V Bar-Ad1, J Palmer2, L Li3, Y Lai3, B Lu2, R E Myers3, Z Ye3, R Axelrod4, J M Johnson4, M Werner-Wasik2, S W Cowan5, N R Evans5, B T Hehn6, C C Solomides7, C Wang3. 1. Department of Radiation Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, 111 S. 11th St., Philadelphia, PA, 19107, USA. voichita.bar-ad@jefferson.edu. 2. Department of Radiation Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, 111 S. 11th St., Philadelphia, PA, 19107, USA. 3. Department of Medical Oncology, Thomas Jefferson University, Philadelphia, PA, USA. 4. Department of Medical Oncology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA. 5. Department of Thoracic Surgery, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA. 6. Department of Pulmonology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA. 7. Department of Pathology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA.
Abstract
PURPOSE: Many studies recently focus on complicated and expensive genomic tests, but the prognostic values of biochemical markers which are easily obtained in clinics are largely overlooked and without further exploration. This study assesses the association of neutrophil-lymphocyte-ratio (NLR) with prognosis of lung cancer patients. METHODS: In 1032 patients with histologically confirmed lung cancer, the association of pretreatment NLR values with overall survival (OS) was evaluated using a Cox proportional hazards model and the temporal relationship of longitudinal NLR was assessed using a mixed effects model. RESULTS: Compared to the patients with a low pretreatment NLR value, those with elevated NLR exhibited a statistically significant worse OS with a hazard ratio (HR) of 1.50 (P < 0.0001) after adjusting for age, gender, race, smoking status, drinking status, tumor stage, tumor grade, histology, and treatments. A significant trend of increasing HRs along with increasing NLR values was observed. The increased risk of death conferred by pretreatment NLR values reached a peak level around 2 years after diagnosis. Moreover, in longitudinal analysis, we observed a trend of dramatically increased NLR values in patients who died during follow-up, but stable NLR values in those who were still alive, with a significant interaction of death-alive status with follow-up time (P < 0.0001). CONCLUSIONS: Elevated NLR is a potential biomarker to identify lung cancer patients with poor prognosis and should be validated in a future clinical trial.
PURPOSE: Many studies recently focus on complicated and expensive genomic tests, but the prognostic values of biochemical markers which are easily obtained in clinics are largely overlooked and without further exploration. This study assesses the association of neutrophil-lymphocyte-ratio (NLR) with prognosis of lung cancerpatients. METHODS: In 1032 patients with histologically confirmed lung cancer, the association of pretreatment NLR values with overall survival (OS) was evaluated using a Cox proportional hazards model and the temporal relationship of longitudinal NLR was assessed using a mixed effects model. RESULTS: Compared to the patients with a low pretreatment NLR value, those with elevated NLR exhibited a statistically significant worse OS with a hazard ratio (HR) of 1.50 (P < 0.0001) after adjusting for age, gender, race, smoking status, drinking status, tumor stage, tumor grade, histology, and treatments. A significant trend of increasing HRs along with increasing NLR values was observed. The increased risk of death conferred by pretreatment NLR values reached a peak level around 2 years after diagnosis. Moreover, in longitudinal analysis, we observed a trend of dramatically increased NLR values in patients who died during follow-up, but stable NLR values in those who were still alive, with a significant interaction of death-alive status with follow-up time (P < 0.0001). CONCLUSIONS: Elevated NLR is a potential biomarker to identify lung cancerpatients with poor prognosis and should be validated in a future clinical trial.
Authors: A William Blackstock; James E Herndon; Electra D Paskett; Michael C Perry; Stephen L Graziano; Joseph J Muscato; Michael P Kosty; Wallace L Akerley; Jimmie Holland; Stewart Fleishman; Mark R Green Journal: J Natl Cancer Inst Date: 2002-02-20 Impact factor: 13.506
Authors: A William Blackstock; James E Herndon; Electra D Paskett; Antonius A Miller; Christopher Lathan; Harvey B Niell; Mark A Socinski; Everett E Vokes; Mark R Green Journal: J Clin Oncol Date: 2005-12-19 Impact factor: 44.544
Authors: Irene Orlow; Bernard J Park; Urvi Mujumdar; Himali Patel; Puiki Siu-Lau; Brian A Clas; Robert Downey; Raja Flores; Manjit Bains; Nabil Rizk; Gemma Dominguez; Jen Jani; Marianne Berwick; Colin B Begg; Mark G Kris; Valerie W Rusch Journal: J Clin Oncol Date: 2008-07-20 Impact factor: 44.544
Authors: Devin C Koestler; Carmen J Marsit; Jennifer A Doherty; Laurie Grieshober; Stefan Graw; Matt J Barnett; Mark D Thornquist; Gary E Goodman; Chu Chen Journal: Cancer Prev Res (Phila) Date: 2018-09-25
Authors: Dwight H Owen; Lai Wei; Erin M Bertino; Thomas Edd; Miguel A Villalona-Calero; Kai He; Peter G Shields; David P Carbone; Gregory A Otterson Journal: Clin Lung Cancer Date: 2018-08-22 Impact factor: 4.785