Neutrophil-to-lymphocyte ratio and risk of lung cancer mortality in a low-risk population: A cohort study
Neutrophil-to-lymphocyte ratio and risk of lung cancer mortality in a low-risk population: A cohort study
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DOI：
10.1002/ijc.32640
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发表时间：
2019-09-14
影响因子：
6.4
通讯作者：
Ryu, Seungho
中科院分区：
文献类型：
--
作者：
Kang, Jihoon;Chang, Yoosoo;Ryu, Seungho
中性粒细胞与淋巴细胞比率（NLR）与肺癌患者的不良预后相关，但 NLR 对罹患肺癌风险的预测作用尚不清楚。我们研究了无肺癌成人中 NLR 与肺癌死亡率之间的关联。对 527,124 名未患肺癌的韩国成年人进行了一项队列研究，并随访了长达 16 年。通过国家死亡记录确定生命状况和肺癌相关死亡。使用 Cox 比例风险模型估算肺癌死亡率的风险比 (HR) 和 95% 置信区间 (CI)。在 4,567,495.8 人年的随访中，确定了 574 例肺癌死亡病例。较高的 NLR 与肺癌死亡率呈正相关。将 NLR 的第 2、3、4 和 5 分位数与最低五分位数进行比较，肺癌死亡率的多变量调整 HR (95% CI) 分别为 1.26 (0.96-1.67)、1.23 (0.93-1.63)、1.33 (1.01-1.75) 和 1.47 (1.13-1.92)。在调整肺功能和其他可能的混杂因素后，在从不吸烟者和低风险个体中，最高 NLR 五分位数中也观察到肺癌死亡率最高的风险。在男性中，血小板与淋巴细胞的比率与肺癌死亡率呈反 J 形相关，但在女性、低风险个体或从不吸烟者中，这一趋势既不是线性也不是 U 形。在这个由年轻和中年个体组成的大型队列中，NLR 与低风险个体肺癌死亡风险增加独立相关，表明全身炎症在我们研究人群中肺癌死亡率中的作用。
Neutrophil-to-lymphocyte ratio (NLR) is associated with poor prognosis in patients with lung cancer, but the predictive role of NLR on the risk of developing lung cancer is unknown. We investigated the association between NLR and lung cancer mortality in lung cancer-free adults. A cohort study was performed with 527,124 Korean adults who were free of lung cancer and were followed for up to 16 years. Vital status and lung cancer-related deaths were ascertained through national death records. Hazard ratios (HRs) and 95% confidence intervals (CIs) for lung cancer mortality were estimated using a Cox proportional hazards model. During 4,567,495.8 person-years of follow-up, 574 lung cancer deaths were identified. A higher NLR was positively associated with lung cancer mortality. The multivariable-adjusted HR (95% CI) for lung cancer mortality comparing quintiles 2, 3, 4 and 5 of NLR to the lowest quintile were 1.26 (0.96-1.67), 1.23 (0.93-1.63), 1.33 (1.01-1.75) and 1.47 (1.13-1.92), respectively. The highest risk of lung cancer mortality was also observed in the highest NLR quintile among never-smokers and low-risk individuals after adjusting for lung function and other possible confounders. Platelet-to-lymphocyte ratio showed an inverse J-shaped association with lung cancer mortality in men but the trends in women, low-risk individuals or never-smokers were neither linear nor U-shaped. In this large cohort of young and middle-aged individuals, NLR was independently associated with increased risk of lung cancer mortality in low-risk individuals, indicating a role of systemic inflammation in lung cancer mortality in our study population.