Correlation analysis of NLR, PLR and tyrosine-kinase inhibitors in the treatment of advanced lung adenocarcinoma

Abstract

Objective To analyze the correlation between neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR) in peripheral blood and the therapeutic effect and prognosis of patients with advanced lung adenocarcinoma treated with tyrosine-kinase inhibitors. Methods Retrospective analysis was utilized to measure the clinical pathological characteristics and follow-up data of 40 cases with advanced lung adenocarcinoma definitely diagnosed by pathology.Correlation analysis was performed by Spearman test, and comparison of the sample rate was measured by the chi square test.Survival analysis was performed by Kaplan-Meier method, Log-rank test was used to compare patients survival difference among different groups.COX regression model was utilized to analyze the prognostic factors of patients with lung cancer. Results Through the ROC curve, the optimal cut-off points of NLR and PLR were calculated to be 3.74 and 205.1 respectively.In NLR<3.74 group, objective response rate(ORR), the median progression-free survival(PFS) and the median overall survival(OS) were 86.9%(20/23), 9.02 months and 12.37 months respectively.In NLR ≥3.74 group, ORR, the median PFS and the median OS was ORR were 35.2%(6/17), 3.15 months and 5.12 months respectively.Compared with NLR ≥ 3.74 group, NLR<3.74 group had a higher ORR(P=0.036), PFS(P=0.011) and OS(P=0.021), the difference was statistically significant.In PLR<205.1 group, ORR, the median PFS and the median OS was ORR were 85.7%(18/21), 9.67 months and 14.35 months respectively.In PLR ≥ 205.1 group, ORR, the median PFS and the median OS was ORR were 42.1%(8/19), 3.21 months and 9.25 months respectively.Compared with group PLR ≥ 205.1, PLR<205.1 group had a higher ORR(P=0.045) and PFS(P=0.018), the difference was statistically significant.COX multivariate analysis showed that NLR was an independent prognostic factor for PFS(RR=1.091, 95%CI: 1.004-1.185, P=0.039) and OS(RR=0.986, 95%CI: 0.932-1.148, P=0.021). PLR was an independent prognostic indicator of PFS(RR=1.100, 95%CI: 0.996-1.005, P=0.024). Conclusion NLR and PLR may be independent prognostic factors in patients with advanced lung adenocarcinoma. Key words: Lung cancer; Neutrophil-to-lymphocyte ratio; Platelet-to-lymphocyte ratio; Prognosis