Clinical impact of neutrophil-to-lymphocyte ratios in the blood and bronchoalveolar lavage fluid in patients with lung cancer
HS. Nam*a (Prof), WK. Ryua (Dr), H. Chaa (Dr), Y. Moona (Prof), C. Kimb (Prof)
a Inha University Hospital, Incheon, KOREA, REPUBLIC OF ; b Jeju National University Hospital, Jeju, KOREA, REPUBLIC OF
The cumulative results indicate that the neutrophil-to-lymphocyte ratio of peripheral blood (pbNLR) is a cost-effective and useful prognostic factor in patients with various cancers, including lung cancer. Bronchoalveolar lavage (BAL) is a common, easily and safely performed diagnostic/therapeutic procedure for all lung disease patients. Furthermore, the BAL fluid of patients with lung cancer is in direct contact with the lung tumor, in contrast to peripheral blood. However, no study has reported on the clinical utility of the NLR of BAL fluid (bNLR) for patients with lung cancer. To investigate the clinical utility of the bNLR as a prognostic factor in patients with lung cancer, we conducted a retrospective review of the prospectively collected data.
A total of 48 patients were classified into high bNLR (n=31) and low bNLR (n=17) groups. A high pbNLR and high bNLR were associated with a shorter overall survival (p < 0.001 and p=0.020, respectively). Moreover, the results of survival analysis according to the combination score that encompasses the bNLR and the pbNLR show that an increment in the combination score was associated with a shorter overall survival (p < 0.001). A multivariable analysis confirmed that TNM stage (p=0.002), pbNLR (p=0.009), bNLR (p=0.008), and C-reactive protein (p=0.029) were independent predictors of overall survival. Similar to the pbNLR, a high bNLR value was associated with a poor prognosis in patients with lung cancer. Although further studies are required to apply our results clinically, this is the first study to show the clinical value of the bNLR in patients with lung cancer.
Disclosure of funding source(s): none