Predictive Value of Neutrophil-to-Lymphocyte Ratio for the Assessment of Remission in Cushing’s Disease

Abstract

Objective: In recent years neutrophil-to-lymphocyte ratio is defined as one of the new and early prognostic markers for many carcinomas including some types of intracranial tumors. The aim of the present study is to assess the association between preoperative and postoperative neutrophil-to-lymphocyte ratios and remissions in patients with Cushing's disease. Method: The present study was carried out using the data of 162 consecutive patients operated for Cushing's disease by a single surgeon (NG) between 1997 and 2017. Clinical records were analyzed retrospectively. Neutrophil-to-lymphocyte ratios calculated from complete blood counts recorded preoperatively, on postoperative 1 st day and at postoperative 3 rd month in 24 patients in early, and 3 rd month remissions and correlations among them were investigated. Results: A statistically significant difference was observed between preoperative, postoperative 1 st day and postoperative 3 rd month NLRs in patients who were in early stage emission (p=0.001) or not (p=0.002). Any statistically significant difference was not found between patients who were in remission or not at 3 rd months in terms of NLRs measured at different time points. There was a statistically significant difference between preoperative, postoperative first day and postoperative 3 rd month NLRs in patients in remission (p=0.001) or not (p=0.005) during longterm follow-up. No statistically significant difference was found between NLRs measured at different times among those who were remission or not during long-term follow-up. Conclusion: Cushing's disease is a disease directly associated with stress hormones and its effects on NLR is inevitable. New studies with larger patient series will shed light on this issue.