Clinical significance of preoperative inflammatory markers in non-small cell lung cancer patients: A multicenter retrospective study

Abstract

Inflammatory biomarkers have been associated with clinical outcomes in non-small cell lung cancer (NSCLC). However, the best prognostic marker(s) has not been identified, and the association between inflammatory markers and clinical characteristics is poorly understood. We selected 1,237 patients with resected NSCLC from Kyushu University (2003–2015) and Kyushu Cancer Center (2009–2015) in Japan. Pearson product-moment correlation coefficient among inflammatory markers and area under curve (AUC) of receiver operating characteristic (ROC) curve analyses for overall survival (OS) were calculated. We analyzed the associations between inflammatory markers and clinical factors using Student’s t -test. Univariate and multivariate analyses with Cox proportional hazards regression analyses were performed to evaluate the relationship between survival and clinical factors. The cut-off values for neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio, and derived NLR (dNLR) were determined by ROC curve analyses for OS. We found a strong positive correlation between NLR and dNLR (r = 0.9629). The AUC of LMR was the highest amongst the measured metrics, and the AUC of NLR was higher than dNLR. Levels of some inflammatory markers were associated with sex, smoking, squamous cell carcinoma, and pathological stage. LMR ≥ 5.11 and lactate dehydrogenase (LDH) concentration ≥ 222 (U/L) were independent predictors of both disease-free survival (DFS) and OS (LMR; P = 0.0009 and 0.0008, LDH; P = 0.0195 and 0.0187, respectively). Certain inflammatory markers, potentially linked to smoking, were associated with an advanced pathological stage in NSCLC. LMR and LDH were independent predictors of both DFS and OS.

The Prediction Potential of the Pretreatment Lung Immune Prognostic Index for the Therapeutic Outcomes of Immune Checkpoint Inhibitors in Patients With Solid Cancer: A Systematic Review and Meta-Analysis

“…Lymphocyte infiltration in the tumor is also associated with a better response to immunotherapy and prognosis in solid tumor patients ( 29 ). LDH and dNLR are independent risk factors for mortality among patients, and are correlated with poor outcomes in several solid cancer types according to the current evidence ( 30 , 31 ).…”

“…Lymphocyte infiltration in the tumor is also associated with a better response to immunotherapy and prognosis in solid tumor patients (29). LDH and dNLR are independent risk factors for mortality among patients, and are correlated with poor outcomes in several solid cancer types according to the current evidence (30,31). Immunotherapy has demonstrated great clinical success in certain cancers, but so far, immunotherapy has only achieved success in a limited number of cancers (32).…”

Prediction of Recurrence-Free Survival of Patients with Stage III Non-Small Cell Lung Cancer after Treatment on the Basis of the Use of Run Indicators of Laboratory Blood Test

“…Воспаление в зоне опухоли причастно к пролиферации и выживанию клеток злокачественной опухоли, ангиогенезу в ткани опухоли и метастазированию [6]. Поэтому внимание исследователей все более привлекают системные воспалительные маркеры в крови, такие как лимфоциты (Л) [7], нейтрофилы (Н), тромбоциты (Тр) [8,9], С-реактивный белок (С-РБ) [10] и альбумин [11], а также соотношение Н и Л, Тр и Л [12][13][14][15], уровня С-РБ и альбумина [16], Тр и альбумина [17] в качестве прогностических маркеров при раке. Интерес к подобным показателям понятен, поскольку количественная и полуколичественная оценка содержания клеток крови -рутинный и относительно недорогой тест, который, как правило, проводится для каждого поступающего в стационар.…”

“…Для этого в расчет принимались только те факторы, которые связаны с развитием опухоли и могут оказывать свое влияние на возникновение рецидива. Считается, что к ним относятся размер опухоли, распространенность регионарных метастазов и степень дифференцировки клеток опухоли (Grade) [12] одногодичного наблюдения после проведенного лечения до наступления рецидива заболевания.…”

Assessing the Prognostic Value of the Neutrophil-to-Lymphocyte Ratio in Stage I Non-Small-Cell Lung Cancer with Complete Resection

“…In the real world, postoperative recurrence and death are equally present in stage IA patients without the aforementioned high-risk factors. Several studies have shown that inflammatory biomarkers such as NLR, lactate dehydrogenase (LDH), and RDW-SD affect the prognosis of patients with advanced lung cancer [ 4 , 5 ]. The relationship between inflammatory indicators and postoperative stage I NSCLC is still unclear [ 6 , 7 ].…”