Wang Jun, Kalhor Neda, Hu Jianhua, Wang Baocheng, Chu Huili, Zhang Bicheng, Guan Yaping, Wu Yun
Department of Oncology, General Hospital, Jinan Command of the People's Liberation Army, Jinan, China.
Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States of America.
PLoS One. 2016 Oct 3;11(10):e0163397. doi: 10.1371/journal.pone.0163397. eCollection 2016.
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.
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.
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).
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.
中性粒细胞与淋巴细胞比值（NLR）已被证明是多种癌症的预后指标。我们旨在研究NLR与手术治疗的非小细胞肺癌（NSCLC）患者生存率之间的关联。
这项大型回顾性研究纳入了2002年12月至2010年11月期间在德克萨斯大学MD安德森癌症中心接受I-III期NSCLC初次手术的1245例患者。我们使用Kaplan-Meier方法分析了高NLR或低NLR患者中NLR与临床病理变量、局部无复发生存期（LRFS）、远处无复发生存期（DRFS）、无复发生存期（RFS）、总生存期（OS）和疾病特异性生存期（DSS）之间的关系。使用95%置信区间（CIs）的风险比（HRs）来评估NLR的预后强度。
治疗前NLR与组织学类型（P = 0.003）和肿瘤分级（P = 0.028）之间存在统计学显著关联。在中位随访时间50.6个月时，高NLR与DRFS降低（P = 0.011）、OS（P < 0.0001）和DSS（P = 0.004）相关；它与LRFS和RFS无关。多变量Cox分析进一步显示，NLR（P = 0.027）、病理分期（P < 0.0001）和淋巴管侵犯（P < 0.0001）是DRFS的强独立预测因素。NLR也是预测OS不良（P = 0.002）和DSS不良（P = 0.017）的独立标志物。
治疗前NLR可作为预测I-III期NSCLC患者远处复发和死亡的生物标志物。NLR与病理分期相结合可以更好地预测I-II期NSCLC患者的OS和DSS。
