Research Article
The Relatıonshıp between Neutrophil / Lymphocytes Ratio and Platelet / Lymphocytes Ratio wıth Prognosis in Operated Stage 1-2 of Non- Small Cell Lung Cancer Disease: One Central Experience
Abstract
Aim:
The relationship between neutrophil / lymphocyte ratio (NLR) and platelet /
lymphocyte ratio (PLR) and the prognosis of various cancers has been
demonstrated. However, the impact of NLR and PLR on the prognosis of non-small
cell lung cancer (NSCLC) remains controversial. The aim of this study was to
investigate the prognostic value of NLR and PLR before surgery in stage 1-2
NSCLC patients undergoing radical resection in our hospital.
Materials and Methods:
We included 59 patients with stage 1-2 NSCLC undergoing radical resection at
our center between 2001 and 2014. The follow-up files of the patients were
reviewed and necessary informations were obtained. Receiver operating curve
(ROC) analysis was used for the optimal cut-off value of NLR and PLR (4.7 for
NLR, 199 for PLR). The Kaplan-Meier univariate analysis was
used to examine the effect of NLR and PLR on overall survival (OS) and
disease-free survival (DFS).
Results:
There was no relationship between NLR and PLR classifications and clinical
parameters except for age. OS mean was 53 months, DFS mean was 43 months in the
group with NLR < 4.7, OS mean was 44 months and DFS mean was 28 months in
the group with NLR> 4.7 (p = 0.031 for OS, p = 0.126 for DFS). OS mean was 55
months, DFS mean was 39.5 months in the group with PLR < 199, OS mean was 42
months, DFS mean was 30.6 months in the group with PLR > 199 (p=0,020 for OS,
p=0,856 for DFS).
Discussion and Conclusion:
High pretreatment NLR and PLR values are independent predictors of poor
prognosis in patients with opere lung cancer. Preoperative NLR and PLR values
can be used as a prognostic parameter before radical resection in patients with
stage 1-2 NSCLC.
References
- KAYNAKLAR 1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA: a cancer journal for clinicians. 2015; 65:5–29.
- 2. Miller KD, Siegel RL, Lin CC, Mariotto AB, Kramer JL, Rowland JH, et al. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin. 2016;66(4):271-289.
- 3. Otsuka K, Hata A, Takeshita J, Okuda C, Kaji R, Masago K, et al. EGFR-TKI rechallenge with bevacizumab in EGFR-mutant non-small cell lung cancer. Cancer chemotherapy and pharmacology. 2015; 76:835–841.
- 4. Chansky K, Sculier JP, Crowley JJ, Giroux D, Van Meerbeeck J, Goldstraw P. The International Association for the Study of Lung Cancer Staging Project: prognostic factors and pathologic TNM stage in surgically managed non-small cell lung cancer. Journal of Thoracic Oncology. 2009; 4(7):792±801. doi: 10.1097/JTO.0b013e3181a7716e PMID: 19458556
- 5. O’Byrne KJ, Gatz emeier U, Bondarenko I. Molecular biomarkers in non-small-cell lung cancer: a retrospective analysis of data from the phase 3 FLEX study. Lancet Oncol. 2011; 12: 795-805.
- 6. Wang J, Kalhor N, Hu J, Wang B, Chu H, Zhang B, et al. Pretreatment Neutrophil to Lymphocyte Ratio Is Associated with Poor Survival in Patients with Stage I-III Non-Small Cell Lung Cancer. PLoS One. 2016 Oct 3;11(10):e0163397. doi: 10.1371/journal.pone.0163397. eCollection 2016.
- 7. Cukic V. Neutrophil/Lymphocyte ratio and platelet/lymphocyte ratio in patients with NSCLC. Mater Sociomed. 2016 Oct;28(5):378-381. doi: 10.5455/msm.2016.28.378-381. Epub 2016 Oct 17.
- 8. Deng M, Ma X, Liang X, Zhu C, Wang M. Are pretreatment neutrophil-lymphocyte ratio and platelet-lymphocyte ratio useful in predicting the outcomes of patients with small-cell lung cancer? Oncotarget. 2017 Mar 24. doi: 10.18632/oncotarget.16553. [Epub ahead of print]
- 9. Wu Y, Chen Y, Yang X, Chen L, Yang Y. Neutrophil-tolymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were associated with disease activity in patients with systemic lupus erythematosus. Int Immunopharmacol. 2016; 36: 94-9.
