Medical Oncology Service, Vall d'Hebron University Hospital, Barcelona, Spain.
Clin Transl Oncol. 2012 Nov;14(11):864-9. doi: 10.1007/s12094-012-0872-5. Epub 2012 Jul 19.
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 ≥ 5. Median survival for the entire cohort was 9.3 months. We found that patients with undifferentiated carcinoma and patients with NLR ≥ 5 had a worse survival. Median PFS of patients with NLR <5 was 5.62 months and in patients with NLR ≥ 5 was 3.25 months (p = 0.098), and OS was 11.1 versus 5.6 months for patients with NLR<5 and NLR ≥ 5, 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.
中性粒细胞与淋巴细胞比值（NLR），全身性炎症的一个指标，与许多类型的癌症的生存预后更差有关。本研究的目的是研究血液 NLR 作为非小细胞肺癌（NSCLC）患者预后因素的临床意义。
回顾性分析 2004 年 4 月至 2009 年 3 月期间在我院诊断为 IV 期 NSCLC 的患者。分析了潜在的预后因素，如组织学、性别、体能状态、化疗反应和 NLR。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）。
共有 171 例患者纳入研究，60 例（35.1%）患者 NLR≥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≥5 的患者生存更差。NLR<5 的患者中位 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 OS 分别为 11.1 个月和 5.6 个月（p=0.017）。在化疗期间，一个周期后 NLR 正常化的患者有更好的结果（OS 8.7 对 4.3 个月，p=0.001，对于 NLR 正常化的患者和持续升高的患者）。多变量分析后，组织学和 NLR 仍然是生存的独立预测因素（p<0.05）。
在我们的分析中，升高的 NLR 是晚期 NSCLC 患者生存更短的预测因素，治疗第一周期 NLR 的变化预测生存。NLR 是一种易于测量、可重复的检测方法，可考虑纳入 NSCLC 患者的常规实践。
