Background: Lung cancer are divided into 2 groups; i.e. Small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). About 30% of NSCLC is squamus cell carcinoma and the other is adeno carcinoma. Late diagnosis makes such a high mortality rate. Early diagnosis plays a very important role in the management of therapy. Case: Patients complain of chronic cough more than 6 months, decreased appetite and weight loss. Chest X-ray and CT scan show a density of round shape mass, with firm border and smooth regular edge, also lympnodes enlargement (T2N2Mx) stage IIb. Appearance of lung mass is benign according to clinically and radiologically. FNAB-CT Guiding results are difference each time examination. The first result is squamous cell carcinoma but the last result is teratoma. Discussion: Based on the multidisciplinary discussion on Tumor Board Meeting, the diagnosis was decide as Squamous cell Carcinoma. The choice management of stage IIb lung cancer is surgery (Lobectomy). Histopathology finding post surgery is a Squamus Cell Carcinoma. Patients were then given adjuvant chemotherapy for 4 cycles with Platinum Base regimen paxuscarboplatin with the aim of clearing micrometastase that may still be left behind. The complete respons of platinum based chemotherapy following surgery in early stage of squamous cell carcinoma. Conclusion: Difficulties of lung cancer diagnostic are still the problem in the management of lung mass. Difference of diagnostic makes difference treatment choice. Multidiscipline discussion is needed to decide the diagnostic and treatment judgment.

Background: Lung cancer is the leading cause of death from cancer. One type of cancer is non-small cell lung cancer (NSCLC). The body fights against cancer cells by immune surveillance mechanisms involving the role of neutrophils and lymphocytes. Chemotherapy is a modality that is usually used as a therapy in patients’ NSCLC. To assess chemotherapy’s prognostic, research needs to be done to find the relationship between the neutrophil-lymphocytes ratio before chemotherapy with objective response after chemotherapy in patients with NSCLC Methods: This study was an observational study of retrospective cohort analytics which samples are secondary data from medical records of NSCLC patients in RSUD Dr. Soetomo who received chemotherapy by linking the neutrophils-lymphocytes ratio before chemotherapy with objective response after chemotherapy based on RECIST’s criteria and analyzed by spearman correlation test method and RNL cut off value with ROC curve and kappa test Results: Sixty-four subjects were analyzed in this study, the relationship of neutrophil-lymphocyte ratio with chemotherapy objective response after 2 cycles with P=0.354 (