Abstract
Previously we and others proposed the Neutrophil-Lymphocyte Ratio (NLR) was a prognostic marker in the patients with advanced NSCLC. But whether its prognostic value was influenced by other factors was never discussed before. The aim of this study was to evaluate the influence of albumin level on the prognostic value of the baseline NLR. A total of 325 patients were retrospectively enrolled from October 2007 to October 2014. The baseline NLR and demographic features were recorded, together with the overall survival (OS). Survival analysis was performed by the Kaplan-Meier method. The cut-off value of NLR (3.19) was determined by the receiver operator characteristics analysis. The patients were dichotomized into high (≥3.19) and low (<3.19) NLR groups. Both groups had similar demographic features. However, the low group had longer OS (22.3 m) than the higher one (13.1 m, P<0.001). Interestingly, it was also found that the albumin level had an impact on its prognostic value. For patient with compromised albumin level (<35 g/L), NLR had no relationship with the OS (P=0.380). However in patients with normal albumin level (≥35 g/L), high NLR strongly indicated poor OS (13.6 m vs 24.5 m, P<0.001). This study argued the NLR was a convenient prognostic marker, but its prognostic value was influenced by albumin level.
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