Prognostic value of NLR, PLR and CEA in advanced non-small cell lung cancer

doi:10.3969/j.issn.1004-583X.2021.02.009

Abstract

Abstract:

Objective To investigate the prognostic value of neutrophil-to-lymphocyte ratio(NLR), platelet-to-lymphocyte ratio(PLR), and carcinoembryonic antigen(CEA) in patients with advanced non-small cell lung cancer(NSCLC). Methods One hundred and thirty-five cases of advanced NSCLC were divided into high and low NLR group, high and low PLR group and high and low CEA group, and the general clinical data among the groups were compared. The evaluation value of NLR, PLR and CEA on the prognosis of advanced NSCLC was compared. Results The median OS of low PLR group was significantly higher than that of high PLR group (χ²=6.128, P=0.013). The median OS of low CEA group was significantly higher than that of high CEA group (χ²=12.18, P<0.01). Among NLR, PLR and CEA, the index NLR 0.761 was the largest in the area under the ROC curve (AUC). Conclusion NLR, PLR and CEA can evaluate the prognosis of patients with advanced NSCLC to different degrees, among which NLR has the best predictive efficacy.

Key words: carcinoma, non-small-cell lung, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, prognosis

CLC Number:

R730.26

Bao Xinran, Ha Minwen. Prognostic value of NLR, PLR and CEA in advanced non-small cell lung cancer[J]. Clinical Focus, 2021, 36(2): 139-143.

Add to citation manager EndNote|Ris|BibTeX

URL: https://huicui.hebmu.edu.cn/EN/10.3969/j.issn.1004-583X.2021.02.009

https://huicui.hebmu.edu.cn/EN/Y2021/V36/I2/139

Figures/Tables 8

References 26

[1]	Siegel RL, Miller KD, Jemal A. Cancer statistics[J]. CA Cancer J Clin., 2017,67(1):7-30. doi: 10.3322/caac.21387 URL
[2]	Mandaliya H, Jones M, Oldmeadow C, et al. Prognostic biomarkers in stage IV non-small cell lung cancer (NSCLC): neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), platelet to lymphocyte ratio (PLR) and advanced lung cancer inflammation index (ALI)[J]. Transl Lung Cancer Res, 2019,8(6):886-894. doi: 10.21037/tlcr URL
[3]	Diakos CI, Charles KA, McMillan DC, et al. Cancer-related inflammation and treatment effectiveness[J]. Lancet Oncol, 2014,15(11):493-503. pmid: 92571988404604968
[4]	王洪玲, 李琳, 王键玮, 等. 中性粒细胞淋巴细胞比值与小细胞肺癌预后关系的分析[J]. 河北医科大学学报, 2018,39(4):391-395.
[5]	王晓东, 张涛, 崔凯, 等. 术前外周血小板计数与淋巴细胞计数比值对非小细胞肺癌根治术后并辅助化疗患者预后的影响[J]. 陕西医学杂志, 2019,48(9):1147-1150.
[6]	Zhang X, Zhang W, Feng LJ. Prognostic significance of neutrophil lymphocyte ratio in patients with gastric cancer: a meta-analysis[J]. PLoS One, 2014,9(11):111906. doi: 10.1371/journal.pone.0111906 pmid: 25401500
[7]	胡小秀, 何义富, 罗会芹, 等. 外周血NLR、PLR与食管小细胞癌临床预后的关系[J]. 临床肿瘤学杂志, 2019,24(6):543-547.
[8]	Xiao WK, Chen D, Li SQ, et al. Prognostic significance of neutrophil-lymphocyte ratio in hepatocellular carcinoma: a meta-analysis[J]. BMC Cancer, 2014,14:117. doi: 10.1186/1471-2407-14-117 URL
[9]	Bhatti I, Patel M, Dennison AR, et al. Utility of postoperative CEA for surveillance of recurrence after resection of primary colorectal cancer[J]. Int J Surg, 2015,16(4):123-128. doi: 10.1016/j.ijsu.2015.03.002 URL
[10]	Deng K, Yang L, Hu B, et al. The prognostic significance of pretreatment serum CEA levels in gastric cancer: a meta-analysis including 14651 patients[J]. PLoS One, 2015,10(4):124151. doi: 10.1371/journal.pone.0124151 pmid: 25879931
[11]	Mantovani A, Allavena P, Sica A, et al. Cancer-related inflammation[J]. Nature, 2008,454(7203):436-444. doi: 10.1038/nature07205 pmid: 18650914
[12]	Kano S, Homma A, Hatakeyama H, et al. Pretreatment lymphocyte-to-monocyte ratio as an independent prognostic factor for head and neck cancer[J]. Head Neck, 2017,39(2):247-253. doi: 10.1002/hed.24576 URL
[13]	Roxburgh CS, McMillan DC. Role of systemic inflammatory response in predicting survival in patients with primary operable cancer[J]. Future Oncol, 2010,6(1):149-163. doi: 10.2217/fon.09.136 URL
[14]	Lin GN, Peng JW, Liu PP, et al. Elevated neutrophil-to-lymphocyte ratio predicts poor outcome in patients with advanced non-small-cell lung cancer receiving first-line gefitinib or erlotinib treatment[J]. Asia Pac J Clin Oncol, 2017,13(5):189-194.
[15]	Nakamura T, Matsumine A, Matsubara T, et al. The combined use of the neutrophil-lymphocyte ratio and C-reactive protein level as prognostic predictors in adult patients with soft tissue sarcoma[J]. J Surg Oncol, 2013,108(7):481-5. doi: 10.1002/jso.23424 pmid: 24018883
[16]	Coussens LM, Werb Z. Inflammation and cancer[J]. Nature, 2002,420(6917):860-867. pmid: 12490959
[17]	Weitzman SA, Gordon LI. Inflammation and cancer: role of phagocyte-generated oxidants in carcinogenesis[J]. Blood, 1990,76(4):655-663. pmid: 2200535
[18]	Kusumanto YH, Dam WA, Hospers GA, et al. Platelets and granulocytes, in particular the neutrophils, form important compartments for circulating vascular endothelial growth factor[J]. Angiogenesis, 2003,6(4):283-287. pmid: 15166496
[19]	Gao YY, Zhang HD, Li Y, et al. Preoperative pulmonary function correlates with systemic inflammatory response and prognosis in patients with non-small cell lung cancer: results of a single-institution retrospective study[J]. Oncotarget, 2017,8(16):27489-27501. doi: 10.18632/oncotarget.v8i16 URL
[20]	Iseki Y, Shibutani M, Maeda K, et al. The impact of the preoperative peripheral lymphocyte count and lymphocyte percentage in patients with colorectal cancer[J]. Surg Today, 2017,47:743-754.
[21]	王伟, 朱川, 黄小平, 等. 淋巴细胞比值对中晚期非小细胞肺癌患者预后的评估价值[J]. 中国处方药, 2020,18(4):19-21.
[22]	崔浩, 吴瑶瑶, 章龙珍. 术前NLR、PLR与三阴性乳腺癌患者预后的相关性分析[J]. 现代肿瘤医学, 2019,27(12):2087-2091.
[23]	李东, 盛伟伟, 史晓洋, 等. 术前NLR-PLR评分与结直肠癌临床病理特征及预后关系的研究[J]. 中华消化外科杂志, 2020,2020(3):308-314.
[24]	徐小峰, 戴宏宇, 乔建兵, 等. 外周血NLR和PLR评估晚期非小细胞肺癌一线含铂双药化疗疗效和预后的价值[J]. 现代肿瘤医学, 2020,28(15):2627-2631.
[25]	Miao Y, Yan Q, Li S, et al. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio are predictive of chemotherapeutic response and prognosis in epithelial ovarian cancer patients treated with platinum-based chemotherapy[J]. Cancer Biomark, 2016,17(1):33-40.
[26]	Tazzyman S, Barry ST, Ashton S, et al. Inhibition of neutrophil infiltration into A549 lung tumors in vitro and in vivo using a CXCR2-specific antagonist is associated with reduced tumor growth[J]. Int J Cancer, 2011,129(4):847-858.

