Neutrophil to lymphocyte ratio (NLR) as an indicator of poor prognosis in stage IV non-small cell lung cancer
Neutrophil to lymphocyte ratio (NLR) as an indicator of poor prognosis in stage IV non-small cell lung cancer
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DOI：
10.1007/s12094-012-0872-5
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发表时间：
2012-11-01
影响因子：
3.4
通讯作者：
Felip, E.
中科院分区：
文献类型：
--
作者：
Cedres, S.;Torrejon, D.;Felip, E.
中性粒细胞与淋巴细胞比率（NLR）是全身炎症的一个指标，与许多类型癌症的生存率降低有关。本研究旨在探讨血NLR作为非小细胞肺癌（NSCLC）患者预后因素的临床意义。分析了潜在的预后因素，如组织学、性别、体能状态、对化疗的反应和NLR。在基线和化疗期间评估NLR。通过Kaplan-Meier方法计算总生存期（OS）和无进展生存期（PFS）。研究共纳入171例患者，60例（35.1%）患者的NLR为千分之一5。整个队列的中位生存期为9.3个月。我们发现，未分化癌患者和NLR为千分之一日元5的患者生存率更低。NLR < 5的患者的中位PFS为5.62个月，NLR <5的患者为3.25个月（p = 0.098），NLR < 5和NLR <5的患者的OS分别为11.1个月和5.6个月（p = 0.017）。在化疗治疗期间，一个周期后NLR恢复正常的患者结局更好（OS 8.7 vs. 4.3个月，p = 0.001，NLR恢复正常的患者和持续升高的患者）。多因素分析后，组织学和NLR仍然是生存期的独立预测因素（p < 0.05）。在我们的分析中，NLR升高是晚期NSCLC患者生存期较短的预测因素，第一个治疗周期内NLR的变化预测生存期。NLR是一种易于测量、可重复的检测，可考虑纳入NSCLC患者的常规实践中。
Neutrophil to lymphocyte ratio (NLR), an index of systemic inflammation, has been associated with worse survival for many types of cancer. The aim of this study is to investigate the clinical significance of the blood NLR as a prognostic factor in non-small cell lung cancer (NSCLC) patients.Stage IV NSCLC patients diagnosed in our institution between April 2004 and March 2009 were retrospectively reviewed. Potential prognostic factors such as histology, gender, performance status, response to chemotherapy and NLR were analyzed. NLR was assessed baseline and during chemotherapy treatment. Overall survival (OS) and progression free survival (PFS) were calculated by the Kaplan-Meier method.A total of 171 patients were included in the study and 60 patients (35.1 %) presented a NLR a parts per thousand yen5. Median survival for the entire cohort was 9.3 months. We found that patients with undifferentiated carcinoma and patients with NLR a parts per thousand yen5 had a worse survival. Median PFS of patients with NLR < 5 was 5.62 months and in patients with NLR a parts per thousand yen5 was 3.25 months (p = 0.098), and OS was 11.1 versus 5.6 months for patients with NLR < 5 and NLR a parts per thousand yen5, respectively (p = 0.017). During the chemotherapy treatment, patients who normalized NLR after one cycle presented better outcomes (OS 8.7 vs. 4.3 months, p = 0.001, for patients who normalized NLR and for patients who remained persistently elevated). After multivariate analysis, histology and NLR remained independent predictors of survival (p < 0.05).In our analysis, elevated NLR is a predictor of shorter survival in patients with advanced NSCLC and the variation of NLR during the first cycle of treatment predicts survival. NLR is an easily measured, reproducible test that could be considered to be incorporated in the routine practice in NSCLC patients.