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Prognostic significance of neutrophil/lymphocyte ratio (NLR) and correlation with PET–CT metabolic parameters in small cell lung cancer (SCLC)

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Abstract

Purpose

The aim of this study is to detect the prognostic significance of neutrophil/lymphocyte ratio (NLR) in SCLC and to evaluate the relation with 18F-FDG PET–CT metabolic parameters (PET–CT MPs).

Methods

Demographic parameters, laboratory values including NLR and other clinical variables were analyzed in 112 patients with small cell lung cancer (SCLC) and 54 of these patients had results of metabolic parameters detected with 18 FDG PET–CT [including SUVmax, SUVmean, metabolic tumor volume (MTV), whole body MTV (WBMTV), TLG (total lesion glycolysis), whole body TLG (WBTLG)] were evaluated for survival analyses.

Results

Mean and median overall survival (OS) and progression-free survival (PFS) were found to be significantly longer in cases with NLR < 4 compared with NLR > 4 in totally. Also stage, performance status, response to first-line therapy, LDH, and lymphocyte count were found to be prognostic for OS and PFS. MTV, WBMTV and WBTLG were found to be prognostic for both OS and PFS, while SUVmax found to be significant for OS. Patients with NLR ≥ 4, MTV ≥ 60.1, WBMTV ≥ 120 and WBTLG ≥ 1000 points had lower OS and PFS. A moderate positive correlation was found between NLR and SUVmean (r: 0.36), SUVmax (r: 0.34), TLG (r: 0.39), MTV (r: 0.51), WBMTV (r: 0.40), and WBTLG (r: 0.46).

Conclusion

There is relationship between PET–CT metabolic parameters and NLR in SCLC. Highest correlation was found with NLR and MTV, WBMTV, and WBTLG, and evaluation of NLR together with these parameters predicts survival times and tumor biology more clearly in SCLC.

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Acknowledgements

This article has been approved of as an Oral Presentation in 7. Turkish Society of Medical Oncology Congress (21–25 March 2018).

Funding

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Authors and Affiliations

  1. Department of Medical Oncology, Çukurova University Faculty of Medicine, Balcalı, 01130, Adana, Turkey

    Cem Mirili, Semra Paydas, Ali Ogul, Serkan Gokcay, Mahmut Buyuksimsek, Abdullah Evren Yetisir, Bilgin Karaalioglu & Mert Tohumcuoglu

  2. Department of Nuclear Medicine, Çukurova University Faculty of Medicine, Adana, Turkey

    Isa Burak Guney

  3. Department of Biostatistics, Çukurova University Faculty of Medicine, Adana, Turkey

    Gulsah Seydaoglu

  4. Department of Internal Medicine, Çukurova University Faculty of Medicine, Adana, Turkey

    Tuba Korkmaz Kapukaya

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  1. Cem Mirili
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Correspondence to Cem Mirili.

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Mirili, C., Guney, I.B., Paydas, S. et al. Prognostic significance of neutrophil/lymphocyte ratio (NLR) and correlation with PET–CT metabolic parameters in small cell lung cancer (SCLC). Int J Clin Oncol 24, 168–178 (2019). https://doi.org/10.1007/s10147-018-1338-8

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