Clinical significance of preoperative inflammatory markers in non-small cell lung cancer patients: A multicenter retrospective study

• Published in: PloS one Vol. 15; no. 11; p. e0241580
• Main Authors: Takada, Kazuki, Takamori, Shinkichi, Matsubara, Taichi, Haratake, Naoki, Akamine, Takaki, Kinoshita, Fumihiko, Ono, Yuki, Wakasu, Sho, Tanaka, Kensuke, Oku, Yuka, Oba, Taro, Osoegawa, Atsushi, Tagawa, Tetsuzo, Takenoyama, Mitsuhiro, Shimokawa, Mototsugu, Oda, Yoshinao, Mori, Masaki
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 02.11.2020; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Aged, 80 and over; Apoptosis; Biological markers; Biology and Life Sciences; Biomarkers; Biomarkers - blood; Blood Cell Count; Blood Platelets - immunology; C-Reactive Protein - analysis; Cancer research; Cancer therapies; Carcinoma, Non-Small-Cell Lung - blood; Carcinoma, Non-Small-Cell Lung - immunology; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - surgery; Care and treatment; Cell survival; Chemotherapy; Clinical significance; Correlation; Correlation coefficient; Correlation coefficients; Development and progression; Disease-Free Survival; Evaluation; Female; Hospitals; Humans; Identification and classification; Inflammation; Inflammation - blood; Inflammation - diagnosis; Inflammation - immunology; Japan - epidemiology; L-Lactate dehydrogenase; L-Lactate Dehydrogenase - blood; Lactate dehydrogenase; Lactic acid; Lung cancer; Lung diseases; Lung Neoplasms - blood; Lung Neoplasms - immunology; Lung Neoplasms - mortality; Lung Neoplasms - surgery; Lymphocytes; Lymphocytes - immunology; Male; Mathematical analysis; Medical prognosis; Medical records; Medicine and Health Sciences; Middle Aged; Monocytes; Monocytes - immunology; Neoplasm Staging; Neutrophils; Non-small cell lung cancer; Non-small cell lung carcinoma; Oncology; Patients; Pneumonectomy; Preoperative Period; Prognosis; Regression analysis; Retrospective Studies; Risk Factors; ROC Curve; Serum Albumin, Human - analysis; Small cell lung carcinoma; Smoking; Smoking - blood; Smoking - epidemiology; Smoking - immunology; Squamous cell carcinoma; Surgery; Survival; Variables; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0241580

Inflammatory biomarkers have been associated with clinical outcomes in non-small cell lung cancer (NSCLC). However, the best prognostic marker(s) has not been identified, and the association between inflammatory markers and clinical characteristics is poorly understood. We selected 1,237 patients with resected NSCLC from Kyushu University (2003-2015) and Kyushu Cancer Center (2009-2015) in Japan. Pearson product-moment correlation coefficient among inflammatory markers and area under curve (AUC) of receiver operating characteristic (ROC) curve analyses for overall survival (OS) were calculated. We analyzed the associations between inflammatory markers and clinical factors using Student's t-test. Univariate and multivariate analyses with Cox proportional hazards regression analyses were performed to evaluate the relationship between survival and clinical factors. The cut-off values for neutrophil-lymphocyte ratio (NLR), lymphocyte-monocyte ratio (LMR), platelet-lymphocyte ratio, and derived NLR (dNLR) were determined by ROC curve analyses for OS. We found a strong positive correlation between NLR and dNLR (r = 0.9629). The AUC of LMR was the highest amongst the measured metrics, and the AUC of NLR was higher than dNLR. Levels of some inflammatory markers were associated with sex, smoking, squamous cell carcinoma, and pathological stage. LMR ≥ 5.11 and lactate dehydrogenase (LDH) concentration ≥ 222 (U/L) were independent predictors of both disease-free survival (DFS) and OS (LMR; P = 0.0009 and 0.0008, LDH; P = 0.0195 and 0.0187, respectively). Certain inflammatory markers, potentially linked to smoking, were associated with an advanced pathological stage in NSCLC. LMR and LDH were independent predictors of both DFS and OS.