Scilla Katherine A, Bentzen Søren M, Lam Vincent K, Mohindra Pranshu, Nichols Elizabeth M, Vyfhuis Melissa A, Bhooshan Neha, Feigenberg Steven J, Edelman Martin J, Feliciano Josephine L
University of Maryland Marlene and Stewart Greenebaum Comprehensive Cancer Center, Baltimore, Maryland, USA.
Johns Hopkins School of Medicine, Baltimore, Maryland, USA
Oncologist. 2017 Jun;22(6):737-742. doi: 10.1634/theoncologist.2016-0443. Epub 2017 May 22.
Neutrophil-lymphocyte ratio (NLR) is a measure of systemic inflammation that appears prognostic in localized and advanced non-small cell lung cancer (NSCLC). Increased systemic inflammation portends a poorer prognosis in cancer patients. We hypothesized that low NLR at diagnosis is associated with improved overall survival (OS) in locally advanced NSCLC (LANSCLC) patients.
Records from 276 patients with stage IIIA and IIIB NSCLC treated with definitive chemoradiation with or without surgery between 2000 and 2010 with adequate data were retrospectively reviewed. Baseline demographic data and pretreatment peripheral blood absolute neutrophil and lymphocyte counts were collected. Patients were grouped into quartiles based on NLR. OS was estimated using the Kaplan-Meier method. The log-rank test was used to compare mortality between groups. A linear test-for-trend was used for the NLR quartile groups. The Cox proportional hazards model was used for multivariable analysis.
The NLR was prognostic for OS ( < .0001). Median survival in months (95% confidence interval) for the first, second, third, and fourth quartile groups of the population distribution of NLR were 27 (19-36), 28 (22-34), 22 (12-31), and 10 (8-12), respectively. NLR remained prognostic for OS after adjusting for race, sex, stage, performance status, and chemoradiotherapy approach ( = .004).
To our knowledge, our series is the largest to demonstrate that baseline NLR is a significant prognostic indicator in LANSCLC patients who received definitive chemoradiation with or without surgery. As an indicator of inflammatory response, it should be explored as a potential predictive marker in the context of immunotherapy and radiation therapy.
Neutrophil-lymphocyte ratio measured at the time of diagnosis was associated with improved overall survival in 276 patients with stage IIIA and IIIB non-small cell lung cancer (NSCLC) treated with definitive chemoradiation with or without surgery. To our knowledge, our series is the largest to demonstrate that baseline neutrophil-lymphocyte ratio is a significant prognostic indicator in locally advanced NSCLC patients who received definitive chemoradiation with or without surgery. Neutrophil-lymphocyte ratio is an inexpensive biomarker that may be easily utilized by clinicians at the time of locally advanced NSCLC diagnosis to help predict life expectancy.
中性粒细胞与淋巴细胞比值（NLR）是全身炎症的一种度量指标，在局限性和晚期非小细胞肺癌（NSCLC）中似乎具有预后价值。全身炎症增加预示癌症患者预后较差。我们假设诊断时低NLR与局部晚期NSCLC（LANSCLC）患者的总生存期（OS）改善相关。
回顾性分析2000年至2010年间276例接受确定性放化疗（无论是否手术）且有充分数据的IIIA期和IIIB期NSCLC患者的记录。收集基线人口统计学数据以及治疗前外周血中性粒细胞和淋巴细胞绝对计数。根据NLR将患者分为四分位数组。采用Kaplan-Meier法估计OS。采用对数秩检验比较组间死亡率。对NLR四分位数组采用线性趋势检验。采用Cox比例风险模型进行多变量分析。
NLR对OS具有预后价值（P<0.0001）。NLR人群分布的第一、第二、第三和第四四分位数组的中位生存期（月，95%置信区间）分别为27（19 - 36）、28（22 - 34）、22（12 - 31）和10（8 - 12）。在调整种族、性别、分期、体能状态和放化疗方法后，NLR对OS仍具有预后价值（P = 0.004）。
据我们所知，我们的系列研究是规模最大的，证明了基线NLR是接受确定性放化疗（无论是否手术）的LANSCLC患者的一个重要预后指标。作为炎症反应的一个指标，在免疫治疗和放射治疗背景下，应将其作为一种潜在的预测标志物进行探索。
在276例接受确定性放化疗（无论是否手术）的IIIA期和IIIB期非小细胞肺癌（NSCLC）患者中，诊断时测得的中性粒细胞与淋巴细胞比值与总生存期改善相关。据我们所知，我们的系列研究是规模最大的，证明了基线中性粒细胞与淋巴细胞比值是接受确定性放化疗（无论是否手术）的局部晚期NSCLC患者的一个重要预后指标。中性粒细胞与淋巴细胞比值是一种廉价的生物标志物，临床医生在局部晚期NSCLC诊断时可轻松利用它来帮助预测预期寿命。
