The significance of hemogram parameters for diagnosis, prognosis and treatment of lung cancer

INTRODUCTION AND AIM: Lung cancer is one of the disease that cause high rate of mobidity and mortality worldwide. Despite surgery, chemotherapy and targeted therapies, five-year survival rates are low. Staging at the time of diagnosis and choosing appropriate treatment is one of the main factors that can improve prognosis. Prognosis of the disease affects the treatment regimen and duration so there is a need for a new predictor of prognosis. Studies shows that systemic inflammatory response has an important role in the etiopathogenesis of cancer. It is thought that the deterioration in systemic inflammatory balance may accelerate the oncologic process and worsen the prognosis. We aimed to investigate the relationship between neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR) and platelet/lymphocyte ratio (PLR) with survival and mortality. MATERIALS AND METHODS: This retrospective study was conducted between January 2016 and June 2019 at Sakarya University Training and Research Hospital after obtaining the approval of the ethics. The patients who has diagnosed lung cancer and followed by the Oncology Clinic of Sakarya University Training and Research Hospital were included in the study. Neutrophil/lymphocyte ratio (NLR), lymphocyte/monocyte ratio (LMR), thrombocyte/neutrophil ratio (PLR) were calculated by recording of absolute neutrophil, absolute lymphocyte, absolute monocyte and platelet values from the complete blood count at the time of diagnosis. The cut-off values were determined as 5.28 for NLR, 2.07 for LMR and 150 for PLR. These values were compared with overall survival of patients. RESULTS: Total of 309 patinents, 209 (%90,3) male and 30 (%9,7) female were included the study. The mean age was 63,9±9,6 (age range: 30-89). Smoking rate was %93,2 (n: 288). At the time of diagnosis, 7.8% of the cases were stage-1 (n: 24), 12.6% were stage-2 (n: 39), 36.9% were stage-3 (n: 114) and 42% were stage-4 (n: 132). The most common histological type was adeno carcinoma with 38.8% (n: 120) followed by squamous cell carcinoma with 32.4% (n: 100). The median survival time was 13 months and the highest median survival was observed in patients with adeno carcinoma with 17 months, and the lowest rate was observed in patients with carcinoid tumors and the tumors whose pathology could not be categorized with 5 months (p <0.05). Overall survival is shorter in patients with high NLR levels and longer in patients with high LMR levels (p <0.05 for both). No statistically significant relationship was found in survival analysis with PLR level. CONCLUSION: High NLR and low LMR values were associated with short overall survival but not with PLR not. The cut off values specified for NLR and LMR may be beneficial to predict prognosis in patients with lung cancer. Further comprehensive prospective studies are needed to elucidate the effects of NLR, LMR and PLR on survival and mortality.