Pretreatment Neutrophil Lymphocyte Research Articles

383P Pre-treatment body mass index and neutrophil lymphocyte ratio predict 3-years progression free survival in locally advanced stage nasopharyngeal carcinoma

383P Pre-treatment body mass index and neutrophil lymphocyte ratio predict 3-years progression free survival in locally advanced stage nasopharyngeal carcinoma

Prognostic Significance of Pre-Treatment Neutrophil-Lymphocyte Ratio and Platelet-Lymphocyte Ratio in Head and Neck Malignancies.

Carcinoma is the second most common cause of death worldwide. The neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) are essential markers of inflammation and tumorigenesis in various cancers including head and neck cancers. Pretreatment platelet- lymphocytic ratio can be used as an independent predictor of mortality whereas neutrophil- lymphocytic ratio is an independent predictor of recurrence. The main aim of this study is to compare the pre-treatment neutrophil lymphocyte ratio and platelet-lymphocyte ratio in the patients of head and neck malignancies with those of the control group. 100 patients with histologically diagnosed cases of head and neck malignancies. Age and sex matched healthy subjects attending Otorhinolaryngology out-patient department for any other complaints (100 control subjects). Complete blood count had been done to calculate absolute neutrophil count and absolute lymphocyte count. The mean age of the subjects in the study group was 55.73 ± 11.56years. In control group, the mean age group was 54.11 ± 10.46years. NLR and PLR significantly increased in cases than controls. NLR associated with T stage, histological type and histological grade but not with site and nodal involvement. PLR associated with T stage, metastasis but not with the histological grade, histological type, site and nodal involvement. From this study, we conclude that pre-treatment NLR and PLR were closely associated both with the size of primary tumor and also with the stage of malignant disease in patients of head and neck malignancies.

Pre-treatment neutrophil-lymphocyte and monocyte-lymphocyte ratios give clues about response, survival, and recurrence in diffuse large B-cell lymphoma

Background: Diffuse large B cell lymphoma is a heterogeneous tumor group consisting of large and transformed B cells that makeup 30-40% of all non-Hodgkin lymphoma. Numerous studies point out that initial parameters and posttreatment responses can be used as prognostic factors. We aimed to examine the relationship between diagnosis, clinical and laboratory parameters, treatment response and survival using neutrophil-lymphocyte and monocytelymphocyte ratios. Methods: A total of 80 patients, followed in our hematology clinic between January 2009-2019, were included in the study and were analyzed retrospectively. Results: The median value of neutrophil-lymphocyte ratio was 3.5 (0.3-50.2) and of monocyte-lymphocyte ratio was 0.3 (0.1-4.8). In the group with neutrophil-lymphocyte ratio ? 3.5 response rates was significantly lower and exitus rate and the bulky mass presence were significantly higher compared to the group with > 3.5 values (p < 0.05). In the group with monocyte-lymphocyte ratio ? 0.30, the exitus rate was significantly higher compared to group with < 0.30 values (p < 0.05). Conclusion: A statistically significant bulky mass presence was demonstrated in the population above the neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio cut off. Although not considered to be sufficient alone, these parameters could be used as prognostic factors in combination with current scoring systems.

Tumor volume reduction after induction chemotherapy with gemcitabine plus cisplatin in nasopharyngeal carcinoma.

To evaluate the tumor volume reduction after induction chemotherapy (IC) with gemcitabine plus cisplatin (GP) and to build prediction models for tumor volume reduction in nasopharyngeal carcinoma (NPC). NPC patients who received GP IC were retrospectively enrolled. The gross tumor volume of the nasopharynx and lymph nodes (GTVnx and GTVnd) were contoured before and after IC. Univariate and multivariate analyses were performed to identify associated factors. Nomogram models were constructed to predict the possibility of tumor volume reduction. A total of 192 patients were enrolled. The mean relative volume reduction for GTVnx and GTVnd was 29.66% and 31.75%, respectively. The volume reduction of GTVnx and GTVnd had a weak association (r = 0.229, p < 0.001). For GTVnx volume reduction, pre-treatment neutrophil count (p = 0.043), lymphocyte count (p = 0.026), LDH level (p = 0.005), and BMI (p = 0.020) were independently associated factors. For GTVnd volume reduction, pre-treatment EBV-DNA (p = 0.029), GTVnd volume (p < 0.001), eosinophil count (p = 0.043), NLR (p = 0.039), LDH level (p = 0.026), and serum potassium level (p = 0.027) were independently associated factors. For the GTVnx nomogram model, areas under the receiver-operating characteristic curve (AUC) were 0.702 and 0.698 for the training and validation cohorts, respectively. For the GTVnd nomogram model, the AUC was 0.872 and 0.758 for the training and validation cohorts, respectively. Tumor volumes reduce significantly after GP induction chemotherapy. Nomogram models for predicting the possibility of tumor volume reduction are built.

