Clinical Research Papers:
Preoperative pulmonary function correlates with systemic inflammatory response and prognosis in patients with non-small cell lung cancer: results of a single-institution retrospective study
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Yongyin Gao1,*, Hongdian Zhang2,*, Yue Li1, Dandan Wang1, Yinlu Ma1, Qing Chen1
1Department of Cardio-pulmonary Functions, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and therapy, Tianjin, China
2Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and therapy, Tianjin, China
*These authors have contributed equally to this work
Qing Chen, email: qingchenTJCH@yeah.net
Keywords: non-small cell lung cancer, pulmonary function, systemic inflammatory response, prognosis
Received: August 24, 2016 Accepted: November 22, 2016 Published: December 25, 2016
This study aimed at analyzing the relationship between preoperative pulmonary function and systemic inflammatory response (SIR) biomarkers, such as neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and lymphocyte-to-monocyte ratio (LMR) in patients with non-small cell lung cancer (NSCLC). Furthermore, the prognostic significance of these markers was also examined. The medical records of 358 NSCLC patients, who underwent curative lung resection, were retrospectively analyzed. Pulmonary function test values <80% of the predicted values were used to indicate impairment. A receiver operating characteristic curve was used to determine the thresholds of the SIR biomarkers. Univariate and multivariate survival analyses were then performed to identify the factors associated with the overall survival (OS). Furthermore, one prognostic model based on independent prognostic factors was established to classify the patients into low-, intermediate-, and high-risk groups. Results demonstrated that, preoperative forced vital capacity (FVC) was simultaneously associated with NLR, PLR, and LMR (P < 0.05). Multivariate analysis identified age, lymph node status, FVC, and NLR as independent prognostic factors for OS. A subgroup analysis showed that the prognostic value of FVC was independent of age, lymph node status, and NLR. The five-year OS rates for low-, intermediate-, and high-risk groups of prognostic model were 60.9%, 35.9%, and 15.3%, respectively (P < 0.05). Overall, preoperative FVC was an independent prognostic predictor of NSCLC. Significant correlations were observed among preoperative pulmonary function, SIR, and prognosis. Thus, the prognostic model may help us identify risk populations with NSCLC.
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