组别	例数	性别		年龄		吸烟	病理类型		ECOG评分
组别	例数	男	女	<60岁	≥60岁	吸烟	鳞癌	腺癌	0~1分	≥2分
NLR≥3.22	72	44	28	30	42	48	37	35	50	22
NLR<3.22	63	37	26	31	32	24	19	44	45	18
χ²值		0.031		0.771		11.020	6.239		0.063
P值		0.778		0.380		0.001	0.012		0.801

组别	例数	性别		年龄		吸烟	病理类型		ECOG评分
组别	例数	男	女	<60岁	≥60岁	吸烟	鳞癌	腺癌	0~1分	≥2分
NLR≥3.22	72	44	28	30	42	48	37	35	50	22
NLR<3.22	63	37	26	31	32	24	19	44	45	18
χ²值		0.031		0.771		11.020	6.239		0.063
P值		0.778		0.380		0.001	0.012		0.801

组别	例数	性别		年龄		吸烟	病理类型		ECOG评分
组别	例数	男	女	<60岁	≥60岁	吸烟	鳞癌	腺癌	0~1分	≥2分
PLR≥169.79	75	40	35	30	45	45	39	36	54	21
PLR<169.79	60	41	19	31	29	27	17	43	41	19
χ²值		3.125		1.832		3.013	7.691		0.215
P值		0.077		0.176		0.083	0.006		0.643

组别	例数	性别		年龄		吸烟	病理类型		ECOG评分
组别	例数	男	女	<60岁	≥60岁	吸烟	鳞癌	腺癌	0~1分	≥2分
PLR≥169.79	75	40	35	30	45	45	39	36	54	21
PLR<169.79	60	41	19	31	29	27	17	43	41	19
χ²值		3.125		1.832		3.013	7.691		0.215
P值		0.077		0.176		0.083	0.006		0.643

组别	例数	性别		年龄		吸烟	病理类型		ECOG评分
组别	例数	男	女	<60岁	≥60岁	吸烟	鳞癌	腺癌	0~1分	≥2分
CEA≥8.07	80	50	30	35	45	50	42	30	55	25
CEA<8.07	55	31	24	26	29	30	14	41	40	15
χ²值		0.511		0.163		6.629	9.821		0.247
P值		0.475		0.686		0.010	0.002		0.619