Current Thoracic Surgery 2020 , Vol 5 , Issue 3
Changes in neutrophil to lymphocyte ratio after non-small cell lung cancer resection: a retrospective cohort study
Armagan Hazar1,Serda Kanbur Metin2
1Department of Chest Diseases, Health of Science University Sureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, İstanbul, Turkey
2Department of Thoracic Surgery, Health of Science University Sureyyapasa Chest Diseases and Thoracic Surgery Teaching and Research Hospital, İstanbul, Turkey
DOI : 10.26663/cts.2020.00023 Viewed : 544 - Downloaded : 187 Background: Increasing neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) define and grade systemic inflammation in lung cancer patients. We hypothesized a decrease in NLR and PLR after tumor resection, and their potential prognostic value in follow-up.

Materials and Methods: Adult patients diagnosed previously (and/or histopathologically after lung surgery) with NSCLC were enrolled from the1st January 2016 to 1st January 2018. Patients were grouped according to tumor size (≥ 5 cm and < 5 cm) and sub-grouped by gender and type of surgery (lobectomy and pneumonectomy). Patient information was recorded from the hospital database and included age, gender, hemogram and blood biochemistry values, results, and before and after lung resection. Total leukocyte count, neutrophil count, NLR, PLR, PLT/MPV, and C-reactive protein (CRP) were recorded and calculated. Mortality was recorded during the follow-up period.

Results: Among the 314 included patients (56, 18% female, mean age 60 years, SD=11) pneumonectomy and lobectomy numbers were 56 (18%) and 258 (82%), respectively, and 92 (29%) patients had larger tumors and 222 (71%) had smaller tumors NLR, PLR and CRP median values immediately before and after tumor resection were 17.08 vs. 10.03, P < 0.001, 315.61 vs. 215.10, P < 0.001, and 9.0 vs. 9.5, P = 0.10, respectively. Median follow-up was 300 days (IQR 198-381), and 36 (11.5%) patients died. Cox regression showed that a post-operative NLR ≥ 12.0 was a significant prognostic indicator (HR: 2.09, CI 95% [1.08-4.06], and P = 0.029).

Conclusions: NLR >12 after lung resection may be an important prognostic value for six-month mortality. NLR and PLR may be useful biomarkers in NSCLC immediately post-surgery and for long-term follow-up. Keywords : lung cancer, neutrophil, lymphocyte, biomarkers, thoracic surgery