| PurposeLung cancer is the malignant tumor with the highest morbidity and mortality in the world,among which non-small cell lung cancer(NSCLC)accounts for about 85%,and most patients are already in the advanced stage when diagnosed.Inflammation plays an important role in the occurrence,development and metastasis of malignant tumors.Previous results regarding the prognostic value of the neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)and lymphocyte to white blood cell ratio(LWR)in advanced NSCLC have been described.The relationship between pretreatment complete blood parameters and curatively resected NSCLC patients has also been studied,but the association between pretreatment complete blood cell parameters and prognosis of advanced NSCLC patients has yet to be identified.The object of the present study was to assess the pretreatment complete blood cell parameters in patients with advanced NSCLC.MethodA retrospective analysis was performed on 268 patients with advanced NSCLC admitted to the affiliated hospital of Qingdao university on January 1,2009 to December 31,2015.The basic clinical characteristics and laboratory data of patients were obtained through a computerized medical record system.Complete blood cell data,including neutrophil count,lymphocyte count,platelet count and monocyte count,were collected in the week prior to treatment.Gender,age,smoking history,pathological type,PS score and staging of the patients were also collected.The ratios of neutrophil to white blood cell ratio(NWR),NLR,platelet to white blood cell ratio(PWR),PLR,monocyte to white blood cell ratio(MWR),monocyte to lymphocyte ratio(MLR)and LWR were calculated.Receiver operating curves(ROCs)was used to determine the optimal cut off values of the NWR,NLR,PWR,PLR,MWR,MLR and LWR.The response evaluation criteria in solid tumors(RECIST)were used to evaluate the efficacy of tumor treatment.SPSS 20.0 was used for statistical analysis.Kaplan Meier was used to build the survival curve.Using Cox proportional hazards regression model for univariate and multivariate analysis to evaluate the relationship between complete blood cell parameters of advanced NSCLC patients prior to treatment and progressive free survival(PFS)and overall survival(OS).The X~2 test was used to evaluate the differences between complete blood cell parameters and clinical characteristics.ResultAccording to the ROCs,the optimal thresholds were determined as NWR:0.67,NLR:2.85,PWR:37.23,PLR:166.56,MWR:0.074,MLR:0.31,LWR:0.24.Each parameter is divided into two groups according to the cut off value.Univariate analysis revealed that sex(P=0.038),histological type(P<0.0001),NWR(P=0.026),NLR(P=0.044),and MLR(P=0.012)were all associated with PFS,whereas histological type(P=0.003),NWR(P=0.003),NLR(P=0.015),MLR(P=0.006),and LWR(P=0.043)were significantly correlated with OS in patients with advanced NSCLC.Multivariate analysis revealed that histological type(P=0.002)was an independent prognostic factor for PFS in patients with advanced NSCLC.Whereas histological type(P=0.005),NWR(P=0.005),NLR(P=0.014),MLR(P=0.006),and LWR(P=0.034)were independent prognostic factors for OS.Both PFS(P<0.0001)and OS(P=0.002),the prognosis of adenocarcinoma patients is better than that of squamous cell carcinoma patients.Adenocarcinoma patients in the lower NWR,NLR,MLR and higher LWR groups had better OS.There were gender differences of patients in the NLR and MLR groups,while there were differences in PS score of patients in the LWR group.ConclusionTaken together,this study concluded that histological type is an independent prognostic factor for PFS in advanced NSCLC patients,and that histological type,NWR,NLR,MLR,and LWR are independent prognostic factors for OS in advanced NSCLC patients. |
PDF Full Text Request