Prognostic impact of a new score using neutrophil-to-lymphocyte ratios in the serum and malignant pleural effusion in lung cancer patients

Abstract

AbstractsBackgroundsVarious studies have reported that the neutrophil-to-lymphocyte ratio in the serum (sNLR) may serve as a cost-effective and useful prognostic factor in patients with various cancer types. However, no study has reported the prognostic impact of the NLR in malignant pleural effusion (MPE). To address this gap, we investigated the clinical impact of NLR as a prognostic factor in MPE (mNLR) and a new scoring system that use NLRs in the serum and MPE (smNLR score) in lung cancer patients.MethodsWe retrospectively reviewed all of the patients who were diagnosed with lung cancer and who presented with pleural effusion. To maintain the quality of the study, only patients with malignant cells in the pleural fluid or tissue were included. The patients were classified into three smNLR score groups, and clinical variables were investigated for their correlation with survival.ResultsIn all, 158 patients were classified into three smNLR score groups as follows: 84 (53.2%) had a score of 0, 58 (36.7%) had a score of 1, and 16 (10.1%) had a score of 2. In a univariate analysis, high sNLR, mNLR, and increments of the smNLR score were associated with shorter overall survival (p < 0.001, p = 0.004, and p < 0.001, respectively); moreover, age, Eastern Cooperative Oncology Group performance status (ECOG PS), histology, M stage, hemoglobin level, albumin level, and calcium level were significant prognostic factors. A multivariable analysis confirmed that ECOG PS (p < 0.001), histology (p = 0.001), and smNLR score (p < 0.012) were independent predictors of overall survival.ConclusionsThe new smNLR score is a useful and cost-effective prognostic factor in lung cancer patients with MPE. Although further studies are required to generalize our results, this information will benefit clinicians and patients in determining the most appropriate therapy for patients with MPE.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-017-3550-8) contains supplementary material, which is available to authorized users.

Prognostic Immune Cell Profiling of Malignant Pleural Effusion Patients by Computerized Immunohistochemical and Transcriptional Analysis

“…In addition to histopathological parameters, other factors such as peripheral blood immune cell composition also correlated survival of MPE patients (e.g., "N", the serum neutrophils to lymphocytes ratio as part of the LENT scoring system) [2,11]. Furthermore, in the microenvironment of solid tumors, the immune score-which is based on the immune cell type, density, and location of where lymphocytes infiltrate-is a novel prognostic factor [12,13].…”

ERS/EACTS statement on the management of malignant pleural effusions

“…Lymphocytes, however, are fundamental to immune-mediated cancer control and low counts result in less effective tumour destruction and worse survival [151][152][153]. The NLR combines these two variables to provide a simple prognostic value that has been shown to be accurate in many cancers [41,145,[154][155][156][157][158][159][160].…”

Neutrophil, Platelets, and Eosinophil to Lymphocyte Ratios Predict Gleason Score Upgrading in Low-Risk Prostate Cancer Patients

“…Neutrophil-to-lymphocyte ratio (NLR) has been proposed as an indicator of cancer-related inflammation and unfavorable prognosis in several types of cancer [16,17]. In PCa, higher NLR was associated with disease aggressiveness in metastatic patients.…”