Preoperative neutrophil-to-lymphocyte ratio correlates with PD-L1 expression in immune cells of patients with malignant pleural mesothelioma and predicts prognosis

Abstract

We assessed the prognostic value of five complex inflammatory and nutritional parameters, namely neutrophil-to-lymphocyte ratio (NLR), prognostic nutritional index (PNI), C-reactive protein-to-NLR ratio (C/NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) using data from patients with malignant pleural mesothelioma (MPM) undergoing extrapleural pneumonectomy (EPP). Moreover, the correlation between these five parameters and programmed cell death protein 1 ligand-1 (PD-L1) expression in the tumor microenvironment was evaluated. This study included consecutive MPM patients who underwent EPP. The histological subtype of the eligible patients (n = 61) correlated with all five parameters. Moreover, the PD-L1 expression scores for immune cells correlated with NLR and PLR, and the PD-L1 expression scores for both tumor cells and immune cells were inversely correlated with both PNI and LMR. Univariate analysis elucidated that NLR, PNI, and C/NLR were predictors of 5-year overall survival (OS), and multivariate analysis revealed that NLR was an independent predictor of 5-year OS, suggesting that NLR is a preoperative, prognostic factor for patients with MPM who are scheduled for EPP. To the best of our knowledge, this is the first study to evaluate the prognostic potentials of NLR, PNI, C/NLR, PLR, and LMR simultaneously in patients with MPM who underwent EPP.

Nivolumab in pretreated pleural mesothelioma: Results from an observational real-world study of patients treated within the AIFA 5% Fund

“…This finding mirrors the existing literature in which neutrophils to lymphocytes ratio is associated with worse outcomes in PM. 20,21 Interestingly, in our study histology did not prove to be either prognostic or predictive at univariate analysis. This might be explained by the low number of non-epithelioid histology patients enrolled and further investigation regarding the activity of nivolumab in non-epithelioid mesothelioma is warranted.…”

Correlation of Peripheral Blood Inflammatory Indicators to Prognosis After Intravenous Thrombolysis in Acute Ischemic Stroke: A Retrospective Study

“…In a retrospective study, it was found that C-NLR could be used as an important indicator to predict the poor prognosis of patients with malignant pleural mesothelioma undergoing extrapleural pneumonectomy, which has a certain clinical significance. 42 There are also studies that define C-NLR as CRP×neutrophil-to-lymphocyte ratio to predict poor prognosis in patients with heart failure and pancreatic cancer after surgery. 43 , 44 However, studies on the combination of CRP and LMR are relatively lacking, and C-NLR and C-LMR are rarely used in the field of cerebrovascular diseases.…”