Assessment of prognostic value of "neutrophil to lymphocyte ratio" and "prognostic nutritional index" as a sytemic inflammatory marker in non-small cell lung cancer

Creative Commons License

Kos F. T., Hocazade C., Kos M., Uncu D., Karakas E., Dogan M., ...More

Asian Pacific Journal of Cancer Prevention, vol.16, no.9, pp.3997-4002, 2015 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 16 Issue: 9
  • Publication Date: 2015
  • Doi Number: 10.7314/apjcp.2015.16.9.3997
  • Journal Name: Asian Pacific Journal of Cancer Prevention
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.3997-4002
  • Keywords: Lung cancer, Lymphocyte, Neutrophil, Prognosis, Prognostic nutritional index
  • Lokman Hekim University Affiliated: No


Background: Systemic inflammatory response was shown to play an important role in development and progression 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 nutritional index (PNI) in patients with non-small cell lung cancer (NSCLC). Materials and Methods: NSCLC patients diagnosed in our institution were retrospectively reviewed. Demographic and clinicopathologic characteristics were recorded. NLR and PNI was calculated before the application of any treatment. Results: A total of 138 patients 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 with low NLR, it was calculated as 10.0 (95%CI 5.0-15.0) months in the group with high NLR (p<0.0001). While median 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 evaluated as independent risk factors for overall survival for all patients in multivariate analysis (p<0.0001, p=0.04 and p<0.001, respectively). Conclusions: NLR (≥3.24) and PNI (<49.5) at diagnosis is an independent marker of poor outcome in patients with NSCLC. NLR and PNI is an easily measured, reproducible prognostic tests that could be considered in NSCLC patients.