Simple Peripheral Blood Cell Parameters to Predict Prognosis in Non-Small Cell Lung Cancer

Abstract

The relationship between chronic inflammation and cancer development is a known entity. There are many studies that have shown that inflammation is not only related to cancer pathogenesis but also to prognosis in the literature. Some serum inflammatory parameters such as neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and lymphocyte-monocytes ratio (LMR) have been associated with survival in various types of cancer. The aim of this study was to investigate the prognostic relationship between resected non-small cell carcinomas and these parameters. Between January 2010 and December 2018, 693 patients who were operated without neo-adjuvant therapy were included in the study. The cutoff values for NLR, LMR, and PLR were determined by receiver operating curve (ROC) method. The patients were divided into high and low value groups, and Kaplan-Meier, log-rank, and Cox regression analyses were used to investigate the difference in survival between the groups. The optimal cutoff values for NLR, LMR, and PLR were 4.6, 2.95, and 141.2, respectively. In the high NLR group, the survival was significantly worse than in the low NLR group (HR, 1.81, p = 0.02). Similarly, the survival of the high PLR group was significantly poor (HR, 1.4, p = 0.002). On the contrary, OS was found to be significantly worse in the low LMR group generally for all stage and specific for each stage (HR, 2.0, p = 0.001). NLR, LMR, and PLR values obtained from the preoperative blood of the patients are a statistically significant prognostic factor for the survival of resected non-small cell lung cancer. In the prognosis estimation of the patients, inflammatory parameters can be specified besides the stage. Here, we investigated the prognostic significance of inflammatory parameters in surgically treated non-small cell lung cancer in a large series. The median and 5-year OS were found significantly worse in high NLR, high PLR, and low LMR groups. Furthermore, LMR is an independent prognostic factor for each stage of surgically treated non-small cell lung cancers.