The role of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in determining the prognosis of patients with testicular cancer

Background: Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), as systemic inflammatory response markers, have been shown to play a role in prognostic factors for patients with malignancies in recent years. However, their application as the prognostic factors of testicular cancer remains unknown. This study aims to evaluate the prognostic role of testicular malignancies using preoperative hematological parameters, NLR and PLR, and their pre-diagnostic role in the staging of testicular cancer. Methods: This was a cross-sectional retrospective study of thirty-nine patients who underwent radical orchiectomy due to testicular cancer at the Department of Urology Haji Adam Malik General Hospital between January 2014 and December 2018. For each patient, clinical features including age, sex, clinical stage, chemotherapy, radiology report, pre-treatment neutrophil count, lymphocyte count, platelet count, NLR, PLR, and postoperative histopathological report were collected. Then we analyzed the association between NLR, PLR and the testicular cancer metastasis incidence. Result: The mean age of the patients was 27.56 ± 17.47 years. Seventeen patients had seminoma (42.5%), 16 others were yolk sac type of cancer (40.0%), and the rest six patients were teratoma (3 patients), lymphoma (2 patients), and embryonal carcinoma (1 patient). More than half (66.48%) of the patients received chemotherapy after radical orchiectomy, with 48.70% in clinical stage III. PLR was associated with testicular cancer metastases (p=0.024), while NLR was not (p=0.729). Conclusion: High pre-treatment PLR levels are associated with the occurrence of metastasis in testicular cancer patients. Hematological parameters will become critical in the preoperative evaluation of such testicular cancer cases. The potential prognostic significance of NLR and PLR in testicular cancer should be tested with further studies.

Neutrophil-Lymphocyte Ratio and Circulating Tumor Cells Counts Predict Prognosis in Gastrointestinal Cancer Patients.

PurposeThe purpose of this study is to explore the prognostic value of associating pre-treatment neutrophil–lymphocyte ratio (NLR) with circulating tumor cells counts (CTCs) in patients with gastrointestinal cancer.Materials and MethodsWe collected the related data of 72 patients with gastric cancer (GC) and colorectal cancer (CRC) who received different therapies from August 2016 to October 2020, including age, gender, primary tumor location, TNM stage, tumor-differentiation, NLR, CTCs, disease-free survival (DFS) and overall survival (OS). We chose the optimal cut-off value of NLR >3.21 or NLR ≤3.21 and CTC >1 or CTC ≤1 by obtaining receiver operating characteristic (ROC) curve. The Kaplan–Meier survival analysis and Cox regression analysis were used to analyze DFS and OS. To clarify the role of the combination of NLR and CTCs counts in predicting the prognosis, we analyzed the DFS and OS when associated NLR and CTCs counts.ResultsA high NLR (>3.21) was associated with shorter DFS (P <0.0001) and OS (P <0.0001). Patients with high CTCs level (>1) had shorter DFS (P = 0.001) and OS (P = 0.0007) than patients with low CTCs level. Furthermore, patients who had both higher NLR and higher CTCs counts had obvious shorter DFS (P <0.0001) and OS (P <0.0001).ConclusionsPatients with higher NLR and more CTCs respectively tended to have poor prognosis with shorter DFS and OS, which might be regarded as predictors of gastrointestinal cancer. In particular, associating NLR and CTCs counts might be a reliable predictor in patients with gastrointestinal cancer.

