Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Division of Pulmonology and Critical Care Medicine, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
In Vivo. 2020 Jul-Aug;34(4):2179-2185. doi: 10.21873/invivo.12027.
BACKGROUND/AIM: While blood neutrophil-to-lymphocyte ratio (NLR) has been associated with poor prognosis in NSCLC, however few studies have focused on pleural fluid white blood cell differential count. We conducted a retrospective multicenter cohort study to evaluate the predictive value of pleural NLR in non-small cell lung cancer (NSCLC) patients with malignant pleural effusion (MPE).
From the multicenter lung cancer cohort, 134 epidermal growth factor receptor (EGFR) wild-type patients with NSCLC were selected for evaluation. Receiver operating characteristic (ROC) curve analysis was performed for pretreatment pleural NLR to determine the cut-off value for predicting disease progression within 100 days after the diagnosis.
The low-pleural NLR group showed significantly longer overall survival (OS) and progression free survival (PFS) compared to the high-pleural NLR group. After stratification using quartile cut-off values of pleural NLR, the correlation between risk of disease progression and pleural NLR was shown to be dose-dependent. The multivariate analysis on PFS showed that high-pleural NLR (p=0.004) was an independent predictor for shorter PFS with HR of 1.036 (1.011-1.061).
Increased pleural NLR is predictive of early disease progression in EGFR mutation wild-type NSCLC patients with MPE.
背景/目的：虽然血液中性粒细胞与淋巴细胞比值（NLR）与非小细胞肺癌（NSCLC）的预后不良相关，但很少有研究关注胸腔液白细胞分类计数。我们进行了一项回顾性多中心队列研究，以评估胸膜 NLR 在非小细胞肺癌（NSCLC）合并恶性胸腔积液（MPE）患者中的预测价值。
从多中心肺癌队列中，选择了 134 例表皮生长因子受体（EGFR）野生型 NSCLC 患者进行评估。对预处理胸膜 NLR 进行接受者操作特征（ROC）曲线分析，以确定预测诊断后 100 天内疾病进展的截断值。
低胸膜 NLR 组的总生存期（OS）和无进展生存期（PFS）明显长于高胸膜 NLR 组。根据胸膜 NLR 的四分位截断值进行分层后，疾病进展风险与胸膜 NLR 之间的相关性呈剂量依赖性。PFS 的多变量分析显示，高胸膜 NLR（p=0.004）是 MPE 中 EGFR 突变野生型 NSCLC 患者较短 PFS 的独立预测因子，HR 为 1.036（1.011-1.061）。
胸膜 NLR 升高可预测 EGFR 突变野生型 NSCLC 合并 MPE 患者的早期疾病进展。
