Clinical significance of preoperative neutrophil-lymphocyte vs platelet-lymphocyte ratio in primary operable patients with non-small cell lung cancer

Am J Surg. 2015 Sep;210(3):526-35. doi: 10.1016/j.amjsurg.2015.03.022. Epub 2015 Jun 1.

Abstract

Background: Our aim was to determinate the prognostic value of neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) in primary operable patients with non-small cell lung cancer (NSCLC).

Methods: Six hundred seventy-eight NSCLC patients were enrolled in this study. The prognostic significance of both markers was determined by both univariate and multivariate Cox survival analysis. The cut-off value for NLR and PLR was selected by using receiver operating characteristic curve analysis.

Results: Multivariate analysis showed that NLR was an independent prognostic factor for disease-free survival (hazard ratio = 1.593, 95% confidence interval [CI] 1.277 to 1.988, P < .001) and overall survival (hazard ratio = 1.624, 95% CI 1.304 to 2.022, P < .001). The area under the curve was .640 (95% CI .599 to .682, P < .001) for NLR and .547 (95% CI .503 to .590, P = .036) for PLR, indicating that NLR was superior to PLR as a predictive factor in primary operable NSCLC patients.

Conclusions: Preoperative NLR represents a significant independent prognostic indicator in primary operable NSCLC patients. Our results also demonstrate that high-risk patients based on the NLR do not benefit from adjuvant chemotherapy.

Keywords: Neutrophil–lymphocyte ratio; Non–small cell lung cancer; Platelet–lymphocyte ratio; Prognosis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung / blood
  • Carcinoma, Non-Small-Cell Lung / mortality*
  • Carcinoma, Non-Small-Cell Lung / surgery
  • Disease-Free Survival
  • Female
  • Humans
  • Lung Neoplasms / blood
  • Lung Neoplasms / mortality*
  • Lung Neoplasms / surgery
  • Lymph Node Excision
  • Lymphocyte Count*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neutrophils / metabolism*
  • Platelet Count*
  • Pneumonectomy
  • Preoperative Period
  • Prognosis
  • ROC Curve
  • Retrospective Studies