Metin ÖZKAN, Ersin Özaslan ÖZASLAN, Mevlüde İNANÇ, Ayşe Ocak DURAN, İbrahim İLERİ, Mahmut UÇAR, Oktay BOZKURT

Evre 1–2 Opere Küçük Hücreli Dışı Akciğer Kanseri Hastalarında Nötrofil/Lenfosit ve Platelet/Lenfosit Oranlarının Prognoz ile İlişkisi: Tek Merkez Deneyimi

Amaç: Nötrofil/lenfosit oranı (NLO) ve platelet/lenfosit oranı (PLO) ile çeşitli kanserlerin prognozu arasındaki ilişki gösterilmiştir. Ancak NLO ve PLO'nun küçük hücreli dışı akciğer kanseri (KHDAK) prognozuna etkisi hala tartışmalıdır. Bu çalışmamızın amacı, hastanemizde radikal rezeksiyon uygulanan Evre 1-2 KHDAK hastalarında operasyon öncesi NLO ve PLO'nun prognostik değerini araştırmaktır. Gereç ve Yöntemler: Çalışmaya 2001-2014 yıllarında merkezimizde takip edilen ve radikal rezeksiyon uygulanan 59 Evre 1-2 KHDAK hastası dahil edilmiştir. Hastaların takip dosyaları incelenmiş ve gerekli bilgiler alınmıştır. NLO ve PLO'nun optimal cut-off değeri için receiver operating curve (ROC) analizi kullanılmıştır (NLO için 4,7; PLO için 199). NLO ve PLO'nun genel sağkalım (GSK) ve hastalıksız sağkalım (HSK) üzerine etkisini incelemek için tek değişkenli Kaplan-Meier analizi kullanılmıştır. Bulgular: NLO ve PLO sınıflamaları ile klinik parametreler arasında yaş haricinde herhangi bir ilişki bulunmamıştır. NLO 4,7 olan grupta ise GSK ortanca değeri 38 ay, HSK ortanca değeri 24 ay olarak bulundu (GSK için p=0,031; HSK için p=0,204). PLO 199 olan grupta ise GSK ortanca değeri 37,5 ay, HSK ortanca değeri 31,5 ay olarak bulundu (GSK için p=0,033; HSK için p=0,518). Kaplan-Meier analizine göre NLO

The Relationship between Neutrophil/Lymphocyte and Platelet/Lymphocyte Ratios and Prognosis in Operated Patients with Stage 1–2 Non-small Cell Lung Cancer: A One-Center Experience

Aim: The relationship between neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) and prognosis in various cancers has been demonstrated. However, the effect of NLR and PLR on prognosis in non-small cell lung cancer (NSCLC) remains controversial. In this study, we aimed to investigate the prognostic value of NLR and PLR before surgery in patients with stage 1–2 NSCLC who underwent radical resection in our hospital.Materials and Methods: Fifty-nine patients with stage 1–2 NSCLC who underwent radical resection and were followed up at our center between 2001 and 2014 were included in this study. The follow-up files of the patients were reviewed and the necessary data were obtained. Receiver operating curve (ROC) analysis was used for optimal NLR and PLR cut-off values (4.7 for NLR, 199 for PLR). The Kaplan–Meier univariate analysis was used to examine the effect of NLR and PLR on overall survival (OS) and disease-free survival (DFS). Results: No relationship was found between NLR and PLR classifications and clinical parameters, except for age. In the group with NLR 4.7, the OS median was 38 months and the DFS median 24 months (p=0.031 for OS; p=0.204 for DFS). In the group with PLR 199, the OS median was 37.5 months and the DFS median 31.5 months (p=0.033 for OS; p=0.518 for DFS). According to the Kaplan–Meier analysis, the patients with NLO

