title: Neutrophil-lymphocyte ratio as a prognostic marker for chemotherapy in advanced lung cancer.
abstract: BACKGROUND
  Lung cancer ranks first both in morbidity and mortality in malignancies, but prognostic biological markers are lacking. The neutrophil-lymphocyte ratio (NLR) was proposed as a convenient biological marker. This study aimed to explore the prognostic value of NLR in advanced non-small cell lung cancer (NSCLC).
  
  
  METHODS
  This retrospective study screened patients admitted from October 2007 to October 2014. Patients had histopathologically confirmed, treatment-naïve, metastatic NSCLC, and were prescribed platinum doublet chemotherapy. NLR and demographic data were collected, together with the outcome of chemotherapy. Progression-free survival (PFS) and overall survival (OS) were analyzed using the Kaplan-Meier method and Cox regression model.
  
  
  RESULTS
  A total of 325 patients were enrolled. The cutoff value for NLR (3.19) was determined by receiver operator characteristic analysis. Patients were dichotomized into high (≥3.19) and low (&lt;3.19) NLR groups. Both groups had similar demographic features. However, the low-NLR group had longer PFS (6.1 months) and OS (22.3 months) than the high-NLR group (5.1 months, p = 0.002; 13.1 months, p&lt;0.001, respectively). Multivariate analysis confirmed that NLR was inversely related to the prognosis of these patients (HR = 1.684, 95%: 1.297-2.185, p&lt;0.001).
  
  
  CONCLUSIONS
  This study argues that NLR is a convenient prognostic biological marker for advanced NSCLC patients treated with first-line chemotherapy and warrants further validation.
authors.affiliation: Division of Thoracic Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu - China.
authors.forename: Zhu-Lin
authors.initials: ZL
authors.lastname: Liu
authors.affiliation: Department of Laboratory Medicine, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu - China.
authors.forename: Ting-Ting
authors.initials: TT
authors.lastname: Zeng
authors.affiliation: Division of Thoracic Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu - China.
authors.forename: Xiao-Juan
authors.initials: XJ
authors.lastname: Zhou
authors.affiliation: Department of Laboratory Medicine, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu - China.
authors.forename: Ya-Nv
authors.initials: YN
authors.lastname: Ren
authors.affiliation: Department of Laboratory Medicine, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu - China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Division of Thoracic Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu - China.
authors.forename: Xin-Xing
authors.initials: XX
authors.lastname: Zhang
authors.affiliation: Division of Thoracic Oncology, Cancer Center, State Key Laboratory of Biotherapy, West China Hospital, West China Medical School, Sichuan University, Chengdu - China.
authors.forename: Zhen-Yu
authors.initials: ZY
authors.lastname: Ding
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015331:Cohort Studies; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000473:pathology; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000473:pathology*; D017239:Paclitaxel / Q000008:administration & dosage; D000068437:Pemetrexed / Q000008:administration & dosage; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D000093542:Gemcitabine
chemical_list: D000068437:Pemetrexed; D003841:Deoxycytidine; D017239:Paclitaxel; D000093542:Gemcitabine