Skip to main content
Top
Published in: BMC Cancer 1/2017

Open Access 01-12-2017 | Research article

High neutrophil-to-lymphocyte ratios confer poor prognoses in patients with small cell lung cancer

Authors: Dan Liu, Yi Huang, Lei Li, Juan Song, Li Zhang, Weimin Li

Published in: BMC Cancer | Issue 1/2017

Login to get access

Abstract

Background

The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are easily obtained from routine blood tests. We investigated the associations of the NLR and PLR with the clinical parameters and prognoses of small cell lung cancer (SCLC) patients.

Methods

Pre-treatment clinical and laboratory data from 139 patients with SCLC were retrospectively studied with univariate analyses. The NLR and PLR values were divided into two separate groups: high NLR (>4.55, n = 32) vs low NLR (≤4.55, n = 107) and high PLR (>148, n = 63) vs low PLR (≤148, n = 76). Kaplan-Meier survival analyses and Cox proportional hazard models were used to examine the effects of NLR and PLR on overall survival.

Results

Chi-square analyses revealed significant associations of high NLR with tumour stage, hepatic metastasis, radiotherapy and chemotherapy and significant associations of high PLR with tumour stage, bone and hepatic metastases, exposure to cooking oil fumes, and chemotherapy. Mann-Whitney U tests demonstrated an association of high NLR with smoking exposure, and high NLR and high PLR were correlated with several laboratory parameters. Kaplan-Meier analyses revealed that high NLR and high PLR conferred poor prognoses for SCLC patients. Moreover, multivariate analysis demonstrated that NLR, tumour stage, and hepatic metastasis were independent prognostic factors for survival. In this study, we found that NLR and PLR were associated with several factors that reflect the inflammatory (white blood cell count, WBC; lactate dehydrogenase, LDH) and nutritional (albumin, ALB; haemoglobin, HB; and cholesterol) status of SCLC patients at diagnosis.

