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Clinical and Translational Oncology
Published in: Clinical and Translational Oncology 6/2017

01-06-2017 | Research Article

Neutrophil to lymphocyte ratio associated with prognosis of lung cancer

Authors: V. Bar-Ad, J. Palmer, L. Li, Y. Lai, B. Lu, R. E. Myers, Z. Ye, R. Axelrod, J. M. Johnson, M. Werner-Wasik, S. W. Cowan, N. R. Evans, B. T. Hehn, C. C. Solomides, C. Wang

Published in: Clinical and Translational Oncology | Issue 6/2017

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Abstract

Purpose

Many studies recently focus on complicated and expensive genomic tests, but the prognostic values of biochemical markers which are easily obtained in clinics are largely overlooked and without further exploration. This study assesses the association of neutrophil–lymphocyte-ratio (NLR) with prognosis of lung cancer patients.

Methods

In 1032 patients with histologically confirmed lung cancer, the association of pretreatment NLR values with overall survival (OS) was evaluated using a Cox proportional hazards model and the temporal relationship of longitudinal NLR was assessed using a mixed effects model.

Results

Compared to the patients with a low pretreatment NLR value, those with elevated NLR exhibited a statistically significant worse OS with a hazard ratio (HR) of 1.50 (P < 0.0001) after adjusting for age, gender, race, smoking status, drinking status, tumor stage, tumor grade, histology, and treatments. A significant trend of increasing HRs along with increasing NLR values was observed. The increased risk of death conferred by pretreatment NLR values reached a peak level around 2 years after diagnosis. Moreover, in longitudinal analysis, we observed a trend of dramatically increased NLR values in patients who died during follow-up, but stable NLR values in those who were still alive, with a significant interaction of death–alive status with follow-up time (P < 0.0001).

Conclusions

Elevated NLR is a potential biomarker to identify lung cancer patients with poor prognosis and should be validated in a future clinical trial.
Appendix
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Metadata
Title
Neutrophil to lymphocyte ratio associated with prognosis of lung cancer
Authors
V. Bar-Ad
J. Palmer
L. Li
Y. Lai
B. Lu
R. E. Myers
Z. Ye
R. Axelrod
J. M. Johnson
M. Werner-Wasik
S. W. Cowan
N. R. Evans
B. T. Hehn
C. C. Solomides
C. Wang
Publication date
01-06-2017
Publisher
Springer International Publishing
Published in
Clinical and Translational Oncology / Issue 6/2017
Print ISSN: 1699-048X
Electronic ISSN: 1699-3055
DOI
https://doi.org/10.1007/s12094-016-1593-y

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