Impact of pre-treatment lymphocyte monocyte ratio and neutrophil lymphocyte ratio on pathologic response in breast cancer patients receiving neoadjuvant chemotherapy.

e12623 Background: Hematologic markers have been looked at as potential prognostic biomarkers in a variety of cancers. Ni and colleagues (2014) have shown that an elevated pre-treatment lymphocyte-to-monocyte ratio (LMR) was significantly associated with improved disease-free survival (DFS) in patients with locally advanced breast cancer receiving neoadjuvant chemotherapy (NACT). Given the prognostic implications of hematologic inflammatory parameters, we sought to understand if such biomarkers will predict response to neoadjuvant chemotherapy (NACT) in patients with breast cancer. Methods: We conducted a retrospective review of breast cancer patients treated with NACT at our institution (2008-2018). Data on patient characteristics, stage, pathologic characteristics, and blood counts were collected. Blood parameters prior to NACT were used to calculate LMR and neutrophil-to-lymphocyte ratio (NLR). To test the impact of LMR and NLR on pathologic response, a two sample mean test was used first as univariate analysis. Next, logistic regression was employed for multivariate analysis controlling for patient characteristics with interaction of LMR and NLR with ER, PR and HER2 status. Results: A total of 50 patients were included. 38% of patients achieved a pathologic complete response (pCR). The mean LMR was 3.69 (1.4-12.5), and the mean NLR was 2.55 (0.66 – 9.31). On univariate analysis, a high NLR was associated with a higher likelihood of achieving a pCR (OR = 1.64, 95% CI = 1.01-2.63). A high LMR was associated with a higher likelihood of pCR; however, this was not statistically significant (OR = 1.08, 95% CI = 0.78-1.47). On multivariate analysis, patients with HER-2 positive disease with a high LMR had a significantly higher chance of having a pCR (OR = 1.72, 95% CI = 1.06-2.78). Conclusions: Our study showed that NLR was a predictor of pCR in breast cancer patients receiving neoadjuvant chemotherapy. A high NLR was associated with achieving a pCR on univariate analysis. Multivariate analysis suggested that HER-2 positive disease with a high LMR had a significantly higher chance of achieving a pCR. The results of this cohort correlate with previous reports by others showing that pre-NACT LMR and NLR provide prognostic information in patients with breast cancer. Although limited by sample size, this adds to the growing body of literature supporting peripheral blood counts as a biomarker for outcomes in breast cancer.

Pre-treatment neutrophil-lymphocyte and platelet-lymphocyte ratios as additional markers for breast cancer progression: A retrospective cohort study

BackgroundBreast cancer is the most prevalent cancer that causes significant morbidity and loss of productivity. Around a third of all breast cancer patients are potentially develop distant metastases albeit the current implementation of multidisciplinary treatment. A simple but effective marker to predict the risks of cancer progression is very important for clinicians to improve treatment and surveillance. MethodsWe recruited 1083 non-metastatic patients and analyzed the ratios of neutrophil to lymphocyte (NLR) and platelet to lymphocyte (PLR) in relation to progression-free survivals (PFS) and risks of distant metastases. ResultsBaseline clinicopathological variables were not significantly different in the pretreatment NLR and PLRs. Using maximum points of sensitivity and specificity of the Receiver Operating Characteristic (ROC) curve, cut-off values were determined 2.8 for NLR and 170 for PLR. Higher NLR was associated with skin and chest wall cancer infiltration (T4, P = 0.0001). Elevated PLR was associated with more advanced stages at diagnosis (P = 0.03). High NLR values were significantly associated with risks of disease progression (OR 1.555, 95% CI: 1.206–2.005, P = 0.001). Patients with high NLR had shorter PFS (34.9 vs 53.5 months, Log-rank test = 0.001) and shorter time to develop recurrent distant metastatic disease (66.6 vs 104.6 months, Log-rank test = 0.027). ConclusionHigh NLR is significantly associated with higher risk of disease progression and shorter time to develop metastases particularly among breast cancer patients diagnosed in the advanced stages.

Neutrophil Lymphocyte Ratio: A Predictor of Disease Severity in Nasal Polyposis and Allergic Fungal Rhinosinusitis.

