| ObjectiveAccording to previous studies,tumor-related systemic inflammation plays an important role in predicting the changes of disease and survival time of cancer patients.The purpose of this study was to investigate the preoperative ratio of neutrophil count to lymphocyte count(NLR),lymphocyte count to monocyte count(LMR),platelet count to lymphocyte count(PLR),and the value of combination of LMR and PLR(LMR-PLR)in predicting survival of patients with non-small cell lung cancer(NSCLC).MethodsFrom Mar 2009 to Mar 2010,43 patients who underwent pneumonectomy in our hospital with complete follow-up data were confirmed as NSCLC by cytology or histopathology.Clinical data and inflammatory factors(neutrophil count,lymphocyte count,platelet count,monocyte count,white blood cell count),platelet count and alkali count in peripheral blood about one week before operation were collected.Sexual phosphatase(U/L),hemoglobin(g/L),surgical pathological data(tissue type,location,differentiation degree,lymph node metastasis,etc.)were used to analyze the clinical characteristics and the correlation between inflammatory factors and survival of patients.The cut-off values of ROC curve,NLR,LMR and PLR sum were 2.40,3.73 and 190.62,respectively,and those of laboratory test indicators.We divided the patients into three groups according to their LMR and PLR status and defined them with different scores:LMR-PLR 0(LMR ≤ 3.73 and PLR > 190.62),LMR-PLR 1(LMR > 3.73 or PLR≤190.62),LMR-PLR 2(LMR > 3.73 and PLR ≤190.62).χ2test was used to analyze the relationship between the above four indexes and the clinicopathological parameters of the patients,and Kruskal-Wallis test was used to analyze the correlation between laboratory test indicators.The relationship between the above four indexes and the five-year overall survival(OS)and disease-free survival(DFS)was analyzed by Kaplan-Meier curve method.The log-rank method was used to test the difference.Univariate and multivariate Cox proportional risk models were used to evaluate prognostic indicators,and odds ratio(OR)and 95% confidence interval(95% CI)were used to represent the corresponding influencing factors.ResultsThe 5-year OS survival rate was 53.8% in the high LMR group and 23.5% in the low LMR group(P=0.011).The 5-year OS survival rate of high PLR group was 26.9%,while that of low PLR group was 64.7%.The difference was significant(P=0.005).The 5-year OS survival rate was 30.3% in the high NLR group and 80.0% in the low NLR group(P=0.011).LMR-PLR = 0,11 cases(26%),LMR-PLR = 1,2 cases(5%)and LMR-PLR =2,30 cases(69%).The 5-year OS rate of LMR-PLR for LMR-PLR = 2,LMR-PLR = 1 and LMR-PLR = 0 was 50.0%,43.3%,and 36.4%,respectively(P< 0.05).The median survival time was 56 months,50 months and 47.5 months respectively(P < 0.05).The difference was statistically significant(P < 0.05).Preoperative LMR-PLR was closely related to NLR,LMR,neutrophil ratio,and survival time(P < 0.05).Preoperative LMR-PLR was closely related to NLR,LMR,cell type,neutrophil ratio,survival rate,tumor differentiation,pathological stage and tumor size(P < 0.05).Preoperative NLR was correlated with PLR,neutrophil ratio,white blood cell count,lymphocyte ratio,platelet count and survival time(P < 0.05).Preoperative LMR was correlated with NLR,PLR,neutrophil ratio,lymphocyte ratio,white blood cell count,platelet count and survival time(P < 0.05).Preoperative PLR was significantly correlated with NLR,LMR,the neutrophil ratio,lymphocyte rate,white blood cell count,platelet count and survival time(P< 0.05),the difference was statistically significant.Univariate analysis showed that LMR,tumor location,neutrophil ratio,type of surgical resection,platelet count,pathological stage,LMR-PLR score,NLR,PLR,neutrophil ratio,monocyte ratio and white blood cell count were risk factors for overall survival(OS)and disease-free survival(DFS)in NSCLC patients(P < 0.05).Multivariate analysis showed that LMR,PLR,WBC count,monocyte ratio and LMR-PLR score were independent prognostic factors for DFS and OS in NSCLC patients.Subgroup analysis of pathological stages showed that LMR-PLR score was closely related to DFS and OS in NSCLC patients with pathological stage Ⅱ,and the difference was statistically significant.ConclusionPreoperative LMR,PLR and LMR-PLR scores can be used as prognostic indicators for patients with radical resection of early non-small cell lung cancer. |
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