The Pre-and Post-operative Neutrophil-to-lymphocyte Ratio And Changes In This Ratio Predict Survival After The Complete Resection Of Non-small Cell Lung Cancer

BackgroundAccording to the 2012 Global Cancer Statistics,lung cancer is the highest incidence of malignant tumors in the world,including non-small cell lung cancer(NSCLC)accounts for about 80%,a serious threat to human life.With the continuous development of medical knowledge and the improvement of medical treatment,surgical treatment,radiotherapy,chemotherapy and other treatments have been effective in prolonging the survival time of patients with lung cancer,but the prognosis is still not optimistic.It is of great clinical significance to improve the 5-year survival rate of patients with lung cancer,to find and evaluate the effective prognostic factors of patients with lung cancer.It is helpful to screen out the high risk patients,and to provide the auxiliary treatment。Objective In recent years,more and more studies have found that the occurrence anddevelopment of tumor is closely related with inflammatory factors.The neutrophil-lymphocyte ratio was found related with a variety of tumors,includinglung cancer,gastric cancer,liver cancer and colorectal cancer.At present,however,most studies focus on the relationship between NLR and prognosis of lung cancer before surgery,but less attention is paid to the relationship between the postoperative NLR,and prognosis.The purpose of this study was to evaluate the relationship between the preoperative and postoperative NLR,its changes and prognosis in patients with NSCLC,and to explore its clinical value.MethodIn this retrospective study,the data from 87 patients with NSCLC were collected.The association between the preoperative,postoperative Neutrophil-to-Lymphocyte Ratio(NLR),its changes,patient clinical characteristics and the prognosis,were analyzed using SPSS software.ResultSmoking habit,Surgical procedures,TNM staging,and the number of positive lymph nodes were the clinical indicators of prognosis。As for inflammation related indicators preoperative NLR levels(χ2=4.663,P=0.031),post-operative NLR levels(χ2=23.248,P=0.001)、the changes of NLR(χ2=20.801,P<0.001)and NLR change rate(χ2=10.936,P=0.001)are also prognosis index for NSCLC.Multivariate analysis revealed that a higher changes of NLR(the cut-off point:0.27)and the number of positive lymph nodes were associated with a worse prognosis.ConclusionOur study confirmed that not only NLR before operation were independent predictors of the prognosis of completely surgery NSCLC patients,the postoperative NLR and its changes are also independent predictors for disease free survival(DFS)and overall survival(OS).The postoperative NLR and its changes are better independent predictors than preoperative NLR.NLR only need to get the routine blood test results,and each patient after admission have to do blood examination.It is a simple,cheap and fast evaluation index.In the future work,patients can be divided into high and low risk groups according to the NLR parameters,and then give the best treatment for patients with NSCLC.