title: Are pretreatment neutrophil-lymphocyte ratio and platelet-lymphocyte ratio useful in predicting the outcomes of patients with small-cell lung cancer?
abstract: OBJECTIVE
  The neutrophil-lymphocyte ratio (NLR) and the platelet-lymphocyte ratio (PLR) have been proved to affect the prognosis of various types of cancers. However, the prognostic role of NLR and PLR in patients with small-cell lung cancer (SCLC) remains controversial. The objective of this study is to assess the prognostic values of NLR, PLR and other potential prognostic indexes in SCLC patients.
  
  
  RESULTS
  The optimal cutoff levels were 2.65 for NLR, 125 for PLR and 210 for LDH by ROC curves analysis. Patients in the NLR ≥ 2.65 and LDH ≥ 210 groups were significantly correlated with worse PFS and OS. However, patients in the PLR < 125 group presented longer PFS time than patients in the PLR ≥ 125 group. Multivariate analysis showed that NLR ≥ 2.65 was an independent risk factor for both PFS (HR = 1.38; 95% CI 1.04-1.83; P = 0.027) and OS (HR = 1.35; 95% CI 1.02-1.79; P = 0.039). LDH and the clinical stage were independent prognostic factors for PFS in SCLC patients. LDH, surgery history, thoracic RT and PCI were independent prognostic factors for OS.
  
  
  METHODS
  320 patients with SCLC were enrolled in this research from 2007 to 2014. Data was acquired through patients' medical records and follow-ups. Receiver operating curve (ROC) was used to determine the optimal cut-off levels of NLR, PLR and lactate dehydrogenase (LDH). The Kaplan-Meier univariate analysis and multivariate Cox regression analysis were used to evaluate the impact of the NLR, PLR and other potential prognostic factors on overall survival (OS) and progressive-free survival (PFS).
  
  
  CONCLUSIONS
  Pretreatment elevated NLR and LDH were independent factors for poor prognosis in SCLC patients. High PLR was associated with poor PFS, but it was not an independent prognostic factor for PFS and OS.
authors.affiliation: Cancer Center, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China.|Department of Oncology, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China.
authors.forename: Min
authors.initials: M
authors.lastname: Deng
authors.affiliation: Cancer Center, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China.|Department of Oncology, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China.
authors.forename: Xuelei
authors.initials: X
authors.lastname: Ma
authors.affiliation: Cancer Center, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China.|Department of Oncology, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China.
authors.forename: Xiao
authors.initials: X
authors.lastname: Liang
authors.affiliation: Cancer Center, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China.|Department of Oncology, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China.
authors.forename: Chenjing
authors.initials: C
authors.lastname: Zhu
authors.affiliation: Cancer Center, State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China.|Department of Oncology, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China.
authors.forename: Manni
authors.initials: M
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001792:Blood Platelets / Q000276:immunology*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis / Q000276:immunology* / Q000401:mortality; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000276:immunology*; D010976:Platelet Count; D011379:Prognosis; D012189:Retrospective Studies; D055752:Small Cell Lung Carcinoma / Q000175:diagnosis / Q000276:immunology* / Q000401:mortality; D016019:Survival Analysis; D055815:Young Adult
keywords: lactate dehydrogenase (LDH); neutrophil-lymphocyte ratio (NLR); platelet-lymphocyte ratio (PLR); prognostic factors; small cell lung cancer (SCLC)