- 10. Stotz M, Pichler M, Absenger G, Szkandera J, Arminger F, Schaberl-Moser R, et al. The preoperative lymphocyte to monocyte ratio predicts clinical outcome in patients with stage III colon cancer. British Journal of Cancer. 2014; 110(2):435–440. doi: 10.1038/bjc.2013.785 PMID: 24357796
- 11. Sonpavde G, Pond GR, Armstrong AJ, Clarke SJ, Vardy JL, Templeton AJ, et al. Prognostic impact of the neutrophil-to-lymphocyte ratio in men with metastatic castration-resistant prostate cancer. Clinical Genitourinary Cancer. 2014; 12(5):317–324. doi: 10.1016/j.clgc.2014.03.005 PMID: 24806399
- 12. Yang JJ, Hu ZG, Shi WX, Deng T, He SQ, Yuan SG. Prognostic significance of neutrophil to lymphocyte ratio in pancreatic cancer: a meta-analysis. World journal of gastroenterology. 2015; 21:2807–2815
- 13. Jiang R, Zou X, Hu W, Fan YY, Yan Y, Zhang MX, et al. The elevated pretreatment platelet-to-lymphocyte ratio predicts poor outcome in nasopharyngeal carcinoma patients. Tumour biology. 2015; 36:7775–7787.
- 14. Zhao QT, Yuan Z, Zhang H, Zhang XP, Wang HE, Wang ZK, et al. Prognostic role of platelet to lymphocyte ratio in non-small cell lung cancers: A metaanalysis including 3,720 patients. International journal of cancer. 2016; 139:164–170.
- 15. Unal D, Eroglu C, Kurtul N, Oguz A, Tasdemir A. Are neutrophil/lymphocyte and platelet/lymphocyte rates in patients with non-small cell lung cancer associated with treatment response and prognosis? Asian Pacific Organization for Cancer Prevention. 2013; 14(9):5237–5242.
- 16. Pinato DJ, Mauri FA, Ramakrishnan R, Wahab L, Lloyd T, Sharma R. Inflammation-based prognostic indices in malignant pleural mesothelioma. J Thoracic Oncology. 2012; 7(3):587–594. doi: 10.1097/ JTO.0b013e31823f45c1. PMID: 22307011
- 17. Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002;420(6917):860-867.
- 18. Kemal Y, Yucel I, Ekiz K, Demirag G. Elevated serum neutrophil to lymphocyte and platelet to lymphocyte ratios could be useful in lung cancer diagnosis. Asian Pac J Cancer Prev. 2014; 15(6): 2651-4.
- 19. Wu G, Yao Y, Bai C, Zeng J. Combination of platelet to lymphocyte ratio and neutrophil to lymphocyte ratio is a useful prognostic c factor in advanced non-small cell lung cancer patients. Thorac Cancer. 2015 May; 6 (3): 275-87.
- 20. Hua Z, Liuwei G, Bin Z, Lianmin Z. Prognostic value of platelet to lymphocyte ratio in non-small cell lung cancer: a systematic review and meta-analysis. Sci Rep. 2016; 6: 22618.
- 21. Sarraf KM, Belcher E, Raevsky E, Nicholson AG, Goldstraw P, Lim E. Neutrophil/lymphocyte ratio and its association with survival after complete resection in non-small cell lung cancer. The Journal of thoracic and cardiovascular surgery. 2009; 137(2):425–428. doi: 10.1016/j.jtcvs.2008.05.046 PMID: 19185164
- 22. Pinato D. Prognostic performance of inflammationbased prognostic indices in primary operable non-small cell lung cancer. Br J Cancer. 2014 Apr 15; 110(8): 1930-5.
- 23. Aerts JG, Hegmans JP. Tumor-specifi c cytotoxic T cells are crucial for effi cacy of immunomodulatory antibodies in patients with lung cancer. Cancer Res. 2013; 73: 2381-8.
- 24. Kaneko M, Nozawa H, Sasaki K, Hongo K, Hiyoshi M, Tada N, et al. Elevated neutrophil to lymphocyte ratio predicts poor prognosis in advanced colorectal cancer patients receiving oxaliplatin-based chemotherapy. Oncology. 2012; 82(5):261–268. doi: 10.1159/000337228 PMID: 22538399
- 25. Teramukai S, Kitano T, Kishida Y, Kawahara M, Kubota K, Komuta K, et al. Pretreatment neutrophil count as an independent prognostic factor in advanced non-small-cell lung cancer: an analysis of Japan Multinational Trial Organisation LC00-03. European Journal of Cancer. 2009; 45(11):1950– 1958. doi: 10.1016/j.ejca.2009.01.023 PMID: 19231158
- 26. Grange JM, Krone B, Mastrangelo G. Infection, inflammation and cancer. International journal of cancer. 2011; 128:2240–2241.