Conclusions

NLR is an independent prognostic factor and can be used to predict the mortality risk of SCLC patients.
Literature
1.
go back to reference American Cancer Society. Cancer facts and figures 2014. Atlanta: American Cancer Society; 2014. American Cancer Society. Cancer facts and figures 2014. Atlanta: American Cancer Society; 2014.
2.
go back to reference Hong X, Cui B, Wang M, Yang Z, Wang L, Systemic Immune-inflammation XQ. Index, based on platelet counts and Neutrophil-lymphocyte ratio, is useful for predicting prognosis in small cell lung cancer. Tohoku J Exp Med. 2015;236(4):297–304.CrossRefPubMed Hong X, Cui B, Wang M, Yang Z, Wang L, Systemic Immune-inflammation XQ. Index, based on platelet counts and Neutrophil-lymphocyte ratio, is useful for predicting prognosis in small cell lung cancer. Tohoku J Exp Med. 2015;236(4):297–304.CrossRefPubMed
3.
go back to reference Li J, Dai CH, Chen P, JN W, Bao QL, Qiu H, et al. Survival and prognostic factors in small cell lung cancer. Med Oncol. 2010;27(1):73–81.CrossRefPubMed Li J, Dai CH, Chen P, JN W, Bao QL, Qiu H, et al. Survival and prognostic factors in small cell lung cancer. Med Oncol. 2010;27(1):73–81.CrossRefPubMed
4.
go back to reference Fizazi K, Cojean I, Pignon JP, Rixe O, Gatineau M, Hadef S, et al. Normal serum neuron specific enolase (NSE) value after the first cycle of chemotherapy: an early predictor of complete response and survival in patients with small cell lung carcinoma. Cancer. 1998;82(6):1049–55.CrossRefPubMed Fizazi K, Cojean I, Pignon JP, Rixe O, Gatineau M, Hadef S, et al. Normal serum neuron specific enolase (NSE) value after the first cycle of chemotherapy: an early predictor of complete response and survival in patients with small cell lung carcinoma. Cancer. 1998;82(6):1049–55.CrossRefPubMed
5.
go back to reference Gronowitz JS, Bergstrom R, Nou E, Pahlman S, Brodin O, Nilsson S, et al. Clinical and serologic markers of stage and prognosis in small cell lung cancer. A multivariate analysis. Cancer. 1990;66(4):722–32.CrossRefPubMed Gronowitz JS, Bergstrom R, Nou E, Pahlman S, Brodin O, Nilsson S, et al. Clinical and serologic markers of stage and prognosis in small cell lung cancer. A multivariate analysis. Cancer. 1990;66(4):722–32.CrossRefPubMed
6.
go back to reference Buccheri G, Ferrigno D. Prognostic factors of small cell lung cancer. Hematol Oncol Clin North Am. 2004;18(2):445–60.CrossRefPubMed Buccheri G, Ferrigno D. Prognostic factors of small cell lung cancer. Hematol Oncol Clin North Am. 2004;18(2):445–60.CrossRefPubMed
7.
go back to reference Albain KS, Crowley JJ, LeBlanc M, Livingston RB. Determinants of improved outcome in small-cell lung cancer: an analysis of the 2,580-patient southwest oncology group data base. J Clin Oncol. 1990;8(9):1563–74.CrossRefPubMed Albain KS, Crowley JJ, LeBlanc M, Livingston RB. Determinants of improved outcome in small-cell lung cancer: an analysis of the 2,580-patient southwest oncology group data base. J Clin Oncol. 1990;8(9):1563–74.CrossRefPubMed
8.
go back to reference Moon H, Roh JL, Lee SW, Kim SB, Choi SH, Nam SY, et al. Prognostic value of nutritional and hematologic markers in head and neck squamous cell carcinoma treated by chemoradiotherapy. Radiother Oncol. 2015; Moon H, Roh JL, Lee SW, Kim SB, Choi SH, Nam SY, et al. Prognostic value of nutritional and hematologic markers in head and neck squamous cell carcinoma treated by chemoradiotherapy. Radiother Oncol. 2015;
9.
go back to reference Bremnes RM, Sundstrom S, Aasebo U, Kaasa S, Hatlevoll R, Aamdal S, et al. The value of prognostic factors in small cell lung cancer: results from a randomised multicenter study with minimum 5 year follow-up. Lung Cancer. 2003;39(3):303–13.CrossRefPubMed Bremnes RM, Sundstrom S, Aasebo U, Kaasa S, Hatlevoll R, Aamdal S, et al. The value of prognostic factors in small cell lung cancer: results from a randomised multicenter study with minimum 5 year follow-up. Lung Cancer. 2003;39(3):303–13.CrossRefPubMed
10.
