Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Minami-ku, Fukuoka, Japan.
PLoS One. 2020 Nov 2;15(11):e0241580. doi: 10.1371/journal.pone.0241580. eCollection 2020.
Inflammatory biomarkers have been associated with clinical outcomes in non-small cell lung cancer (NSCLC). However, the best prognostic marker(s) has not been identified, and the association between inflammatory markers and clinical characteristics is poorly understood. We selected 1,237 patients with resected NSCLC from Kyushu University (2003-2015) and Kyushu Cancer Center (2009-2015) in Japan. Pearson product-moment correlation coefficient among inflammatory markers and area under curve (AUC) of receiver operating characteristic (ROC) curve analyses for overall survival (OS) were calculated. We analyzed the associations between inflammatory markers and clinical factors using Student's t-test. Univariate and multivariate analyses with Cox proportional hazards regression analyses were performed to evaluate the relationship between survival and clinical factors. The cut-off values for neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio, and derived NLR (dNLR) were determined by ROC curve analyses for OS. We found a strong positive correlation between NLR and dNLR (r = 0.9629). The AUC of LMR was the highest amongst the measured metrics, and the AUC of NLR was higher than dNLR. Levels of some inflammatory markers were associated with sex, smoking, squamous cell carcinoma, and pathological stage. LMR ≥ 5.11 and lactate dehydrogenase (LDH) concentration ≥ 222 (U/L) were independent predictors of both disease-free survival (DFS) and OS (LMR; P = 0.0009 and 0.0008, LDH; P = 0.0195 and 0.0187, respectively). Certain inflammatory markers, potentially linked to smoking, were associated with an advanced pathological stage in NSCLC. LMR and LDH were independent predictors of both DFS and OS.
炎症标志物与非小细胞肺癌（NSCLC）的临床结局相关。然而，尚未确定最佳预后标志物，并且炎症标志物与临床特征之间的关联尚未得到充分理解。我们从日本九州大学（2003-2015 年）和九州癌症中心（2009-2015 年）选择了 1237 例接受 NSCLC 切除术的患者。计算了炎症标志物之间的皮尔逊积矩相关系数和总生存期（OS）的接收器工作特征（ROC）曲线分析的曲线下面积（AUC）。我们使用学生 t 检验分析了炎症标志物与临床因素之间的关系。使用单变量和多变量 Cox 比例风险回归分析评估了生存与临床因素之间的关系。通过 ROC 曲线分析 OS 确定中性粒细胞与淋巴细胞比值（NLR）、淋巴细胞与单核细胞比值（LMR）、血小板与淋巴细胞比值和衍生 NLR（dNLR）的截断值。我们发现 NLR 与 dNLR 之间存在很强的正相关（r = 0.9629）。在测量的指标中，LMR 的 AUC 最高，而 NLR 的 AUC 高于 dNLR。一些炎症标志物的水平与性别、吸烟、鳞状细胞癌和病理分期有关。LMR≥5.11 和乳酸脱氢酶（LDH）浓度≥222（U/L）是无病生存期（DFS）和 OS 的独立预测因子（LMR；P=0.0009 和 0.0008，LDH；P=0.0195 和 0.0187）。某些炎症标志物可能与吸烟有关，与 NSCLC 的晚期病理分期有关。LMR 和 LDH 是 DFS 和 OS 的独立预测因子。
