Preoperative peripheral blood neutrophil-to-lymphocyte ratios (NLR) and platelet-to-lymphocyte ratio (PLR) related nomograms predict the survival of patients with limited-stage small-cell lung cancer

Abstract

Background: We aim to establish neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) related nomograms based on the clinical data and peripheral blood markers to predict the survivals of patients with limited-stage small-cell lung cancer (LS-SCLC).Methods: A total of 299 LS-SCLC patients after surgery were enrolled in this study. Univariate and multivariate analyses were conducted to select independent prognostic factors to develop the nomograms and then subjected to bootstrap internal validation. The optimal cutoff value of NLR and PLR before surgery was calculated by X-tile (version 3.6.1) and the overall survival (OS) was analyzed by Kaplan-Meier method and compared by log-rank test.Results: According to the X-tile calculation, the NLR value and PLR cutoff values are 2.6 and 156.7, respectively. The prognosis of patients with elevated NLR or PLR value was significantly worse than patients with lower NLR (HR =1.798, 95% CI: 1.284-2.518, P=0.001) or PLR (HR =1.781, 95% CI: 1.318-2.407, P<0.001) value. Two Nomograms were developed according to the two multivariate cox regression models based on NLR and PLR. Concordance index (C-index) curves and calibration curves show that the two models have a better effect in predicting prognosis. At the same time, compared with the tumor node metastasis (TNM) staging system, our models also show better accuracy and stability.Conclusions: Elevated NLR and PLR predict poor prognosis in their respective nomograms in patients with LS-SCLC.

Correlation analysis of lymphocyte-monocyte ratio with pathological complete response and clinical prognosis of neoadjuvant chemotherapy in patients with breast cancer

“…In recent decades, studies on the relationship between inflammation and tumor have been more and more extensive, and it has been confirmed that cancer-related inflammation plays a crucial role in tumor growth, invasion and metastasis [4] . Many inflammatory indicators, including NLR, PLR and LMR are prognostic factors for a variety of malignant tumors including breast cancer [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] . Lymphocytes play a crucial role in tumor immunity, such as cytotoxic cell death, tumor cell proliferation and migration's inhibition, etc.…”

“…Among them, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) have been reported as prognostic factors of various cancers [13] , [14] , [15] . Previous studies have found that NLR is not only associated with the prognosis of patients with breast cancer, lung cancer, colorectal cancer, esophageal cancer and cervical cancer [14] , [15] , [16] , [17] , [18] elevated preoperative NLR is also associated with poor prognosis of breast cancer. PLR is considered as a prognostic marker for gastric cancer, ovarian cancer, colorectal cancer, bile duct cancer and other cancers as well[17,19-21].…”

The Addition of Peripheral Blood Inflammatory Indexes to Nomogram Improves the Predictive Accuracy of Survival in Limited-Stage Small Cell Lung Cancer Patients

“…Tumor-associated inflammation was prevalent in malignant tumors and significantly related to tumor progression and patients' outcome. In recent years, several researchers have investigated the serum-derived inflammatory markers in LS-SCLC and suggested that elevated baseline NLR and PLR were indicators of inferior survival, which could serve as specific biological characteristics to improve the prediction accuracy for survival by Nomogram (12,20,21). However, the existence of strong collinearity among selected variables in the multivariate analyses could bring about the opposite signs of the regression coefficient by comparison with the actual situation.…”

“…Elevated platelet counts, neutrophil-to-lymphocyte ratio (NLR), plateletto-lymphocyte ratio (PLR), and systemic inflammation index (SII) have been found to be remarkably correlated with adverse survival of patients in cervical, colorectal, breast, and non-small cell lung cancers (6)(7)(8)(9)(10)(11). However, few studies have investigated the prognostic implications of inflammatory markers among patients diagnosed with LS-SCLC (12). Recently, research has declared that higher NLR and PLR were associated with inferior prognosis and treatment efficacy in non-SCLC patients treated with immune-checkpoint inhibitors (13)(14)(15), which provided insights into whether inflammatory markers were also indicative of the selection of immunotherapy subsets in patients with SCLC, since immunotherapy has also been recommended in SCLC (16).…”

To Explore the Effect of NLR and PLR on Prognosis of Rectal Cancer on the basis of T3 substage, and to draw the related nomogram

“…NLR and PLR were one of the typical representatives of in ammation, and many studies had shown that they were closely related to tumor progression, metastasis and prognosis [4][5][6][7][8]. The association of elevated NLR and PLR with breast, prostate, biliary, gastric, and pancreatic cancers had been reported in recent years [9][10][11][12][13][14]. PD-1 inhibitors were one of the representative agents of in ammation-related immunotherapy and were widely used in the treatment of cancer, The complement and expansion of immunotherapy was also ongoing Exploring the relationship between NLR and PLR and prognosis of rectal cancer was not only a supplement to TNM staging, but also a further exploration of immunotherapy for rectal cancer.…”