go back to reference Li JR, Zhang Y, Zheng JL. Decreased pretreatment serum cholesterol level is related with poor prognosis in resectable non-small cell lung cancer. Int J Clin Exp Pathol. 2015;8(9):11877–83.PubMedPubMedCentral Li JR, Zhang Y, Zheng JL. Decreased pretreatment serum cholesterol level is related with poor prognosis in resectable non-small cell lung cancer. Int J Clin Exp Pathol. 2015;8(9):11877–83.PubMedPubMedCentral
11.
go back to reference Kang MH, Go SI, Song HN, Lee A, Kim SH, Kang JH, et al. The prognostic impact of the neutrophil-to-lymphocyte ratio in patients with small-cell lung cancer. Br J Cancer. 2014;111(3):452–60.CrossRefPubMedPubMedCentral Kang MH, Go SI, Song HN, Lee A, Kim SH, Kang JH, et al. The prognostic impact of the neutrophil-to-lymphocyte ratio in patients with small-cell lung cancer. Br J Cancer. 2014;111(3):452–60.CrossRefPubMedPubMedCentral
12.
go back to reference Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454(7203):436–44.CrossRefPubMed Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454(7203):436–44.CrossRefPubMed
13.
go back to reference Ghasemzadeh M, Hosseini E. Platelet-leukocyte crosstalk: linking proinflammatory responses to procoagulant state. Thromb Res. 2013;131(3):191–7.CrossRefPubMed Ghasemzadeh M, Hosseini E. Platelet-leukocyte crosstalk: linking proinflammatory responses to procoagulant state. Thromb Res. 2013;131(3):191–7.CrossRefPubMed
14.
go back to reference Bagante F, Tran TB, Postlewait LM, Maithel SK, Wang TS, Evans DB, et al. Neutrophil-lymphocyte and platelet-lymphocyte ratio as predictors of disease specific survival after resection of adrenocortical carcinoma. J Surg Oncol. 2015;112(2):164–72.CrossRefPubMedPubMedCentral Bagante F, Tran TB, Postlewait LM, Maithel SK, Wang TS, Evans DB, et al. Neutrophil-lymphocyte and platelet-lymphocyte ratio as predictors of disease specific survival after resection of adrenocortical carcinoma. J Surg Oncol. 2015;112(2):164–72.CrossRefPubMedPubMedCentral
15.
go back to reference Han LH, Jia YB, Song QX, Wang JB, Wang NN, Cheng YF. Prognostic significance of preoperative lymphocyte-monocyte ratio in patients with resectable esophageal squamous cell carcinoma. Asian Pacific J Cancer Prev. 2015;16(6):2245–50.CrossRef Han LH, Jia YB, Song QX, Wang JB, Wang NN, Cheng YF. Prognostic significance of preoperative lymphocyte-monocyte ratio in patients with resectable esophageal squamous cell carcinoma. Asian Pacific J Cancer Prev. 2015;16(6):2245–50.CrossRef
16.
go back to reference Lee S, SY O, Kim SH, Lee JH, Kim MC, Kim KH, et al. Prognostic significance of neutrophil lymphocyte ratio and platelet lymphocyte ratio in advanced gastric cancer patients treated with FOLFOX chemotherapy. BMC Cancer. 2013;13:350.CrossRefPubMedPubMedCentral Lee S, SY O, Kim SH, Lee JH, Kim MC, Kim KH, et al. Prognostic significance of neutrophil lymphocyte ratio and platelet lymphocyte ratio in advanced gastric cancer patients treated with FOLFOX chemotherapy. BMC Cancer. 2013;13:350.CrossRefPubMedPubMedCentral
17.
go back to reference Szkandera J, Gerger A, Liegl-Atzwanger B, Absenger G, Stotz M, Friesenbichler J, et al. The lymphocyte/monocyte ratio predicts poor clinical outcome and improves the predictive accuracy in patients with soft tissue sarcomas. Int J Cancer. 2014;135(2):362–70.CrossRefPubMed Szkandera J, Gerger A, Liegl-Atzwanger B, Absenger G, Stotz M, Friesenbichler J, et al. The lymphocyte/monocyte ratio predicts poor clinical outcome and improves the predictive accuracy in patients with soft tissue sarcomas. Int J Cancer. 2014;135(2):362–70.CrossRefPubMed
18.
go back to reference Stotz M, Gerger A, Eisner F, Szkandera J, Loibner H, Ress AL, et al. Increased neutrophil-lymphocyte ratio is a poor prognostic factor in patients with primary operable and inoperable pancreatic cancer. Br J Cancer. 2013;109(2):416–21.CrossRefPubMedPubMedCentral Stotz M, Gerger A, Eisner F, Szkandera J, Loibner H, Ress AL, et al. Increased neutrophil-lymphocyte ratio is a poor prognostic factor in patients with primary operable and inoperable pancreatic cancer. Br J Cancer. 2013;109(2):416–21.CrossRefPubMedPubMedCentral
19.