To evaluate Neutrophil Lymphocyte ratio (NLR) as a predictor of disease severity in Nasal Polyposis and Allergic Fungal Rhinosinusitis (AFRS). This was a prospective non-randomized interventional study. Disease severity was graded based on endoscopic and CT scoring. Patients were given pre-operative oral steroids for two weeks and taken up for surgery. The pre-treatment neutrophil lymphocyte ratios were calculated from the differential leucocyte counts and compared with the disease severity and post-operative values. In the interventional arms, the disease severity correlated with the NLR. The mean pre-treatment NLR showed a statistically significant change after the intervention at eight weeks. The NLR normalized in patients with nasal polyposis and continued to be higher in patients with AFRS. NLR correlated to the disease severity and showed a linear correlation with the extent of the disease. NLR could be a potential cost-effective marker for disease severity and prognostication. Level of Evidence: Individual Cohort Study (2b).

Effect of cyclo-oxygenase inhibitor use during checkpoint blockade immunotherapy in patients with metastatic melanoma and non-small cell lung cancer

BackgroundImmune checkpoint inhibitors (ICIs) improve survival outcomes in metastatic melanoma and non-small cell lung cancer (NSCLC). Preclinical evidence suggests that overexpression of cyclo-oxygenase-2 (COX2) in tumors facilitates immune evasion through...

Prognostic value of pre-treatment neutrophil-lymphocyte and platelet-lymphocyte ratio in diffuse large B-cell lymphoma: a single-center experience

Prognostic value of pre-treatment neutrophil-lymphocyte and platelet-lymphocyte ratio in diffuse large B-cell lymphoma: a single-center experience

The evaluation of pretreatment neutrophil–lymphocyte ratio and derived neutrophil–lymphocyte ratio in patients with laryngeal neoplasms

IntroductionSystemic inflammatory biomarkers are promising predictive and prognostic factors for solid cancers. The neutrophil–lymphocyte ratio and derived neutrophil–lymphocyte ratio are used to predict inflammation and used as biomarker in several malignancies. ObjectiveThe purpose of this study was to demonstrate the diagnostic, predictive and prognostic role of neutrophil–lymphocyte ratio and derived neutrophil–lymphocyte ratio in patients with laryngeal neoplasms. MethodsA retrospective study was conducted on medical records involving 229 patients with benign, premalignant and malignant laryngeal neoplasms between 2002 and 2015. The diagnostic, predictive and prognostic role of neutrophil–lymphocyte ratio and derived neutrophil–lymphocyte ratio were evaluated using uni– and multivariate analysis. ResultsThe neutrophil–lymphocyte ratio and derived neutrophil–lymphocyte ratio were not statistically different between patients with benign, premalignant and malignant laryngeal neoplasms. Both neutrophil–lymphocyte ratio and derived neutrophil–lymphocyte ratio were predictive factors for stage, lymph node metastasis, and distant metastasis. Patients with high neutrophil–lymphocyte ratio value (≥4) had a poor prognosis when compared with patients with low neutrophil–lymphocyte ratio value (5 year, Overall Survival: 69.0% vs. 31.1%, p<0.001; 5 year, disease free survival: 70.0% vs. 32.7%, p˂0.001; 5 year, locoregional recurrence free survival: 69.7% vs. 32.0%, p<0.001). Furthermore, neutrophil–lymphocyte ratio was an independent prognostic factor for 5 year: Overall survival (HR=2.396; 95% CI 1.408–4.077; p=0.001), Disease free survival (HR=2.246; 95% CI 1.322–3.816; p=0.006) and locoregional recurrence free survival (HR=2.210; 95% CI 1.301–3.753; p=0.003). ConclusionPretreatment neutrophil–lymphocyte ratio is a useful and reliable predictive and prognostic biomarker for patients with laryngeal carcinoma.

