Pretreatment Neutrophil/Lymphocyte Ratio as a Prognostic Factor for Survival in Patients with Advanced Non-Small Cell Lung Cancer

治療前嗜中性白血球／淋巴球比值可作為非小細胞肺癌患者存活之預測因子

葉金水(Chin-Shui Yeh) ； 紀炳銓(Bin-Chuan Ji) ； 陳正雄(Cheng-Hsiung Chen) ； 蔡偉宏(Woei-Horng Chai) ； 林慶雄(Ching-Hsiung Lin)

《胸腔醫學》 28卷6期 (2013/12) Pp. 321-329

摘要

Introduction: Peripheral neutrophils, lymphocyte counts and the neutrophil/lymphocyte ratio (NLR) have been associated with survival of patients with non-small cell lung cancer (NSCLC). In this study, we investigated the prognostic effect of NLR on overall survival of stage IIIB and IV NSCLC patients.Methods: Patients with stage IIIB and IV NSCLC who underwent radiotherapy or chemotherapy between January 2004 and December 2006 were studied retrospectively. The complete blood count data with differential counts of peripheral blood before chemotherapy or radiotherapy were analyzed. The prognostic effect of clinicopathological factors and NLR were examined by univariate and multivariate analysis. Overall survival curves were derived using the Kaplan-Meier method, and the difference between the high and low NLR groups was assessed by log-rank test.Results: In all, 375 eligible NSCLC patients, including 246 men and 129 women with a mean age of 66.7 years, were enrolled. Median overall survival durations of the low NLR (NLR＜8.91) and high NLR groups (NLR≥8.91) were 10.15 and 2.20 months, respectively (p＜0.001). The pretreatment NLR was an independent prognostic factor for overall survival (hazard ratio: 1.966; 95% CI: 1.527-2.532; p＜0.001), Multivariate analysis showed that age younger 66 years and performance status were independent prognostic factors. Increased pretreatment NLR was associated with a poor prognosis for advanced NSCLC patients.Conclusions: NLR is easily measured and may be utilized as a reliable prognostic predictor for advanced NSCLC.

關鍵字

嗜中性白血球／淋巴球比例值 ； 存活預測因子 ； 非小細胞肺癌

並列摘要

Introduction: Peripheral neutrophils, lymphocyte counts and the neutrophil/lymphocyte ratio (NLR) have been associated with survival of patients with non-small cell lung cancer (NSCLC). In this study, we investigated the prognostic effect of NLR on overall survival of stage IIIB and IV NSCLC patients.Methods: Patients with stage IIIB and IV NSCLC who underwent radiotherapy or chemotherapy between January 2004 and December 2006 were studied retrospectively. The complete blood count data with differential counts of peripheral blood before chemotherapy or radiotherapy were analyzed. The prognostic effect of clinicopathological factors and NLR were examined by univariate and multivariate analysis. Overall survival curves were derived using the Kaplan-Meier method, and the difference between the high and low NLR groups was assessed by log-rank test.Results: In all, 375 eligible NSCLC patients, including 246 men and 129 women with a mean age of 66.7 years, were enrolled. Median overall survival durations of the low NLR (NLR＜8.91) and high NLR groups (NLR≥8.91) were 10.15 and 2.20 months, respectively (p＜0.001). The pretreatment NLR was an independent prognostic factor for overall survival (hazard ratio: 1.966; 95% CI: 1.527-2.532; p＜0.001), Multivariate analysis showed that age younger 66 years and performance status were independent prognostic factors. Increased pretreatment NLR was associated with a poor prognosis for advanced NSCLC patients.Conclusions: NLR is easily measured and may be utilized as a reliable prognostic predictor for advanced NSCLC.

並列關鍵字

neutrophil/lymphocyte ratio ； prognostic factor ； non-small cell lung cancer