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1. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2015. CA Cancer J Clin. 2015;65(1):5–29.
2. Miller KD, Siegel RL, Lin CC ve ark. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin. 2016;66(4):271–89.
3. Otsuka K, Hata A, Takeshita J ve ark. EGFR-TKI rechallenge with bevacizumab in EGFR-mutant nonsmall cell lung cancer. Cancer Chemother Pharmacol. 2015;76(4):835–41.
4. Chansky K, Sculier JP, Crowley JJ, Giroux D, Van Meerbeeck J, Goldstraw P. The International Association for the Study of Lung Cancer Staging Project: prognostic factors and pathologic TNM stage in surgically managed non-small cell lung cancer. J Thorac Oncol. 2009;4(7):792–801.
5. O’Byrne KJ, Gatzemeier U, Bondarenko I ve ark. Molecular biomarkers in non-small-cell lung cancer: a retrospective analysis of data from the phase 3 FLEX study. Lancet Oncol. 2011;12:795–805.
6. Wang J, Kalhor N, Hu J ve ark. Pretreatment neutrophil to lymphocyte ratio is associated with poor survival in patients with stage I-III non-small cell lung cancer. PLoS One. 2016;11(10):e0163397.
7. Cukic V. Neutrophil/Lymphocyte ratio and platelet/ lymphocyte ratio in patients with NSCLC. Mater Sociomed. 2016;28(5):378–81.
8. Deng M, Ma X, Liang X, Zhu C, Wang M. Are pretreatment neutrophil-lymphocyte ratio and plateletlymphocyte ratio useful in predicting the outcomes of patients with small-cell lung cancer? Oncotarget. 2017;8(23):37200–7.
9. Wu Y, Chen Y, Yang X, Chen L, Yang Y. Neutrophil-tolymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were associated with disease activity in patients with systemic lupus erythematosus. Int Immunopharmacol. 2016;36:94–9.
10. Stotz M, Pichler M, Absenger G ve ark. The preoperative lymphocyte to monocyte ratio predicts clinical outcome in patients with stage III colon cancer. Br J Cancer. 2014;110(2):435–40.
11. Sonpavde G, Pond GR, Armstrong AJ ve ark. Prognostic impact of the neutrophil-to-lymphocyte ratio in men with metastatic castration-resistant prostate cancer. Clin Genitourin Cancer. 2014;12(5):317–24.
12. Yang JJ, Hu ZG, Shi WX, Deng T, He SQ, Yuan SG. Prognostic significance of neutrophil to lymphocyte ratio in pancreatic cancer: a meta-analysis. World J Gastroenterol. 2015;21(9):2807–15.
13. Jiang R, Zou X, Hu W ve ark. The elevated pretreatment platelet-to-lymphocyte ratio predicts poor outcome in nasopharyngeal carcinoma patients. Tumour Biol. 2015;36(10):7775–87.
14. Zhao QT, Yuan Z, Zhang H ve ark. Prognostic role of platelet to lymphocyte ratio in non-small cell lung cancers: a metaanalysis including 3,720 patients. Int J Cancer. 2016;139(1):164–70.
15. Unal D, Eroglu C, Kurtul N, Oguz A, Tasdemir A. Are neutrophil/lymphocyte and platelet/lymphocyte rates in patients with non-small cell lung cancer associated with treatment response and prognosis? Asian Pac J Cancer Prev. 2013;14(9):5237–42.
16. Pinato DJ, Mauri FA, Ramakrishnan R, Wahab L, Lloyd T, Sharma R. Inflammation-based prognostic indices in malignant pleural mesothelioma. J Thorac Oncol. 2012;7(3):587–94.
17. Coussens LM, Werb Z. Inflammation and cancer. Nature. 2002;420(6917):860–7.
18. Kemal Y, Yucel I, Ekiz K, Demirag G. Elevated serum neutrophil to lymphocyte and platelet to lymphocyte ratios could be useful in lung cancer diagnosis. Asian Pac J Cancer Prev. 2014;15(6):2651–4.
19. Wu G, Yao Y, Bai C, Zeng J. Combination of platelet to lymphocyte ratio and neutrophil to lymphocyte ratio is a useful prognostic factor in advanced non-small cell lung cancer patients. Thorac Cancer. 2015;6(3):275–87.
20. Hua Z, Liuwei G, Bin Z, Lianmin Z. Prognostic value of platelet to lymphocyte ratio in non-small cell lung cancer: a systematic review and meta-analysis. Sci Rep. 2016;6:22618.
21. Sarraf KM, Belcher E, Raevsky E, Nicholson AG, Goldstraw P, Lim E. Neutrophil/lymphocyte ratio and its association with survival after complete resection in non-small cell lung cancer. J Thorac Cardiovasc Surg. 2009;137(2):425–8.
22. Pinato DJ, Shiner RJ, Seckl MJ, Stebbing J, Sharma R, Mauri FA. Prognostic performance of inflammationbased prognostic indices in primary operable non-small cell lung cancer. Br J Cancer. 2014;110(8):1930–5.
23. Aerts JG, Hegmans JP. Tumor-specific cytotoxic T cells are crucial for efficacy of immunomodulatory antibodies in patients with lung cancer. Cancer Res. 2013;73(8):2381–8.
24. Kaneko M, Nozawa H, Sasaki K ve ark. Elevated neutrophil to lymphocyte ratio predicts poor prognosis in advanced colorectal cancer patients receiving oxaliplatin-based chemotherapy. Oncology. 2012;82(5):261–8.
25. Teramukai S, Kitano T, Kishida Y ve ark. Pretreatment neutrophil count as an independent prognostic factor in advanced non-small-cell lung cancer: an analysis of Japan Multinational Trial Organisation LC00-03. Eur J Cancer. 2009;45(11):1950–8.
26. Grange JM, Krone B, Mastrangelo G. Infection, inflammation and cancer. Int J Cancer. 2011;128(9):2240–1.
27. Moore MM, Chua W, Charles KA, Clarke SJ. Inflammation and cancer: causes and consequences. Clin Pharmacol Ther. 2010;87(4):504–8.
28. Li X, Han Z, Cheng Z ve ark. Preoperative neutrophil-tolymphocyte ratio is a predictor of recurrence following thermal ablation for recurrent hepatocellular carcinoma: a retrospective analysis. PLoS One. 2014;9(10):e110546.
29. Lan H, Zhou L, Chi D ve ark. Preoperative platelet to lymphocyte and neutrophil to lymphocyte ratios are independent prognostic factors for patients undergoing lung cancer radical surgery: a single institutional cohort study. Oncotarget. 2017 May 23;8(21):35301–10.
30. Franco AT, Corken A, Ware J. Platelets at the interfa ce of thrombosis, inflammation, and cancer. Blood. 2015;126(5):582–8.
31. Zhou X, Du Y, Huang Z ve ark. Prognostic value of PLR in various cancers: a meta-analysis. PLoS One. 2014;9(6):e101119.
32. Goubran HA, Burnouf T, Radosevic M, El-Ekiaby M. The platelet-cancer loop. Eur J Intern Med. 2013;24(5):393– 400.
33. Gay LJ, Felding-Habermann B. Contribution of platelets to tumour metastasis. Nat Rev Cancer. 2011;11(2):123– 34.