IMMUNE MARKERS IN SURGICALLY RESECTED EARLY STAGE NON-SMALL CELL LUNG CANCER PATIENTS

Purpose: Non-small cell lung cancer (NSCLC) is the most common cancer and the leading cause of cancer-related deaths worldwide. Inflammatory markers, such as C-reactive protein (CRP), neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio and platelet-lymphocyte ratio (PLR), serve as indexes for the immune status of the host and the degree of tumor progression. In this study, we evaluated NLR and PLR values in early stage lung cancer patients before and after surgery and its correlation with clinical variables and survival. Methods: We retrospectively examined 127 patients with primary NSCLC including adenocarcinoma and squamous cell carcinoma who underwent complete surgical resection. NLR and PLR were calculated before the operation and after 1 week from the operation. Pearson correlation test, Kaplan-Meier method and cox regression models are used as statistical methods. Results: There were 106 men (83.5 %) and 21 female (16.5 %) lung cancer patients. Median age of the pateints was 60.6 (range: 31-84) years. Histologically confirmed adenocancer patients were 59 (46.5 %) and 44 patients (34.6 %) were squamous cell cancer. Median OS was 33.4 months (range: 0-64 months). NLR of patients before and after surgery were statistically significant (p=0.001) but PLR was not statistically significant (p=0.991). NLR was higher before surgery (3173 +/- 2504) but there was no significant association between age, gender, stage, lymphovascular invasian, grade, lymph node status and NLR (p=0.891, p=0.793, p=0.489, p=0.865, p=0392 and p=0.743). Conclusions: In our study; we evaluated the NLR and PLR of early stage NSCLC patients before surgery and after surgery. There was a significant reduction of NLR after surgery in our patients. Maybe, NLR could be a predictive marker for the relapse of NSCLC. There is limited evidence in literature in early stage lung cancer. As immunotherapies are being used in larger populations of lung cancer patients, immune markers started to become more important and in future they will be used for the prediction of therapy response.