Pretreatment Neutrophil-to-Lymphocyte Ratio,Lymphocyte-to-Monocyte Ratio And Platelet-to-lymphocyte Ratio As Predictive And Prognostic Fators For Advanced Non-small Cell Lung Cancer(NSCLC)

Objective:Accumulating evidence shows that NLR,LMR and PLR levels can reflect the inflammatory levels and is associated with the prognosis of patients with non-small cell lung cancer(NSCLC).This study mainly focuses on the neutrophils/lymphocyte ratio before and after chemotherapy(NLR),lymphocyte/mononuclear ratio(LMR)and platelets/lymphocyte ratio(PLR)to predict prognosis of patients with advanced NSCLC and the curative effect of chemotherapyMethod:177 patients with advanced NSCLC diagnosed from March 2013 to January 2017 were retrospectively reviewed.Prognostic factors such as gender,age,smoking history,pathological pattern,number of metastatic site and pre-and post-chemotherapy neutrophil count,lymphocyte count,mononuclear cell count,platelet count were analyzed.The correlation between the Neutrophil-to-Lymphocyte Ratio(NLR)level,Lymphocyte-to-Mononuclear ratio(LMR)level,Platelets-to-Lymphocyte ratio(PLR)level before chemotherapy and patient clinical characteristics,were analyzed using SPSS software.Univariate and multivariate Cox regression models showed the association between the pre-and post-chemotherapy Neutrophil-to-Lymphocyte Ratio(NLR)level,Lymphocyte-to-Mononuclear ratio(LMR)level,Platelets-to-Lymphocyte ratio(PLR)level and median PFS,the response to chemotherapy.Inspection standard at P < 0.05.Results:The median age of 177 patients was 60,and median PFS was 164 days.Patients were divided into groups according to the median pre-chemotherapy Neutrophil-to-Lymphocyte Ratio(NLR)level,Lymphocyte-to-Mononuclear ratio(LMR)level,Platelets-to-Lymphocyte ratio(PLR)level(NLR = 2.64,LMR= 3.5 and PLR = 161.74),Univariate analysis showed remarkable correlation between pre-chemotherapy NLR and pathological stage(p < 0.001),Pre-chemotherapy LMR levels correlated significantly with gender(p=0.024),smoking history(p=0.030),pathological stage(p=0.002).And Pre-chemotherapy PLR levels correlated with age(p=0.030).Patients who had long median PFS were seen more frequently in low pre—chemotherapy NLR(p<0.001),PLR(p=0.002)and adenocarcinoma group(p=0.001).Multivariate analysis revealed that NLR and pathological pattern were promising biomarkers for evaluating the efficacy of PFS in patients with advanced NSCLC.NLR,PLR and median PFS.After receiving platinum-based first-line chemotherapy in patients with advanced NSCLC,the changes in Neutrophil-to Lymphocyte Ratio(NLR)level before and after two weeks of chemotherapy correlated with PFS(p=0.032),and the changes in pre-and post-chemotherapy Platelets-to-Lymphocyte ratio(PLR)level correlated with PFS(p=0.007).Conclusions:Univariate analysis of the study showed that pre-chemotherapy NLR,PLR and pathological pattern were associated with PFS.Multivariate analysis revealed that elevated pre-chemotherapy NLR was a predictor of shorter survival in patients with advanced NSCLC.In addition,the changes in pre-and post-chemotherapy NLR and PLR correlated with PFS.NLR and PLR were easily measured,reproducible tests that could be considered to be incorporated in the routine practice in advanced non-small cell lung cancer patients.