA-NSCLC between 2007 and 2016. Median follow-up for living patients was 61.1 months. On multivariable analysis, pre-NLR ≥ 5 was associated with worse overall survival (
Neutrophil-to-lymphocyte ratio can predict outcome in extensive-stage small cell lung cancer
Radiology and Oncology, 2020
Background The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) were analyzed in various carcinomas and their potential prognostic significance was determined. The objective of present study was to determine the correlation between these parameters and the survival of patients with small cell lung cancer (SCLC), since very few studies have been published on this type of carcinoma. Patients and methods One hundred and forty patients diagnosed with SCLC at University Hospital Center Zagreb, between 2012 and 2016 were retrospectively analyzed. Extensive-stage disease (ED) was verified in 80 patients and limited-stage disease (LD) in 60 patients. We analyzed the potential prognostic significance of various laboratory parameters, including NLR, PLR, and LMR, measured before the start of treatment. Results Disease extension, response to therapy, chest irradiation and prophylactic cranial irradiation (PCI), as well as hemoglob...
Prognostic Value of Platelet to Lymphocyte Ratio in Patients with Non-Small Cell Lung Cancer
The Egyptian Journal of Hospital Medicine, 2018
Background: The prognostic value of Platelet-to-lymphocyte ratio (PLR) in patients with non-small-cell lung cancer (NSCLC) is still indistinct. We conducted this study to assess the prognostic significance of pretreatment PLR in patients with unresectable NSCLC. Aim of the Work: to assess the prognostic significance of pre-treatment PLR in patients with NSCLC. Material and Methods: we retrospectively reviewed 130 patients treated for NSCLC with definitive/palliative chemotherapy and/or radiotherapy in Ain-Shams University hospital, Clinical Oncology department between January 2014 and December 2016. Pre-treatment CBC was available for the 130 patients to calculate PLR by dividing the absolute platelet count by the absolute lymphocytic count. Results: Out of 130 patients with available pre-treatment complete blood picture, population age ranged from 23 to 87 years. Male to female ratio was 4.8:1. Adenocarcinoma presents 51% of cases. Unresectable stage II and stage III present 2% and 27% respectively, while Stage IV presents 69%. Using a cutoff value of 150, high PLR>150 was significantly associated with poor overall survival (OS) (median OS: 10.33 months; 95% CI: 6.23-14.42), compared to patients with PLR<150; (median OS: 24.63 months, 95% CI: 11.5-37.76, p=0.008), but not PFS. In multivariate analysis, PLR>150 was an independent poor prognostic factor for OS; (HR=1.9, 95% CI; 1.092-3.3, p=0.023). Conclusion: High PLR is associated with poor OS in patients with unresectable NSCLC.
Journal of Thoracic Oncology, 2017
Background: Stent placement is an increasingly used treatment for malignant tracheobronchial stenosis. The main complication related to airway stents is bacterial colonization causing chronic cough and sputum, halitosis, recurrent bronchial infections, pneumonia and even sepsis. The main objectives were to describe potentially pathogenic bacteria (PPM) involved in stent colonization and to analyze PPM dynamics during follow-up. Methods: Prospective study in patients with malignant stenosis treated with stent placement. Bronchial washings (BW) were performed before and at least 1 month after stent placement. Qualitative cultures of PPM isolated in BW were performed. Statistical analyses with R-3.2.3. Results: Total of 65 patients, 56 (86%) men, mean age 64 (±10) y/o, 58 (89%) current or former smokers, 2 (3%) bronchiectasis, 28 (43%) COPD. Cancers were: primary lung cancer (n¼52, 80%) followed by thyroid (n¼4, 6%), esophagus (n¼2, 3%) and other (n¼7, 11%); stenosis were located in trachea (n¼14, 21%), main carina (n¼16, 25%) and main bronchi (n¼35, 54%); and stent types included metal (n¼30, 46%) and silicone (n¼35, 54%). Isolated PPM in BW (table 1). Airway colonization was absent in 14 (21.5%) and present in 79%, of which it was persistent in 33 (50.8%) and intermittent in 16 (24.6%). Only 2 (3.1%) became negative. Median time until colonization was 35 days (IQR 28-116), with no significant differences between stent types or location. Conclusion: The majority of patients with malignant stenosis treated with airway stents develop early and persistent colonization by PPM, regardless of stent type.
Lung Cancer, 2013
Introduction: A tumor-promoting impact of neutrophils and macrophages has been demonstrated in some cancers. However, the prognostic significance of innate immune cells in patients with non-small cell lung cancer (NSCLC) is unclear. Methods: A total of 335 consecutive patients resected for stage I-IIIA NSCLC were assessed for CD66b + neutrophils and CD163 + macrophages in the tumor nests and adjacent stromal tissue by immunohistochemistry in whole tissue sections using stereology as well as automatic computerized quantification. Findings were correlated with clinical and histopathological parameters, baseline blood inflammatory markers (C-reactive protein (CRP) and white blood cell count (WBC)). Endpoints were recurrence-free survival (RFS) and overall survival (OS). Results: Elevated CRP above median (101 nmol/l) and WBC above median (8.6 × 10 9 cells/l) were associated with poor RFS (p ≤ 0.002) and poor OS (p ≤ 0.01). Higher density of CD66b + in tumor nests and stroma was associated with elevated CRP and WBC, squamous cell histology, tumor size, and necrosis (p ≤ 0.01). Higher density of CD163 + macrophages in tumor nests and stroma was associated with elevated CRP and lymph node metastases (p ≤ 0.049). The densities of tumor nest CD66b + neutrophils and CD163 + macrophages were not significantly correlated with RFS or OS, irrespective of assessment method. Conclusions: The densities of tumor-associated CD66b + neutrophils and CD163 + macrophages in NSCLC were correlated with adverse prognostic factors and systemic blood inflammation markers, but not directly correlated with RFS or OS. Further research of chronic inflammation in NSCLC is warranted.
systemic inflammation response (SIR), which represents one of the crucial steps for tumor growth by promoting angiogenesis (3-5). Indeed, several studies demonstrated the strong association between an elevated neutrophil-to-lymphocyte ratio (NLR) and a poor prognosis both in early and advanced stages of NSCLC (6-33). The NLR is derived from the absolute neutro-phil and absolute lymphocyte counts of a full blood count and the SIR is specifically related to the appearance of neutrophilia with a relative lymphocytopenia thus resulting in a framework of immunosuppression. The threshold usually chosen in patients with NSCLC to define an elevated NLR was >5 (7, 12, 13). Furthermore, the Glasgow Prognostic Score (GPS), an inflammation based scoring system calculated by combined serum C-reactive protein (CRP) and albumin, was shown to be a simple and reliable tool in predicting progression-free survival (PFS) and overall survival (OS) in many cancers (34-44). Recently, targeted therapy with tyrosine kinase inhibitors (TKIs) was shown