Assessment of Prognostic Value of “Neutrophil to Lymphocyte Ratio” and “Prognostic Nutritional Index” as a Sytemic Inflammatory Marker in Non-small Cell Lung Cancer

Background: Systemic inflammatory response was shown to play an important role in development andprogression of many cancer types and different inflammation-based indices were used for determining prognosis.We aimed to investigate the prognostic effects of neutrophil to lymphocyte ratio (NLR) and prognostic nutritionalindex (PNI) in patients with non-small cell lung cancer (NSCLC). Materials and
Methods: NSCLC patientsdiagnosed in our institution were retrospectively reviewed. Demographic and clinicopathologic characteristicswere recorded. NLR and PNI was calculated before the application of any treatment.
Results: A total of 138patients were included in the study. Patients were divided into two groups according to NLR (<3.24 or ≥3.24)and PNI (<49.5 or ≥49.5). While median overall survival was 37.0 (95% CI 17.5-56.5) months in the group withlow NLR, it was calculated as 10.0 (95%CI 5.0-15.0) months in the group with high NLR (p<0.0001). Whilemedian overall survival was 7.0 (95%CI 3.5-10.5) months in the group with low PNI, it was calculated as 33.0(95% CI 15.5-50.4) months in the group with high PNI (p<0.0001). Stage, NLR and PNI levels were evaluatedas independent risk factors for overall survival for all patients in multivariate analysis (p<0.0001, p=0.04 andp<0.001, respectively).
Conclusions: NLR (≥3.24) and PNI (<49.5) at diagnosis is an independent marker ofpoor outcome in patients with NSCLC. NLR and PNI is an easily measured, reproducible prognostic tests thatcould be considered in NSCLC patients.