Neutrophil-Lymphocyte Ratio as a Prognostic Marker for Lung Adenocarcinoma After Complete Resection.
BACKGROUND
The neutrophil-lymphocyte ratio (NLR) is a simple and low-cost index that may be a benchmark for systemic inflammatory response and antitumor immunity. The goal of the study was to investigate the prognostic value of preoperative NLR in patients with lung adenocarcinoma after complete resection.


METHODS
The subjects were 361 consecutive patients with lung adenocarcinoma who underwent complete resection between 2000 and 2009. Perioperative clinical and laboratory data were evaluated retrospectively. The cohort was divided using the cut-off value for preoperative NLR identified in receiver operating characteristic analysis. Correlations of NLR with clinicopathological characteristics and prognosis were examined.


RESULTS
A high NLR was significantly correlated with a smoking history >10 pack-years (p = 0.023), pathological stage II or III (p < 0.001), lymphatic invasion (p = 0.003), and pleural invasion (p = 0.039). In univariate analysis, the high NLR group had significantly lower 5-year overall survival (86.0 vs. 77.1 %, p < 0.001) and 5-year recurrence-free survival (75.1 vs. 59.9 %, p < 0.001). Multivariate analysis showed that NLR was an independent prognostic factor (hazard ratio 1.822, 95 % confidence interval 1.133-2.931, p = 0.013).


CONCLUSIONS
These results show that preoperative NLR is an independent prognostic factor in patients with lung adenocarcinoma after complete resection. NLR may reflect host immunity and systemic inflammation that facilitates tumor growth.
Yusuke
Y
Takahashi
Masafumi
M
Kawamura
Tai
T
Hato
Masahiko
M
Harada
Noriyuki
N
Matsutani
Hirotoshi
H
Horio
D000230:Adenocarcinoma / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D000077192:Adenocarcinoma of Lung; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D042601:Lymphatic Vessels / Q000473:pathology; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009504:Neutrophils; D010994:Pleura / Q000473:pathology; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000097:blood; D015996:Survival Rate; D055815:Young Adult