[Prognostic Value of Neutrophil-to-lymphocyte Ratio in Patients with Lung Adenocarcinoma Treated with Radical Dissection]

Zhongguo Fei Ai Za Zhi. 2018 Aug 20;21(8):588-593. doi: 10.3779/j.issn.1009-3419.2018.08.04.
[Article in Chinese]

Abstract

Background: Previous studies have shown that the neutrophil-to-lymphocyte ratio (NLR) has a significant impact on the prognosis of many malignant tumors such as gastric cancer, colorectal cancer and pancreatic cancer, but the study on the prognosis of patients with resectable lung adenocarcinoma is less. The aim of this study is to investigate the correlation between the NLR and the clinicopathologic features of adenocarcinoma of lung patients who underwent radical pneumonectomy. Furthermore, this study aimed to clarify the predictive and prognostic significance of NLR in patients who underwent pneumonectomy for lung adenocarcinoma.

Methods: This study reviewed the medical records of 163 patients with lung adenocarcinoma who underwent pneumonectomy. The receiver operating characteristic (ROC) curve and Youden index were used to determine the cut-off value of the NLR. Survival curves were described by Kaplan-Meier method and compared by Log-rank test. The univariate and multivariate analyses were performed with the Cox proportional hazard model to identify the prognostic factors.

Results: When the NLR value was 2.96, the Youden index was maximal, with a sensitivity of 77.5% and a specificity of 75.9%. The 5-year survival rate in the low NLR group was higher than that in the high NLR group (P<0.05). The univariate and multivariate analyses showed that TNM staging and NLR were independent factors in predicting survival rate.

Conclusions: The NLR value was a simple and useful tool to predict the prognosis of lung adenocarcinoma after radical pneumonectomy.

【中文题目:中性粒细胞/淋巴细胞比值预测根治性切除 肺腺癌患者预后分析】 【中文摘要:背景与目的 已有的研究表明中性粒细胞计数/淋巴细胞计数比(neutrophil-to-lymphocyte ratio, NLR)对胃癌、结直肠癌、胰腺癌等多种恶性肿瘤的预后有显著影响,但是其对可切除肺腺癌患者预后影响目前研究较少。本研究旨在分析NLR与肺腺癌患者术后临床病理特征及预后的关系。方法 回顾性分析163例经病理确诊为肺腺癌并行肺腺癌根治切除术患者的临床随访病理资料。根据术前1周内化验结果计算NLR值。通过对受试者工作特征曲线(receiver operating characteristic curve, ROC)的分析得出NLR的临界值(cut-off值)。采用Kaplan-Meier生存曲线和Cox比例风险模型研究NLR对肺腺癌术后患者预后的影响。结果 采用5年生存作为终点绘制NLR值的ROC曲线,当NLR值为2.96时,正确指数(Youden指数)最大,敏感度为77.5%,特异度为75.9%。低NLR组累计5年生存率显著高于高NLR组(P<0.05)。单因素及多因素生存分析显示:TNM分期和NLR水平与生存率显著相关(P<0.05)。结论NLR值作为一项便捷且有效的指标,可用于初步判断肺腺癌术后患者预后状况。 】 【中文关键词:肺肿瘤;中性粒细胞与淋巴细胞比值;生存;预后】.

Keywords: Lung neoplasms; Neutrophil-to-lymphocyte ratio; Prognosis; Survival.

MeSH terms

  • Adenocarcinoma / diagnosis*
  • Adenocarcinoma / immunology
  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Adenocarcinoma of Lung
  • Aged
  • Cell Count
  • Female
  • Follow-Up Studies
  • Humans
  • Kaplan-Meier Estimate
  • Lung Neoplasms / diagnosis*
  • Lung Neoplasms / immunology
  • Lung Neoplasms / pathology
  • Lung Neoplasms / surgery*
  • Lymphocytes / cytology*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Neutrophils / cytology*
  • Pneumonectomy*
  • Prognosis
  • ROC Curve
  • Retrospective Studies

Grants and funding

本研究受安徽省自然基金(No.1708085MH179)资助