Pretreatment neutrophil-lymphocyte and platelet-lymphocyte ratio predict clinical outcome and prognosis for cervical Cancer

Variations in systemic inflammatory response biomarker levels have been associated with adverse clinical outcome in various malignancies. In this study, we aimed to evaluate the predictive and prognostic role of the pretreatment neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in cervical cancer. We retrospectively investigated 616 patients who underwent initial radical hysterectomy with pelvic lymphadenectomy for cervical cancer between July 2012 and December 2014 in China. Their clinical and histopathological markers and complete blood counts were obtained and analyzed. Then we chose the group of 339 of the total 616 patients who were not combined preoperative radiotherapy or chemotherapy for the survival analysis. Prognostic factors were assessed by univariate and multivariate analyses. The ROC curve revealed NLR and PLR had significant ability to predict parametrial involvement, and the cutoff values for NLR and PLR were 2.5 and 138.8 respectively. Clinicopathologic analysis showed that NLR was linked to age, parametrial involvement, tumor-invasion depth and histologic grade, and PLR was related to age, parametrial involvement, tumor-invasion depth and FIGO stage. Univariate analysis identified high PLR as a significant poor predictor for progression-free survival (PFS) and overall survival (OS), and NLR exhibited no predict power on OS or PFS. Multivariable analysis showed that PLR was an independent predictor of PFS, but not OS. NLR and PLR were associated with the clinical characteristics of cervical cancer. Additionally, PLR had independence prognostic value for PFS in patients with cervical cancer receiving radical hysterectomy with pelvic lymphadenectomy.

A comparison of three clinical factors as predictive markers for response to immunotherapy in non-small cell lung cancer.

e21158Background: While prior studies demonstrated that pre-treatment Neutrophil Lymphocyte Ratio (NLR) < 5 and tobacco exposure predict benefit from checkpoint inhibition, presently, the only regu...

Pretreatment Neutrophil-Lymphocyte Ratio as a Predictor in Bladder Cancer and Metastatic or Unresectable Urothelial Carcinoma Patients: a Pooled Analysis of Comparative Studies

Background/Aims: Emerging studies have shown that the neutrophil-lymphocyte ratio (NLR) is a potential predictor in various tumors. Our study was conducted to assess the prognostic value of the pretreatment NLR in bladder cancer and metastatic or unresectable urothelial carcinoma (mUC or uUC) patients up to July 2017. The correlation between the pretreatment NLR and pathological characteristics was also evaluated in bladder cancer patients. Methods: The hazard ratio (HR) and odds ratio (OR) with the 95% confidence interval (CI) were extracted or calculated from the included studies for further pooled analysis. A total of 21 studies were included in a pooled analysis. Results: The pooled results indicated that a high pretreatment NLR was associated with reduced overall survival (OS) (HR=1.27, 95% CI=1.12-1.43), relapse-free survival (RFS) (HR=1.41, 95% CI=1.23-1.60), progression-free survival (PFS) (HR=1.75, 95% CI=1.36-2.15), disease-specific survival (DSS) and cancer-specific survival (CSS) (HR=1.27, 95% CI=1.19-1.35) in the bladder cancer patients. Additionally, an elevated pretreatment NLR suggested a worse OS rate in the mUC or uUC patients (HR=1.63, 95% CI=1.34-1.91). The pooled ORs and 95% CIs showed that a high pretreatment NLR could be a risk indicator for certain pathological features, such as lymphovascular invasion, a positive margin status and advanced tumor stage. Conclusions: our results showed that a high pretreatment NLR predicted poor prognosis in bladder cancer, mUC and uUC patients.

1651P - Pre-treatment neutrophil lymphocyte ratio/platelet lymphocyte ratio as surrogate markers of survival in non-metastatic head and neck cancer patients: An observational study

Background: Neutrophil lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are known to be surrogate markers of inflammation and have been shown to predict mortality in patients with heart disease and cancer. In this study, we evaluate the influence of pre-treatment NLR and PLR on overall survival in head and neck cancer patients. Methods: In this observational correlational study, subjects with a diagnosis of non-metastatic head and neck cancer were analyzed for neutrophil-lymphocyte ratio and the platelet-lymphocyte ratio at baseline before the start of their cancer-directed therapy. Results: In this study, 189 subjects were analyzed for neutrophil-lymphocyte ratio and platelet-lymphocyte ratio before their treatment. The mean age of the study sample was 54.5±11.8. Forty-two percent underwent surgery followed by adjuvant chemoradiation while remaining underwent concurrent chemoradiation. Neoadjuvant chemotherapy was done in 29.4% of the study population. Mean NLR was 3.4±3.13 and PLR was 12.7±8.8. ROC analysis revealed 2.23 as the cutoff for NLR and 9.49 as the cutoff for PLR. Based on these cutoffs a Kaplan-Meir analysis on overall survival showed significantly improved survival (67.5% vs 58% at their mean estimates of 52 and 36 months) in those with <2.23 NLR ratio compared to > 2.23 (Log Rank χ2=5.3, p = 0.02). Similarly, those with <9.49 PLR had better overall survival (69% vs 56% at their mean estimates of 46 and 39 months) compared to > 9.49 (Log Rank χ2=8.1, p = 0.005). Lower NLR also showed better disease-free survival (44 vs 33 months, Log Rank χ2=4.8, p = 0.03) and lower PLR also showed better disease-free survival (44 vs 33 months, Log Rank χ2=8.2, p = 0.004). Conclusions: Both NLR and PLR are inflammatory biomarkers in cancer. The results from this study suggest pretreatment NLR and PLR as predictive markers of survival in non-metastatic head and neck cancer patients. Legal entity responsible for the study: Vijay Agarwal Funding: HCG Foundation Disclosure: All authors have declared no conflicts of interest.

The Pre-Treatment Neutrophil-Lymphocyte Ratio: a Useful Tool in Predicting Non-Sentinel Lymph Node Metastasis in Breast Cancer Cases

Background:The sentinel lymph node (SLN) biopsy is a highly accurate predictor of overall axillary nodal status in early breast cancer patients. There is however, still a debate on which patients with a positive SLN can benefit from axillary lymph node dissection (ALND). Numerous studies have been designed to identify variables that are predictive of non-SLN metastasis to avoid a complete ALND. The aim of this study was to determine whether the pre-treatment neutrophil-lymphocyte ratio (NLR) can be a predictive factor of non-SLN metastasis in early breast cancer patients.Materials and Methods:The records of 214 consecutive patients with cT1-3N0 invasive breast cancer who had undergone intraoperative SLN evaluation at Songklanagarind Hospital between the 1st of March 2011 and the 30th of May 2016 were examined. Data on patient demographics, tumor variables and NLR were collected and factors for non-SLN metastasis were analyzed using multivariate logistic regression. The power of the NLR was quantified with receiver operating characteristics (ROC) curves as measured by the areas under curves (AUC).Results:Multivariate analysis established presence of lymphovascular invasion (OR 8.4, 95%CI 2.3-31.3, p=0.002), macrometastasis (OR 6.6, 95%CI 1.8-24.7, p=0.005), and NLR (OR 2.3, 95%CI 1.1-4.8, p=0.033) as predictive factors of non-SLN metastasis with statistical significance. The AUC for NLR was 0.7 (95%CI 0.6-0.8) with an optimal cut-off of 2.6 giving a sensitivity of 62%, a specificity of 83.8%, a positive predictive value of 77.3% and a negative predictive value of 70.5%.Conclusion:Pre-treatment NLR is a useful diagnostic aid for predicting additional non-SLN metastasis.

Impact of pretreatment neutrophil-lymphocyte and platelet –lymphocyte ratio in metastatic papillary renal cell cancer.

e16115 Background: Neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are markers of inflammation and have been demonstrated as important prognostic factors in various benign disorders and malignancies. Recently, there have been reports on the utility of NLR and PLR as prognostic factors in patients with metastatic renal cell cancer (RCC) but there is a little data to determine their role in metastatic papillary RCC (pRCC). We aim to evaluate the significance of NLR and PLR in determining overall survival (OS) in metastatic pRCC patients. Methods: Retrospective evaluation of the medical records of patients with metastatic pRCC seen at National Cancer Institute (2000-2014) was undertaken. Patient demographics, tumor characteristics and outcomes were studied. NLR > 5 and PLR > 210 were considered elevated based on previous reports in literature. Kaplan-Meier Survival analysis was done to estimate OS. Results: Out of a total of 106 patients with metastatic pRCC seen during the study time period, 68 had data for NLR and PLR between the time of diagnosis of metastasis and initiation of systemic therapy. Mean age at the time of diagnosis of metastatic disease was 49.7 (±14.3) years. NLR > 5 and PLR > 210 was found in 12 (17.6%) and 26 (38.2%) patients. There was no difference in mean age, gender, histologic subtypes and stage between the patients with elevated NLR vs NLR ≤ 5 or those with elevated PLR vs PLR ≤ 210. Fifty (73.5%) patients died during median follow up of 34.1 mon. All 12 patients with elevated NLR and 24 (92.3%) patients with elevated PLR died. Median estimated OS of patients with elevated NLR was significantly worse than the patients with NLR ≤ 5 (19.2 vs 46.5 mon, p = 0.001). Similarly, elevated PLR portended worse OS (27.3 vs 49.0 mon, p = 0.004). Median OS of patients with neither, either one or both markers elevated was 50.7, 33.0 and 19.2 mon respectively (p = 0.002). Conclusions: To our knowledge, this is the first report evaluating the prognostic impact of NLR and PLR in metastatic pRCC. Elevated PLR and NLR significantly impact OS in these patients. If validated in larger cohorts, it might be reasonable to incorporate NLR and PLR in nomograms predicting OS in metastatic pRCC.

Pretreatment neutrophil-lymphocyte count ratio may associate with gastric cancer presence.

Inflammation plays a pivotal role in cancer development and progression. Neutrophil-lymphocyte count ratio (NLR) is an indicator of systemic inflammatory response which is supposedly associated with gastric cancer (GC) development and progression. Since this parameter can be easily obtained from routine blood examination, it will be a great economic relief to gastric patients if we can bring it into clinical application. The current study aims to evaluate the pretreatment NLR in gastric cancer patients through retrospectively reviewing the medical records. A total of 327 patients hospitalized on a tertiary care hospital were retrospectively investigated and divided into two groups. Gastric cancer group were composed of patients with newly diagnosed, pathologically confirmed GC and the control group were patients with gastric polyp or benign gastric stromal tumor. The value of NLR in the presence and stage of gastric cancer was investigated in the entire gastric cancer group. Our study showed levels of NLR were significantly higher in gastric cancer cohort (2.17 (1.63-3.09) versus 1.62 (0.85-2.32), p< 0.001). After all the known confounders were excluded, NLR was an independent predicator of GC (OR = 1.446, 95%CI (1.121-1.866), and P= 0.005). Area under ROC curve (AUC) of NLR was 0.694. In addition, the results of Spearman's correlation showed NLR may have a positive correlation with size of tumor, N-stage, distant metastasis, and overall stage (r = 0.256, 0.256, 0.161 and 0.171, resp., all p < 0.05). The current study demonstrated that pre-treatment NLR may be a useful biomarker in the health care of gastric cancer patients.

Relationship of preoperative neutrophil lymphocyte ratio with prognosis in gastrointestinal stromal tumors.

Gastrointestinal stromal tumors are believed to play a role in immunosuppression with their local effect. In some cancers with associated inflammation, an increased pretreatment neutrophil lymphocyte ratio is considered as an indicator of poor prognosis. The aim of our study was to assess the relationship of increased blood neutrophil lymphocyte ratio with disease prognosis in patients with gastrointestinal stromal tumors. The data of 78 patients who underwent surgery with the diagnosis of primary gastrointestinal stromal tumor in our clinic were evaluated retrospectively. The preoperative neutrophil lymphocyte ratio in the peripheral blood was determined. The neutrophil lymphocyte ratio and its relationship with tumor risk and prognosis were compared. The data were evaluated by Pearson's correlation analysis and the Welch ANOVA test. The preoperative neutrophil lymphocyte ratio was significantly increased in the high-risk groups (p<0.05). An increased preoperative neutrophil lymphocyte ratio was associated with shorter survival (r=-0.32, p=0.009). In addition, an increase in the neutrophil lymphocyte ratio was associated with an increase in the mitotic activity of the tumor (r=-0.364, p=0.025). The preoperative neutrophil lymphocyte ratio in gastrointestinal stromal tumors can be used as an indicator of high-risk tumors and poor prognosis.