1.Prognostic value of the combined preoperative plasma levels of fibrinogen and lym-phocyte to monocyte ratio (F-LMR) in patients with non-small cell lung cancer
HUANG WUHAO ; ZHANG HUA ; WANG CHANGLI
Chinese Journal of Clinical Oncology 2017;44(17):857-862
Objective:This study aims to evaluate the correlation of combined preoperative plasma levels of fibrinogen (Fbg) and lym-phocyte to monocyte ratio (LMR) (F-LMR) with the prognosis of patients with non-small cell lung cancer (NSCLC) after complete resec-tion. Methods:The clinical data of 589 patients with NSCLC who underwent complete resection in our hospital were retrospectively analyzed. Receiver operating characteristic curve (ROC) analysis was used to select the cut-off values of Fbg and LMR. Based on the cri-teria of F-LMR, we divided the patients into three groups:F-LMR 0 score, F-LMR 1 score, and F-LMR 2 score. The association between F-LMR and the clinicopathological characteristics was analyzed by theχ2 test. Kaplan-Meier analysis was used to analyze the prognostic factors, and the log-rank test was used to determine the differences in survival rates. Prognostic factors were assessed by univariate and multivariate analyses (Cox's proportional hazards regression model). Results:According to the ROC curve, the cut-off values of Fbg and LMR were 3.48 g/L and 3.23, respectively. F-LMR 0 score had n=215, F-LMR 1 score had n=228, and F-LMR 2 score had n=146. Pre-operative F-LMR was closely related to age, gender, smoking history, tumor location, surgical type, pathological stage, pathological type, and tumor size (P<0.05). Univariate analysis showed that tumor location, surgical type, pathological stage, tumor size, F-LMR score, LMR, and Fbg were associated with survival (P<0.05). Multivariate analysis showed that the pathological stage [disease-free sur-vival (DFS): hazard ratio (HR)=1.700, 95%confidence interval (CI)=1.483-1.950, P<0.001;overall survival (OS):HR=1.703, 95%CI=1.486-1.952, P<0.001] and F-LMR score (DFS:HR=1.264, 95%CI=1.077-1.484, P=0.004;OS:HR=1.301, 95%CI=1.107-1.528, P=0.001) were the independent prognostic factors of NSCLC patients. Conclusion:The preoperative F-LMR score may be a useful blood marker for predicting the prognosis of patients with NSCLC with radical resection.
2.The Role of Neutrophil-to-Lymphocyte Ratio in Predicting Pathological Response for Resectable Non–Small Cell Lung Cancer Treated with Neoadjuvant Chemotherapy Combined with PD-1 Checkpoint Inhibitors
Xiaoyan SUN ; Yingnan FENG ; Bin ZHANG ; Wuhao HUANG ; Xiaoliang ZHAO ; Hua ZHANG ; Dongsheng YUE ; Changli WANG
Cancer Research and Treatment 2022;54(4):1017-1029
Purpose:
The aim of our study was to investigate the value of baseline and preoperative neutrophil-to-lymphocyte ratio (NLR) in predicting the pathological response and disease-free survival (DFS) of neoadjuvant chemotherapy alone or combined with programmed cell death-1 (PD-1) checkpoint inhibitors in patients with resectable non‒small cell lung cancer (NSCLC).
Materials and Methods:
Resectable NSCLC patients who underwent neoadjuvant chemotherapy alone or combined with PD-1 checkpoint inhibitors between January 2018 and January 2020 were included. Peripheral venous blood samples of the patients were collected within 3 days prior to the first neoadjuvant treatment and within 3 days prior to surgery.
Results:
A total of 79 patients in neoadjuvant chemotherapy combined with PD-1 checkpoint inhibitors group and 89 patients in neoadjuvant chemotherapy alone group were included. Thirty-five point four percent of the patients achieved pathological complete response (pCR) in neoadjuvant chemotherapy combined with PD-1 checkpoint inhibitors group, whereas only 9.0% reached pCR in the group of neoadjuvant chemotherapy. High NLR level were correlated with poor pathological response and DFS in neoadjuvant chemotherapy or combined with PD-1 checkpoint inhibitors group. Multivariate analysis revealed that baseline NLR could independently predict pathological response and DFS in the neoadjuvant chemotherapy combined with PD-1 checkpoint inhibitors group.
Conclusion
High NLR level were correlated with poor pathological response and shorter DFS in patients with NSCLC undergoing neoadjuvant chemotherapy or combined with PD-1 checkpoint inhibitors. Meanwhile, baseline NLR could independently predict response to pathological response and DFS, revealing its potential as a screening tool in NSCLC patients who received neoadjuvant chemotherapy combined with PD-1 checkpoint inhibitors.