Pre-diagnosis neutrophil-to-lymphocyte ratio and mortality in individuals who develop lung cancer

Abstract

Purpose The neutrophil-to-lymphocyte ratio (NLR) is a marker of systemic inflammation that has been reported to be associated with survival after chronic disease diagnoses, including lung cancer. We hypothesized that the inflammatory profile reflected by pre-diagnosis NLR, rather than the well-studied pre-treatment NLR at diagnosis, may be associated with increased mortality after lung cancer is diagnosed in high-risk heavy smokers. Methods We examined associations between pre-diagnosis methylation-derived NLR (mdNLR) and lung cancer-specific and all-cause mortality in 279 non-small lung cancer (NSCLC) and 81 small cell lung cancer (SCLC) cases from the β-Carotene and Retinol Efficacy Trial (CARET). Cox proportional hazards models were adjusted for age, sex, smoking status, pack years, and time between blood draw and diagnosis, and stratified by stage of disease. Models were run separately by histotype. Results Among SCLC cases, those with pre-diagnosis mdNLR in the highest quartile had 2.5-fold increased mortality compared to those in the lowest quartile. For each unit increase in pre-diagnosis mdNLR, we observed 22–23% increased mortality (SCLC-specific hazard ratio [HR] = 1.23, 95% confidence interval [CI]: 1.02, 1.48; all-cause HR = 1.22, 95% CI 1.01, 1.46). SCLC associations were strongest for current smokers at blood draw (Interaction Ps = 0.03). Increasing mdNLR was not associated with mortality among NSCLC overall, nor within adenocarcinoma (N = 148) or squamous cell carcinoma (N = 115) case groups. Conclusion Our findings suggest that increased mdNLR, representing a systemic inflammatory profile on average 4.5 years before a SCLC diagnosis, may be associated with mortality in heavy smokers who go on to develop SCLC but not NSCLC.

Discovery of protein biomarkers for venous thromboembolism in non-small cell lung cancer patients through data-independent acquisition mass spectrometry

“…Our clinical data show that neutrophil to lymphocyte ratio (NLR) in VTE group is significantly higher than non-VTE group (5.95 vs 2.40, P =0.002), which indicate that there is activation of inflammatory response in VTE group. Patients with lung cancer often exhibit leukocytosis ( 45 ). Activated neutrophils could enhance thrombosis in cancer patients by releasing neutrophil extracellular traps (NETs) ( 6 ).…”

A biomarker predicting unfavorable prognosis in malignant pleural mesothelioma: systemic immune–inflammation index

“…The onset and development of cancer are significantly influenced by systemic inflammation. Hematological parameters including serum lymphocyte, monocyte, neutrophil, and platelet counts, and NLR, LMR, and PLR calculated using these cell counts are prognostic parameters for malignancies (2,20,21). Recent studies have shown that certain blood markers, such as the ratio of neutrophils to lymphocytes (NLR), the ratio of platelets to lymphocytes (PLR), and the ratio of lymphocytes to monocytes (LMR), represent inflammatory changes in the tumor microenvironment (22).…”

Naples Prognostic Score is an Independent Prognostic Factor in Patients with Small Cell Lung Cancer and Nomogram Predictive Model Established

“…Therefore, neutrophil count is associated with tumor prognosis. 13 , 15 , 16 The role of lymphocytes is to have growth-regulating effects on tumor cells in the tumor immune microenvironment. 17 Lymphocytosis is thought to be associated with a good prognosis, and lymphopenia is thought to be associated with a poor prognosis, whereas increased NLR and decreased LMR are usually accompanied by a substantial decrease in peripheral blood lymphocytes.…”