- 27. Moore MM, Chua W, Charles KA, Clarke SJ. Inflammation and cancer: causes and consequences. Clinical pharmacology and therapeutics. 2010; 87:504–508.
- 28. Li X, Han Z, Cheng Z, Yu J, Liu S, Yu X, et al. Preoperative neutrophil-to-lymphocyte ratio is a predictor of recurrence following thermal ablation for recurrent hepatocellular carcinoma: a retrospective analysis. PloS one. 2014; 9:e110546.
- 29. Lan H, Zhou L, Chi D, Zhou Q, Tang X, Zhu D, et al. Preoperative platelet to lymphocyte and neutrophil to lymphocyte ratios are independent prognostic factors for patients undergoing lung cancer radical surgery: A single institutional cohort study. Oncotarget. 2016 Nov 11. doi: 10.18632/oncotarget.13312. [Epub ahead of print]
- 30. Franco AT, Corken A, Ware J. Platelets at the interface of thrombosis, inflammation, and cancer. 2015; 126: 582-8.
- 31. Zhou X, Du Y, Huang Z, Xu J, Qiu T, Wang J, et al. Prognostic value of PLR in various cancers: a meta-analysis. PLoS One. 2014; 9: e101119.
- 32. Goubran HA, Burnouf T, Radosevic M, El-Ekiaby M.. The platelet-cancer loop. Eur J Intern Med. 2013;24(5):393-400
- 33. Gay LJ, Felding-Habermann B. Contribution of platelets to tumour metastasis. Nature reviews Cancer. 2011; 11:123–134.
Evre 1-2 Opere Küçük Hücreli Dışı Akciğer Kanseri Hastalarında Nötrofil/Lenfosit Oranı ve Platelet/Lenfosit Oranının Prognoz ile İlişkisi: Tek Merkez Deneyimi
Abstract
Amaç:
Nötrofil/lenfosit oranı (NLO) ve platelet/lenfosit oranı (PLO) ile çeşitli
kanserlerin prognozu arasındaki ilişki gösterilmiştir. Ancak NLO ve PLO’ nun küçük
hücreli dışı akciğer kanseri (KHDAK) prognozuna etkisi hala tartışmalıdır. Bu
çalışmamızın amacı, hastanemizde radikal rezeksiyon uygulanan Evre 1-2 KHDAK
hastalarında operasyon öncesi NLO ve PLO’ nun prognostik değerini araştırmaktır.
Gereç ve Yöntemler:
Çalışmaya 2001-2014 yılları arasında merkezimizde takip edilen ve radikal
rezeksiyon uygulanan 59 Evre 1-2 KHDAK hastası dahil edilmiştir. Hastaların
takip dosyaları incelenmiş ve gerekli bilgiler alınmıştır. NLO ve PLO’ nun
optimal cut-off değeri için Receiver operating curve (ROC) analizi
kullanılmıştır (NLO için 4,7, PLO için 199). NLO ve PLO’ nun genel sağ kalım
(GSK) ve hastalıksız sağ kalım (HSK) üzerine etkisini incelemek için The
Kaplan-Meier univariate analysis kullanılmıştır.
Bulgular:
NLO ve PLO sınıflamaları ile klinik parametreler arasında yaş haricinde
herhangi bir ilişki bulunmamıştır. NLO <4,7 olan gurupta GSK ortalaması 53
ay, HSK ortalaması 43 ay, NLO > 4,7 olan grupta ise GSK ortalaması 44 ay,
HSK ortalaması 28 ay, bulundu (GSK için p=0,031, HSK için p=0,126). PLO <
199 olan gurupta GSK ortalaması 55 ay, HSK ortalaması 39,5 ay, PLO > 199
olan gurupta ise GSK ortalaması 42 ay, HSK ortalaması 30,6 ay olarak bulundu
(GSK için p=0,020, HSK için p=0,856).
Tartışma ve Sonuç:
Tedavi öncesi yüksek NLO ve PLO değerleri opere akciğer kanseri hastalarında
kötü prognoz için bağımsız belirteçlerdir. Preoperatif NLO ve PLO değerleri,
Evre 1-2 KHDAK hastalarında radikal rezeksiyon öncesi, prognostik bir parametre olarak
kullanılabilir.
References
- KAYNAKLAR 1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA: a cancer journal for clinicians. 2015; 65:5–29.
