BACKGROUND/OBJECTIVE: Given the poor overall survival (OR) and progression-free survival (PFS) rates for lung cancers managed with surgical resection, there is a need to identify the prognostic markers that would improve the risk stratification of patients with operable lung cancer to inform treatment decisions. We investigate the prognostic utility of two established inflammation-based scores, the neutrophil–lymphocyte ratio (NLR) and the change in neutrophil–lymphocyte ratio (ΔNLR), throughout the operative period in a prospective cohort of patients with lung cancer who underwent surgical resection.
METHODS: Demographic, clinical, and treatment details for 345 patients with lung cancer who underwent surgical resection between 2000 and 2019 at multiple centers across Melbourne, Victoria (Australia), were prospectively collected. Preoperative NLR and ΔNLR were calculated after which Cox univariate and multivariate analyses were conducted for OS and PFS against the known prognostic factors.
RESULTS: Both univariate and multivariate analyses showed that preoperative NLR >4.54, as well as day 1 and day 2 postoperative NLR (P < 0.01), was associated with increased risk for postoperative mortality (hazard ratio 1.8; P < 0.01) and PFS (P < 0.05), whereas ΔNLR was not a significant predictor of OS or PFS.
CONCLUSION: Elevated NLR among patients with lung cancer who underwent surgical resection was prognostic for poor OS and PFS, whereas ΔNLR was not found to be prognostic for either OS or PFS. Further research may yet reveal a prognostic value for ΔNLR when compared across a greater time period.


中文翻译：

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在外科手术切除的肺癌中，基于炎症的生物标记物，中性白细胞与淋巴细胞比例以及中性白细胞与淋巴细胞比例的变化对预后的实用性


背景/目的：鉴于手术切除治疗的肺癌的总体生存率（OR）和无进展生存率（PFS）差，因此有必要确定可改善可手术治疗肺癌患者风险分层的预后标志物告知治疗决策。我们在接受手术切除的肺癌患者的整个手术期间，研究了两个既定的基于炎症的评分，中性粒细胞-淋巴细胞比（NLR）和中性粒细胞-淋巴细胞比（ΔNLR）的变化对预后的实用性。
方法：前瞻性收集了2000年至2019年间在维多利亚州墨尔本（澳大利亚）多个中心接受手术切除的345例肺癌患者的人口统计学，临床和治疗细节。计算术前NLR和ΔNLR，然后针对已知的预后因素对OS和PFS进行Cox单变量和多变量分析。
结果：单因素和多因素分析均显示术前NLR> 4.54以及术后NLR的第1天和第2天（P <0.01）与术后死亡风险增加（危险比1.8; P <0.01）和PFS（P <0.05），而ΔNLR并不是OS或PFS的重要预测指标。
结论：接受手术切除的肺癌患者的NLR升高预示着OS和PFS较差，而ΔNLR则未预示OS或PFS的预后。当在更长的时间段内进行比较时，进一步的研究可能仍会揭示ΔNLR的预后价值。