Department of General Thoracic Surgery and Brest and Endocrinological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
Department of Thoracic Surgery, Okayama University Hospital, 2-5-1 Shikata-cho, Kita-ku, Okayama 700-8558, Japan.
Jpn J Clin Oncol. 2024 Aug 14;54(8):895-902. doi: 10.1093/jjco/hyae058.
Neutrophil-to-lymphocyte ratio (NLR) has been reported as a prognostic biomarker in non-small cell lung cancer (NSCLC); however, the underlying biological rationale remains unclear. The present study aimed to explore the potential utility of NLR as a surrogate biomarker for immune response to cancer and to elucidate the underlying mechanism.
This retrospective study included the medical records of 120 patients with NSCLC who underwent surgery at the study institution in 2012. NLR in peripheral blood was determined from blood test within 30 days before surgery. Tumor immune status was evaluated using immunohistochemical staining to identify CD3+, CD8+ and FOXP3+ tumor-infiltrating lymphocytes (TILs), and the relationship of NLR, with clinicopathologic characteristics including 5-year overall survival (OS), and the tumor immune status was investigated. The median values of NLR and TIL count were used as cutoff points.
The 5-year OS was significantly better in patients with low NLR (<2.2) than in those with high NLR (≥2.2) (70.1% vs. 56.8%, P = 0.042) and in patients with high CD3+ TIL count (≥242) than in those with low CD3+ TIL count (<242) (70% vs. 56.8%, P = 0.019). Additionally, the CD3+ TIL count was negatively correlated with preoperative NLR (P = 0.005).
NLR might potentially reflect the immune status of tumor microenvironment, explaining its impact on prognosis of patients with NSCLC.
中性粒细胞与淋巴细胞比值（NLR）已被报道为非小细胞肺癌（NSCLC）的预后生物标志物；然而，其潜在的生物学原理仍不清楚。本研究旨在探讨 NLR 作为癌症免疫反应替代生物标志物的潜在效用，并阐明其潜在机制。
这是一项回顾性研究，纳入了 2012 年在研究机构接受手术治疗的 120 例 NSCLC 患者的病历。手术前 30 天内通过血液检查确定外周血中的 NLR。使用免疫组织化学染色来评估肿瘤免疫状态，以鉴定 CD3+、CD8+和 FOXP3+肿瘤浸润淋巴细胞（TILs），并研究 NLR 与包括 5 年总生存率（OS）在内的临床病理特征之间的关系，以及与肿瘤免疫状态的关系。NLR 和 TIL 计数的中位数被用作截断值。
低 NLR（<2.2）患者的 5 年 OS 明显优于高 NLR（≥2.2）患者（70.1% vs. 56.8%，P=0.042），高 CD3+TIL 计数（≥242）患者的 5 年 OS 明显优于低 CD3+TIL 计数（<242）患者（70% vs. 56.8%，P=0.019）。此外，术前 NLR 与 CD3+TIL 计数呈负相关（P=0.005）。
NLR 可能反映肿瘤微环境的免疫状态，这可以解释其对 NSCLC 患者预后的影响。
