Pretreatment Neutrophil to Lymphocyte Ratio Is Associated with Poor Survival in Patients with Stage I-III Non-Small Cell Lung Cancer

被引:32
作者
Wang, Jun [1 ,2 ]
Kalhor, Neda [2 ]
Hu, Jianhua [3 ]
Wang, Baocheng [1 ]
Chu, Huili [1 ]
Zhang, Bicheng [4 ]
Gum, Yaping [1 ]
Wu, Yun [2 ]
机构
[1] Gen Hosp, Dept Oncol, Jinan Command Peoples Liberat Army, Jinan, Peoples R China
[2] Univ Texas MD Anderson Canc Ctr, Dept Pathol, Houston, TX 77030 USA
[3] Univ Texas MD Anderson Canc Ctr, Dept Biostat, Houston, TX 77030 USA
[4] Wuhan Gen Hosp, Dept Oncol, Guangzhou Command Peoples Liberat Army, Wuhan, Peoples R China
关键词
C-REACTIVE PROTEIN; NEUTROPHIL/LYMPHOCYTE RATIO; PROGNOSTIC-FACTOR; PREOPERATIVE NEUTROPHIL; CLINICAL-SIGNIFICANCE; PERIPHERAL-BLOOD; INFLAMMATION; PREDICTOR; RESECTION; PLATELET;
D O I
10.1371/journal.pone.0163397
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background Neutrophil-to-lymphocyte ratio (NLR) has been shown to be a prognostic indicator in several types of cancer. We aimed to investigate the association between NLR and survival in surgery-treated non-small cell lung cancer (NSCLC) patients. Study Design This large retrospective study included 1,245 patients who underwent initial surgery for stage I-III NSCLC at The University of Texas MD Anderson Cancer Center between December 2002 and November 2010. We analyzed the relationship of NLR with clinicopathological variables, local recurrence-free survival (LRFS), distant recurrence-free survival (DRFS), recurrence-free survival (RFS), overall survival (OS), and disease-specific survival (DSS) in patients with high or low NLR using Kaplan-Meier method. Hazard ratios (HRs) with 95% confidence intervals (CIs) were used to assess the prognostic strength of NLR. Results There was a statistically significant association between the pretreatment NLR and histology type (P = 0.003) and tumor grade (P = 0.028). At a median follow-up time of 50.6 months, high NLR was associated with reduced DRFS (P = 0.011), OS (P < 0.0001) and DSS (P = 0.004); it was not associated with LRFS and RFS. Multivariable Cox analysis further revealed that NLR (P = 0.027), pathologic stage (P < 0.0001) and lymphovascular invasion (P < 0.0001) were strong independent predictors for DRFS. NLR was also an independent marker predicting poor OS (P = 0.002) and DSS (P = 0.017). Conclusion The pretreatment NLR can serve as a biomarker to predict distant recurrence and death in stage I-III NSCLC patients. Combination of NLR and pathologic stage can better predict the OS and DSS in stage I-II NSCLC patients.
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