go back to reference Smith RA, Bosonnet L, Raraty M, Sutton R, Neoptolemos JP, Campbell F, et al. Preoperative platelet-lymphocyte ratio is an independent significant prognostic marker in resected pancreatic ductal adenocarcinoma. Am J Surg. 2009;197(4):466–72.CrossRefPubMed Smith RA, Bosonnet L, Raraty M, Sutton R, Neoptolemos JP, Campbell F, et al. Preoperative platelet-lymphocyte ratio is an independent significant prognostic marker in resected pancreatic ductal adenocarcinoma. Am J Surg. 2009;197(4):466–72.CrossRefPubMed
20.
go back to reference Kwon HC, Kim SH, Oh SY, Lee S, Lee JH, Choi HJ, et al. Clinical significance of preoperative neutrophil-lymphocyte versus platelet-lymphocyte ratio in patients with operable colorectal cancer. Biomarkers. 2012;17(3):216–22.CrossRefPubMed Kwon HC, Kim SH, Oh SY, Lee S, Lee JH, Choi HJ, et al. Clinical significance of preoperative neutrophil-lymphocyte versus platelet-lymphocyte ratio in patients with operable colorectal cancer. Biomarkers. 2012;17(3):216–22.CrossRefPubMed
21.
go back to reference Wang X, Teng F, Kong L, Yu J. Pretreatment neutrophil-to-lymphocyte ratio as a survival predictor for small-cell lung cancer. OncoTargets Therapy. 2016;9:5761–70.CrossRefPubMedPubMedCentral Wang X, Teng F, Kong L, Yu J. Pretreatment neutrophil-to-lymphocyte ratio as a survival predictor for small-cell lung cancer. OncoTargets Therapy. 2016;9:5761–70.CrossRefPubMedPubMedCentral
22.
go back to reference Templeton AJ, Ace O, McNamara MG, Al-Mubarak M, Vera-Badillo FE, Hermanns T, et al. Prognostic role of platelet to lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Cancer Epidemiol Biomark Prev. 2014;23(7):1204–12.CrossRef Templeton AJ, Ace O, McNamara MG, Al-Mubarak M, Vera-Badillo FE, Hermanns T, et al. Prognostic role of platelet to lymphocyte ratio in solid tumors: a systematic review and meta-analysis. Cancer Epidemiol Biomark Prev. 2014;23(7):1204–12.CrossRef
23.
go back to reference Templeton AJ, McNamara MG, Seruga B, Vera-Badillo FE, Aneja P, Ocana A, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014;106(6):dju124.CrossRefPubMed Templeton AJ, McNamara MG, Seruga B, Vera-Badillo FE, Aneja P, Ocana A, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014;106(6):dju124.CrossRefPubMed
24.
go back to reference Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J. 2010;9:69.CrossRefPubMedPubMedCentral Gupta D, Lis CG. Pretreatment serum albumin as a predictor of cancer survival: a systematic review of the epidemiological literature. Nutr J. 2010;9:69.CrossRefPubMedPubMedCentral
25.
go back to reference Mori S, Usami N, Fukumoto K, Mizuno T, Kuroda H, Sakakura N, et al. The significance of the prognostic nutritional index in patients with completely Resected non-small cell lung cancer. PLoS One. 2015;10(9):e0136897.CrossRefPubMedPubMedCentral Mori S, Usami N, Fukumoto K, Mizuno T, Kuroda H, Sakakura N, et al. The significance of the prognostic nutritional index in patients with completely Resected non-small cell lung cancer. PLoS One. 2015;10(9):e0136897.CrossRefPubMedPubMedCentral
26.
go back to reference Shao N, Cai Q. High pretreatment neutrophil-lymphocyte ratio predicts recurrence and poor prognosis for combined small cell lung cancer. Clin Transl Oncol. 2015;17(10):772–8.CrossRefPubMed Shao N, Cai Q. High pretreatment neutrophil-lymphocyte ratio predicts recurrence and poor prognosis for combined small cell lung cancer. Clin Transl Oncol. 2015;17(10):772–8.CrossRefPubMed
27.
go back to reference He Y, Wang Y, Boyle T, Ren S, Chan D, Rivard C, et al. Hepatic metastases is associated with poor efficacy of Erlotinib as 2nd/3rd line therapy in patients with lung Adenocarcinoma. Med Sci Monitor. 2016;22:276–83.CrossRef He Y, Wang Y, Boyle T, Ren S, Chan D, Rivard C, et al. Hepatic metastases is associated with poor efficacy of Erlotinib as 2nd/3rd line therapy in patients with lung Adenocarcinoma. Med Sci Monitor. 2016;22:276–83.CrossRef
Metadata
Title
High neutrophil-to-lymphocyte ratios confer poor prognoses in patients with small cell lung cancer
Authors
Dan Liu
Yi Huang
Lei Li
Juan Song
Li Zhang
Weimin Li
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2017
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-017-3893-1

Other articles of this Issue 1/2017

BMC Cancer 1/2017 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine