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Assessment of Prognostic Value of "Neutrophil to Lymphocyte Ratio" and "Prognostic Nutritional Index" as a Sytemic Inflammatory Marker in Non-small Cell Lung Cancer

  • Kos, Fahriye Tugba (Department of Medical Oncology, Faculty of Medicine, Duzce University) ;
  • Hocazade, Cemil (Department of Medical Oncology, Ankara Numune Education and Research Hospital) ;
  • Kos, Mehmet (Department of Internal Medicine, Faculty of Medicine, Duzce University) ;
  • Uncu, Dogan (Department of Medical Oncology, Ankara Numune Education and Research Hospital) ;
  • Karakas, Esra (Department of Internal Medicine, Ankara Numune Education and Research Hospital) ;
  • Dogan, Mutlu (Department of Medical Oncology, Ankara Numune Education and Research Hospital) ;
  • Uncu, Hikmet Gulsen (Turkish Drug & Medical Device Institution) ;
  • Ozdemir, Nuriye (Department of Medical Oncology, Ankara Numune Education and Research Hospital) ;
  • Zengin, Nurullah (Department of Medical Oncology, Ankara Numune Education and Research Hospital)
  • Published : 2015.05.18

Abstract

Background: Systemic inflammatory response was shown to play an important role in development and progression of many cancer types and different inflammation-based indices were used for determining prognosis. We aimed to investigate the prognostic effects of neutrophil to lymphocyte ratio (NLR) and prognostic nutritional index (PNI) in patients with non-small cell lung cancer (NSCLC). Materials and Methods: NSCLC patients diagnosed in our institution were retrospectively reviewed. Demographic and clinicopathologic characteristics were recorded. NLR and PNI was calculated before the application of any treatment. Results: A total of 138 patients were included in the study. Patients were divided into two groups according to NLR (<3.24 or ${\geq}3.24$) and PNI (<49.5 or ${\geq}49.5$). While median overall survival was 37.0 (95% CI 17.5-56.5) months in the group with low NLR, it was calculated as 10.0 (95%CI 5.0-15.0) months in the group with high NLR (p<0.0001). While median overall survival was 7.0 (95%CI 3.5-10.5) months in the group with low PNI, it was calculated as 33.0 (95% CI 15.5-50.4) months in the group with high PNI (p<0.0001). Stage, NLR and PNI levels were evaluated as independent risk factors for overall survival for all patients in multivariate analysis (p<0.0001, p=0.04 and p<0.001, respectively). Conclusions: NLR (${\geq}3.24$) and PNI (<49.5) at diagnosis is an independent marker of poor outcome in patients with NSCLC. NLR and PNI is an easily measured, reproducible prognostic tests that could be considered in NSCLC patients.

Keywords

Neutrophil;lymphocyte;prognostic nutritional index;lung cancer;prognosis

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