Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio help identify patients with lung cancer, but do not differentiate between lung cancer subtypes

Nikolić, Igor and Kukulj, Suzana and Samaržija, Miroslav and Jeleč, Vjekoslav and Žarak, Marko and Orehovec, Biserka and Taradi, Ida and Romić, Dominik and Kolak, Toni and Patrlj, Leonardo (2016) Neutrophil-to-lymphocyte and platelet-to-lymphocyte ratio help identify patients with lung cancer, but do not differentiate between lung cancer subtypes. Croatian Medical Journal, 57 (3). pp. 287-292. ISSN 0353-9504

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Abstract

AIM: To assess the diagnostic value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in lung cancer (LC). We compared the ratios between healthy participants and all LC patients, as well patients with different pathohistological LC subtypes. ----- METHODS: We retrieved the data on neutrophil, lymphocyte, and platelet levels in 449 patients with different pathohistological LC subtypes (non-small cell LC, small-cell LC, atypical or metastatic LC, neuroendocrine, and sarcomatoid carcinoma) and 47 healthy controls. NLR and PLR were calculated by dividing the absolute number of neutrophils or platelets with the absolute number of lymphocytes. ----- RESULTS: There were significant differences in both NLR and PLR (P<0.001) between all LC patients and the control group, but there were no differences between patients with different LC subtypes. Reciever operating characteristics analysis for NLR showed the optimal cut-off value of 2.71, with a sensitivity of 77.05% and specificity of 87.23%. The optimal cut-off value for PLR was 182.31, with a sensitivity of 51.09% and specificity of 91.49%. ----- CONCLUSION: The results showed that the NLR and PLR may have added value in the early diagnosis of LC, but further research is needed to confirm these results.

Abstract in Croatian

Omjer neutrofila i limfocita te omjer trombocita i limfocita mogu pomoći u identifikaciji pacijenta s rakom pluća, ali ne i u razlikovanju različitih podtipova tumora ----- Cilj: Odrediti dijagnostičku vrijednost omjera neutrofila i limfocita (prema engl. neutrophil-to-lymphocyte ratio, NLR) i omjera trombocita i limfocita (prema engl. platelet-to-lymphocyte ratio, PLR) za otkrivanje raka pluća. Usporedili smo omjere između zdravih ispitanika i pacijenata s rakom pluća, kao i između pacijenata s različitim patohistološkim podtipovima raka pluća. ----- Postupci: Prikupili smo podatke o razinama neutrofila, limfocita i trombocita kod 449 pacijenata s različitim patohistološkim podtipovima raka pluća (rak pluća ne-malih stanica, rak pluća malih stanica, atipični ili metastatski rak pluća, neuroendokrini, i sarkomatoidni rak) i 47 zdravih kontrolnih ispitanika. Izračunali smo NLR i PLR tako što smo podijelili apsolutni broj neutrofila ili trombocita s apsolutnim brojem limfocita. ----- Rezultati: Pronašli smo značajne razlike kako u NLR tako i u PLR (P< 0,001) između svih pacijenata s rakom pluća i kontrolnih ispitanika, no nismo našli razlike između pacijenata s različitim patohistološkim podtipovima raka pluća. Analiza krivulje osjetljivosti (prema engl. receiver operating characteristics curve, ROC curve) za NLR pokazala je da je optimalna granična vrijednost 2,71, s osjetljivošću od 77,05% i specifičnošću od 87,23%. Optimalna granična vrijednost za PLR bila je 182,31, s osjetljivošću od 51,09% i specifičnošću od 91,49%. ----- Zaključak: Pokazali smo da NLR i PLR mogu poslužiti kao dodatni parametar u ranoj dijagnozi raka pluća, no ovakve rezultate potrebno je potvrditi daljnjim istraživanjima.

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