Correlation Between Neutrophil To Lymphocyte Ratio,Prognostic Nutritional Index And The Prognosis Of Advanced Non-small Cell Lung Cancer Patients

Objective1.To analyze the correlation between the neutrophil-lymphocyte ratio(NLR),prognostic nutritional index(PNI)and the clinical-pathological characteristics of nonsmall cell lung cancer(NSCLC)patients such as gender,age,smoking history,pathological type and the number of metastases.2.To investigate the correlation between the neutrophil-lymphocyte ratio(NLR),prognostic nutritional index(PNI)and the prognosis of patients with non-small cell lung cancer(NSCLC).MethodsA retrospective study on 109 stage III B or IV non-small cell lung cancer patients was conducted in the record room of the first Affiliated Hospital of Anhui Medical University between January 2010 and January 2013.A follow-up study on all the patients was conducted until December 31,2015.The age of the patients was over 18 years old.All the patients were diagnosed of non-small cell lung cancer by cytology or histopathology.All the patients were confirmed to have no contraindications of chemotherapy by performing physical examination,routine analysis of blood,urinalysis,electrocardiogram examination a week before receiving treatment.To verify that there are measurable objective indicators for treatment evaluation,all of them had chest CT,head MRI,bone ECT,abdominal B ultrasound within half a month of treatment.According to the neutrophil-lymphocyte ratio and prognostic nutritional index before the first chemotherapy,these patients were divided the into low neutrophil-lymphocyte ratio(<2.97)group,high neutrophil-lymphocyte ratio(≥2.97)group,low prognostic nutritional index(<45.95)group,high prognostic nutritional index(≥45.95)group.Results were analyzed with SPSS 20.0 software to investigate the relationship between potential prognostic factor such as neutrophil-lymphocyte ratio,prognostic nutritional index,age,gender,pathological type,chemotherapy regimens and the prognosis of patients.Results1.The neutrophil-lymphocyte ratio is not related to gender(P=0.096),age(P=0.760),pathological type(P=0.249),TNM stage(P=0.126)but is significantly related to smoking history,tumor metastasis.High prognostic nutritional index lies with male patients(P=0.027)having no history of smoking(P=0.010)and with a good PS score(P=0.010).2.A multivariate analysis demonstrates that the neutrophillymphocyte ratio(progression free survival,P=0.015;overall survival,P=0.01),prognostic nutritional index(progression free survival,P=0.012;overall survival,P=0.006),age(progression free survival,P<0.001;overall survival,P<0.001)and the number of chemotherapy(progression free survival,P<0.001;overall survival,P<0.001)are independent prognosis factors influencing non-small cell lung cancer.Neutrophil-lymphocyte ratio ≥2.97 and/or prognostic nutritional index<45.95 indicates progression free survival or shorter overall survival.ConclusionsNeutrophil-lymphocyte ratio and prognostic nutritional index,as two simple,convenient and repeatable testing methods,can serve as the testing index of chemotherapy effect and prognosis of non-small cell lung cancer.Higher neutrophil-lymphocyte ratio and lower prognostic nutritional index indicates poor prognosis.