Combined C-reactive protein and Neutrophil to Lymphocyte ratio use predict survival innon-small-cell lung cancer

• Published in: Tunisie Medicale Vol. 95; no. 12; p. 229
• Main Authors: Bacha, Saoussen, Sghaier, Améni, Habibech, Sonia, Cheikhrouhou, Sana, Racil, Hager, Chaouch, Naouel, Zaouri, Béchir, Chabbou, Abdellatif
• Format: Journal Article
• Language: English
• Published: Tunisia 01-12-2017
• Subjects: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor - blood; C-Reactive Protein - analysis; C-Reactive Protein - metabolism; Carcinoma, Non-Small-Cell Lung - blood; Carcinoma, Non-Small-Cell Lung - diagnosis; Carcinoma, Non-Small-Cell Lung - mortality; Carcinoma, Non-Small-Cell Lung - therapy; Female; Humans; Leukocyte Count; Lung Neoplasms - blood; Lung Neoplasms - diagnosis; Lung Neoplasms - mortality; Lung Neoplasms - therapy; Lymphocytes - pathology; Male; Middle Aged; Neutrophils - pathology; Predictive Value of Tests; Prognosis; Retrospective Studies; Survival Analysis
• ISSN: 0041-4131

Inflammation markers have been shown to predict prognosis during cancer including non-small cell lung cancer (NSCLC). In particular, C-reactive protein (CRP) and Neutrophil to Lymphocyte Ratio (NLR) have been investigated. The aim of our work is to study the combination of these two markers in optimizing prognostication in advanced NSCLC.
  We conducted a retrospective study that included all patients diagnosed with primary NSCLC stage IIIB or IV in our respiratory department from January 2005 to January 2013.
A total of 142 male patients were included. Most of them (80.3%) had a Performance Status (PS) 0-1. Median progression-free survival (PFS) was 4.6 months (95% confidence interval (CI) 3.9-5.3) and median overall survival (OS) was 8.9 months (95%CI7.7-10.1). Survival analysis showed that CRP<10 mg/l and NLR<3.87 were predictive of better prognostic (respectively p= 0.015 and 0.049), along with chemotherapy use (p<0.0001), PS <2 (p=0.009) and age<65 (p=0.013). In addition, combined use of NLR and CRP was significantly associated with OS (p=0.0009). Median OS for patients having both high NLR (≥3.87) and CRP (≥10 mg/l) was 6.7 months. It was significantly shorter than patients having only one elevated inflammatory marker (8.8 months; p=0.025).
High CRP and NLR (≥10 mg/l and ≥ 3.87 respectively) were associated with poorer survival in advanced NSCLC. Their combined use maximizes their prognostic value.