Abstract
BackgroundThe neutrophil-to-lymphocyte ratio (NLR) is reported as a biomarker for some solid malignant diseases. Thus far, however, no reports of the relationship between the NLR and adrenal tumors have been published. We analyzed the utility of the preoperative NLR as a biomarker for predicting the prognosis or diagnosis of malignant disease.MethodsA total of 59 patients with adrenal tumors (13 cases of malignant disease and 46 with benign disease) were analyzed in this study from February 2004 to June 2015 at our institute. The NLR was obtained just before adrenalectomy. The diagnosis of adrenal tumor was confirmed by a pathological examination of surgical specimens.ResultsThe NLR in malignant adrenal tumor specimens was significantly higher than in non-malignant specimens (p = 0.028). Adrenocortical carcinoma (ACC) showed the highest NLR among all adrenal tumors. In ACC, the higher NLR group (NLR ≥ 5) showed a significantly poorer overall survival than the lower NLR group (NLR < 5) (p = 0.032).ConclusionsIn adrenal tumors, a higher NLR indicates a higher incidence of malignancy. The NLR might be a new biomarker for predicting the prognosis of adrenal tumor patients.
Highlights
The neutrophil-to-lymphocyte ratio (NLR) is reported as a biomarker for some solid malignant diseases
The cut-off NLR was determined based on the results of a receiver operative curve (ROC) analysis and a multivariate analysis was performed to investigate the factors associated with malignancy in adrenal tumors
Patients We examined a total of 59 cases of adrenal tumor, including 33 cases of adrenal carcinoid (mean size, 22 mm; median NLR, 2.84 (3.41 ± 1.89)), 13 cases of pheochromocytoma (mean size, 40 mm; NLR, 2.03 (2.47 ± 1.54)), nine cases of Adrenocortical carcinoma (ACC) (mean size, 100 mm; NLR, 6.02 (5.04 ± 3.09)), and four cases of malignant lymphoma (mean size, 91 mm; NLR, 3.30 (3.82 ± 2.18)) [Table 1]
Summary
The neutrophil-to-lymphocyte ratio (NLR) is reported as a biomarker for some solid malignant diseases. No reports of the relationship between the NLR and adrenal tumors have been published. We analyzed the utility of the preoperative NLR as a biomarker for predicting the prognosis or diagnosis of malignant disease. About 70% of ACCs are reported to be diagnosed as extra-adrenal lesions [3]. Despite this poor prognosis, some patients have achieved a long disease-free survival [4]. Several candidate prognostic factors of ACC have been reported, including the tumor size, rate of Ki-67 positivity, completeness of resection of the surgical margin, and the clinical stage [5]
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