Prognostic Significance of Combination of Preoperative Platelet Count and Neutrophil-Lymphocyte Ratio (COP-NLR) in Patients with Non-Small Cell Lung Cancer: Based on a Large Cohort Study

Hua Zhang; Lianmin Zhang; Kaikai Zhu; Bowen Shi; Yuesong Yin; Jinfang Zhu; Dongsheng Yue; Bin Zhang; Changli Wang

doi:10.1371/journal.pone.0126496

Prognostic Significance of Combination of Preoperative Platelet Count and Neutrophil-Lymphocyte Ratio (COP-NLR) in Patients with Non-Small Cell Lung Cancer: Based on a Large Cohort Study

PLoS One. 2015 May 7;10(5):e0126496. doi: 10.1371/journal.pone.0126496. eCollection 2015.

Authors

Hua Zhang¹, Lianmin Zhang¹, Kaikai Zhu², Bowen Shi¹, Yuesong Yin¹, Jinfang Zhu¹, Dongsheng Yue¹, Bin Zhang¹, Changli Wang¹

Affiliations

¹ Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin, China; Key Laboratory of Cancer Prevention and Therapy, Tianjin, China; Tianjin Lung Cancer Center, Tianjin, China.
² Department of Pediatrics, Tianjin Medical University General Hospital, Tianjin, China.

Abstract

Introduction: The aim of this study was to investigate the prognostic significance of the combination of the preoperative platelet count and neutrophil-lymphocyte ratio (COP-NLR) for predicting postoperative survival of patients undergoing complete resection for non-small cell lung cancer (NSCLC).

Methods: The preoperative COP-NLR was calculated on the basis of data obtained.Patients with both an increased platelet count (>30.0 × 104 mm(-3)) and an elevated NLR (>2.3) were assigned a score of 2, and patients with one or neither were assigned as a score of 1 or 0, respectively.

Results: A total of 1238 NSCLC patients were enrolled in this analysis. Multivariate analysis using the 15 clinicolaboratory variables selected by univariate analyses demonstrated that the preoperative COP-NLR was an independent prognostic factor for DFS (HR: 1.834, 95%CI: 1.536 to 2.200, P<0.001) and OS (HR: 1.810, 95%CI: 1.587 to 2.056, P<0.001). In sub-analyses by tumor stage (I, II, IIIA), a significant association was found between DFS and OS and level of COP-NLR in each subgroup (P<0.001, P=0.002, P<0.001 for DFS, respectively; P<0.001, P=0.001, P<0.001 for OS). When the subgroup of patients with high-risk COP-NLR (score of 2) was analyzed, no benefit of adjuvant chemotherapy could be found (P=0.237 for DFS and P=0.165 for OS).

Conclusions: The preoperative COP-NLR is able to predict the prognosis of patients with NSCLC and divide these patients into three independent groups before surgery. Our results also demonstrate that high-risk patients based on the COP-NLR do not benefit from adjuvant chemotherapy. Independent validation of our findings is warranted.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Carcinoma, Non-Small-Cell Lung / blood*
Carcinoma, Non-Small-Cell Lung / pathology
Female
Humans
Lung Neoplasms / blood*
Lung Neoplasms / pathology
Lymphocytes / cytology*
Male
Middle Aged
Neutrophils / cytology*
Platelet Count*
Prognosis
Retrospective Studies

Grants and funding

This work was supported by the National Natural Science Foundation of China (81470137 to CL Wang, http://www.nsfc.gov.cn) and Key Program for Anti-cancer Research of Tianjin Municipal Science and Technology Commission (12ZCDZSY15400 to CL Wang, [http://www.tstc.gov.cn/]). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.