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Preoperative neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio are correlated with tumor–node–metastasis stages in patients with non-small cell lung cancer

1 Department of Cardiothoracic Surgery, Chengdu Second People's Hospital, Sichuan University, Chengdu, China
2 Department of Oncology, West China Fourth Hospital, Sichuan University, Chengdu, China

Correspondence Address:
Ke Gao,
Department of Cardiothoracic Surgery, Chengdu Second People's Hospital, Chengdu 610017
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jcrt.jcrt_473_21

Background: The aim of this study is to explore the value of neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for predicting the tumor–node–metastasis (TNM) stages in non-small cell lung cancer (NSCLC) patients. METHODS: This retrospective study included 205 NSCLC patients receiving surgical treatment. We used receiver operating curve analysis to confirm the optimal cutoff values of NLR and PLR. RESULTS: The result showed that the thresholds for NLR and PLR were 1.8 and 103.59, respectively. NLR (P = 0.037; relative risk (RR), 3.027; 95% confidence interval (CI): 1.608–8.581) and PLR (P = 0.001; RR, 3.662; 95% CI: 1.342–9.992) were risks factors in predicting advanced TNM stages (Stage III/IV, all P < 0.05). In addition, NLR with T stage- and N stage-dependent increase may be a potential and independent predictive marker for T and N stage (all P < 0.05); the PLR was identified as a marker for T stage (P = 0.028) but not for N stage. Furthermore, we investigated the combination of NLR and PLR (CNP). A risk stratification based on CNP index was carried out as follows: low risk (NLR ≤1.8 and PLR ≤ 103.59), intermediate risk (either NLR >1.8 or PLR > 103.59), and high risk (both NLR >1.8 and PLR >103.59). The probabilities for developing advanced TNM stage were 6.4% for low, 20.4% for intermediate, and 47.1% for high-risk group (P < 0.001). Conclusion: The levels of preoperative NLR and PLR were capable of indicating advanced TNM stages. According to the CNP index, patients were divided into three risk groups with different significance.

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