- 2. Miller KD, Siegel RL, Lin CC, Mariotto AB, Kramer JL, Rowland JH, et al. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin. 2016;66(4):271-289.
- 3. Otsuka K, Hata A, Takeshita J, Okuda C, Kaji R, Masago K, et al. EGFR-TKI rechallenge with bevacizumab in EGFR-mutant non-small cell lung cancer. Cancer chemotherapy and pharmacology. 2015; 76:835–841.
- 4. Chansky K, Sculier JP, Crowley JJ, Giroux D, Van Meerbeeck J, Goldstraw P. The International Association for the Study of Lung Cancer Staging Project: prognostic factors and pathologic TNM stage in surgically managed non-small cell lung cancer. Journal of Thoracic Oncology. 2009; 4(7):792±801. doi: 10.1097/JTO.0b013e3181a7716e PMID: 19458556
- 5. O’Byrne KJ, Gatz emeier U, Bondarenko I. Molecular biomarkers in non-small-cell lung cancer: a retrospective analysis of data from the phase 3 FLEX study. Lancet Oncol. 2011; 12: 795-805.
- 6. Wang J, Kalhor N, Hu J, Wang B, Chu H, Zhang B, et al. Pretreatment Neutrophil to Lymphocyte Ratio Is Associated with Poor Survival in Patients with Stage I-III Non-Small Cell Lung Cancer. PLoS One. 2016 Oct 3;11(10):e0163397. doi: 10.1371/journal.pone.0163397. eCollection 2016.
- 7. Cukic V. Neutrophil/Lymphocyte ratio and platelet/lymphocyte ratio in patients with NSCLC. Mater Sociomed. 2016 Oct;28(5):378-381. doi: 10.5455/msm.2016.28.378-381. Epub 2016 Oct 17.
- 8. Deng M, Ma X, Liang X, Zhu C, Wang M. Are pretreatment neutrophil-lymphocyte ratio and platelet-lymphocyte ratio useful in predicting the outcomes of patients with small-cell lung cancer? Oncotarget. 2017 Mar 24. doi: 10.18632/oncotarget.16553. [Epub ahead of print]
- 9. Wu Y, Chen Y, Yang X, Chen L, Yang Y. Neutrophil-tolymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were associated with disease activity in patients with systemic lupus erythematosus. Int Immunopharmacol. 2016; 36: 94-9.
- 10. Stotz M, Pichler M, Absenger G, Szkandera J, Arminger F, Schaberl-Moser R, et al. The preoperative lymphocyte to monocyte ratio predicts clinical outcome in patients with stage III colon cancer. British Journal of Cancer. 2014; 110(2):435–440. doi: 10.1038/bjc.2013.785 PMID: 24357796
- 11. Sonpavde G, Pond GR, Armstrong AJ, Clarke SJ, Vardy JL, Templeton AJ, et al. Prognostic impact of the neutrophil-to-lymphocyte ratio in men with metastatic castration-resistant prostate cancer. Clinical Genitourinary Cancer. 2014; 12(5):317–324. doi: 10.1016/j.clgc.2014.03.005 PMID: 24806399
- 12. Yang JJ, Hu ZG, Shi WX, Deng T, He SQ, Yuan SG. Prognostic significance of neutrophil to lymphocyte ratio in pancreatic cancer: a meta-analysis. World journal of gastroenterology. 2015; 21:2807–2815
- 13. Jiang R, Zou X, Hu W, Fan YY, Yan Y, Zhang MX, et al. The elevated pretreatment platelet-to-lymphocyte ratio predicts poor outcome in nasopharyngeal carcinoma patients. Tumour biology. 2015; 36:7775–7787.
- 14. Zhao QT, Yuan Z, Zhang H, Zhang XP, Wang HE, Wang ZK, et al. Prognostic role of platelet to lymphocyte ratio in non-small cell lung cancers: A metaanalysis including 3,720 patients. International journal of cancer. 2016; 139:164–170.
- 15. Unal D, Eroglu C, Kurtul N, Oguz A, Tasdemir A. Are neutrophil/lymphocyte and platelet/lymphocyte rates in patients with non-small cell lung cancer associated with treatment response and prognosis? Asian Pacific Organization for Cancer Prevention. 2013; 14(9):5237–5242.
- 16. Pinato DJ, Mauri FA, Ramakrishnan R, Wahab L, Lloyd T, Sharma R. Inflammation-based prognostic indices in malignant pleural mesothelioma. J Thoracic Oncology. 2012; 7(3):587–594. doi: 10.1097/ JTO.0b013e31823f45c1. PMID: 22307011
- 17. Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002;420(6917):860-867.
- 18. Kemal Y, Yucel I, Ekiz K, Demirag G. Elevated serum neutrophil to lymphocyte and platelet to lymphocyte ratios could be useful in lung cancer diagnosis. Asian Pac J Cancer Prev. 2014; 15(6): 2651-4.
- 19. Wu G, Yao Y, Bai C, Zeng J. Combination of platelet to lymphocyte ratio and neutrophil to lymphocyte ratio is a useful prognostic c factor in advanced non-small cell lung cancer patients. Thorac Cancer. 2015 May; 6 (3): 275-87.
- 20. Hua Z, Liuwei G, Bin Z, Lianmin Z. Prognostic value of platelet to lymphocyte ratio in non-small cell lung cancer: a systematic review and meta-analysis. Sci Rep. 2016; 6: 22618.
- 21. Sarraf KM, Belcher E, Raevsky E, Nicholson AG, Goldstraw P, Lim E. Neutrophil/lymphocyte ratio and its association with survival after complete resection in non-small cell lung cancer. The Journal of thoracic and cardiovascular surgery. 2009; 137(2):425–428. doi: 10.1016/j.jtcvs.2008.05.046 PMID: 19185164
- 22. Pinato D. Prognostic performance of inflammationbased prognostic indices in primary operable non-small cell lung cancer. Br J Cancer. 2014 Apr 15; 110(8): 1930-5.
- 23. Aerts JG, Hegmans JP. Tumor-specifi c cytotoxic T cells are crucial for effi cacy of immunomodulatory antibodies in patients with lung cancer. Cancer Res. 2013; 73: 2381-8.
- 24. Kaneko M, Nozawa H, Sasaki K, Hongo K, Hiyoshi M, Tada N, et al. Elevated neutrophil to lymphocyte ratio predicts poor prognosis in advanced colorectal cancer patients receiving oxaliplatin-based chemotherapy. Oncology. 2012; 82(5):261–268. doi: 10.1159/000337228 PMID: 22538399
- 25. Teramukai S, Kitano T, Kishida Y, Kawahara M, Kubota K, Komuta K, et al. Pretreatment neutrophil count as an independent prognostic factor in advanced non-small-cell lung cancer: an analysis of Japan Multinational Trial Organisation LC00-03. European Journal of Cancer. 2009; 45(11):1950– 1958. doi: 10.1016/j.ejca.2009.01.023 PMID: 19231158
- 26. Grange JM, Krone B, Mastrangelo G. Infection, inflammation and cancer. International journal of cancer. 2011; 128:2240–2241.
- 27. Moore MM, Chua W, Charles KA, Clarke SJ. Inflammation and cancer: causes and consequences. Clinical pharmacology and therapeutics. 2010; 87:504–508.
- 28. Li X, Han Z, Cheng Z, Yu J, Liu S, Yu X, et al. Preoperative neutrophil-to-lymphocyte ratio is a predictor of recurrence following thermal ablation for recurrent hepatocellular carcinoma: a retrospective analysis. PloS one. 2014; 9:e110546.
- 29. Lan H, Zhou L, Chi D, Zhou Q, Tang X, Zhu D, et al. Preoperative platelet to lymphocyte and neutrophil to lymphocyte ratios are independent prognostic factors for patients undergoing lung cancer radical surgery: A single institutional cohort study. Oncotarget. 2016 Nov 11. doi: 10.18632/oncotarget.13312. [Epub ahead of print]
- 30. Franco AT, Corken A, Ware J. Platelets at the interface of thrombosis, inflammation, and cancer. 2015; 126: 582-8.
- 31. Zhou X, Du Y, Huang Z, Xu J, Qiu T, Wang J, et al. Prognostic value of PLR in various cancers: a meta-analysis. PLoS One. 2014; 9: e101119.
- 32. Goubran HA, Burnouf T, Radosevic M, El-Ekiaby M.. The platelet-cancer loop. Eur J Intern Med. 2013;24(5):393-400
- 33. Gay LJ, Felding-Habermann B. Contribution of platelets to tumour metastasis. Nature reviews Cancer. 2011; 11:123–134.
There are 33 citations in total.
Details
| Subjects | Health Care Administration |
|---|---|
| Journal Section | ORIGINAL ARTICLE |
| Authors | |
| Publication Date | September 25, 2017 |
| Acceptance Date | July 21, 2017 |
| Published in Issue | Year 2017 Volume: 22 Issue: 3 |
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