Prognostic Value of Pretreatment Procalcitonin and Neutrophil-lymphocyte Ratio in Extensive-stage Small-cell Lung Cancer

Overview

Journal Cancer Biol Ther

Specialties Oncology
Pharmacology

Date 2024 Mar 27

PMID 38536706

Authors

Dongfang Chen

Jianlin Xu

Yizhuo Zhao

Baohui Han

Runbo Zhong

Affiliations

Soon will be listed here.

Abstract

Background: To investigate the influence of pretreatment neutrophil-to-lymphocyte ratio (NLR) and procalcitonin (PCT) on progression-free survival (PFS) in extensive-stage small-cell lung cancer (SCLC) patients.

Method: A total of 100 extensive-stage SCLC patients were enrolled in our study. Patients were stratified according to the median values of pretreatment NLR and PCT levels: low NLR group (NLR ≤3.17), high NLR group (NLR＞3.17), low PCT group (PCT ≤0.06; ng/ml), high PCT group (PCT＞0.06; ng/ml). The Kaplan-Meier method and multivariable Cox regression model were used to reveal the prognostic effects of pretreatment NLR and PCT on PFS.

Results: The median PFS of the total extensive-stage SCLC patients was 6.0 months. The median PFS of low pretreatment NLR group (NLR ≤3.17) was not significantly different from that of high pretreatment NLR group (6.2 months vs 5.8 months; = .675). Patients with low pretreatment PCT (PCT ≤0.06; ng/ml) had significantly better PFS than patients with high pretreatment PCT (PCT＞0.06; ng/ml) (6.9 months vs 5.7 months; = .043). With the multivariable Cox regression analysis, the response to first-line chemotherapy ( ≤ .001) and pretreatment PCT (HR = 0.516; 95%CI 0.326-0.817; = .005) were identified as independent factors associated with PFS.

Conclusion: Pretreatment PCT is an independent factor associated with PFS in extensive-stage SCLC patients treated with first-line chemotherapy, but pretreatment NLR reflects no significant prognostic value in our study.

Citing Articles

Explainable Machine Learning Predictions for the Benefit From Chemotherapy in Advanced Non-Small Cell Lung Cancer Without Available Targeted Mutations.

Shuang Z, Xingyu X, Yue C, Mingjing Y Clin Respir J. 2024; 18(12):e70044.

PMID: 39696772 PMC: 11655385. DOI: 10.1111/crj.70044.

Procalcitonin, C-reactive protein, and white blood cell count levels in end-stage cancer patients: A retrospective study on inflammatory markers and their prognostic value.

Zhou Q, Lu X, Qian L, Yu C, Xie J, Kong D Medicine (Baltimore). 2024; 103(49):e40792.

PMID: 39654236 PMC: 11631015. DOI: 10.1097/MD.0000000000040792.

References

Kang M, Go S, Song H, Lee A, Kim S, Kang J . The prognostic impact of the neutrophil-to-lymphocyte ratio in patients with small-cell lung cancer. Br J Cancer. 2014; 111(3):452-60. PMC: 4119986. DOI: 10.1038/bjc.2014.317. View

Gong J, Salgia R . Managing Patients With Relapsed Small-Cell Lung Cancer. J Oncol Pract. 2018; 14(6):359-366. PMC: 6002253. DOI: 10.1200/JOP.18.00204. View

van Meerbeeck J, Fennell D, De Ruysscher D . Small-cell lung cancer. Lancet. 2011; 378(9804):1741-55. DOI: 10.1016/S0140-6736(11)60165-7. View

Kahnert K, Kauffmann-Guerrero D, Maria Huber R . SCLC-State of the Art and What Does the Future Have in Store?. Clin Lung Cancer. 2016; 17(5):325-333. DOI: 10.1016/j.cllc.2016.05.014. View

Wasamoto S, Imai H, Tsuda T, Nagai Y, Minemura H, Yamada Y . Pretreatment glasgow prognostic score predicts survival among patients administered first-line atezolizumab plus carboplatin and etoposide for small cell lung cancer. Front Oncol. 2023; 12:1080729. PMC: 9895374. DOI: 10.3389/fonc.2022.1080729. View

Avrillon V, Locatelli-Sanchez M, Folliet L, Carbonnaux M, Perino E, Fossard G . Lung cancer may increase serum procalcitonin level. Infect Disord Drug Targets. 2015; 15(1):57-63. DOI: 10.2174/1871526515666150320162950. View

Kutlu Y, Goktas Aydin S, Bilici A, Oven B, Olmez O, Acikgoz O . Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as prognostic markers in patients with extensive-stage small cell lung cancer treated with atezolizumab in combination with chemotherapy. Medicine (Baltimore). 2023; 102(15):e33432. PMC: 10101285. DOI: 10.1097/MD.0000000000033432. View

Pardo-Cabello A, Manzano-Gamero V . Small cell lung cancer elevates procalcitonin levels in the absence of infection. Lung Cancer. 2019; 134:272-273. DOI: 10.1016/j.lungcan.2019.06.018. View

Cate C, Pettengill O, SORENSON G . Biosynthesis of procalcitonin in small cell carcinoma of the lung. Cancer Res. 1986; 46(2):812-8. View

10.

Heper Y, Akalin E, Mistik R, Akgoz S, Tore O, Goral G . Evaluation of serum C-reactive protein, procalcitonin, tumor necrosis factor alpha, and interleukin-10 levels as diagnostic and prognostic parameters in patients with community-acquired sepsis, severe sepsis, and septic shock. Eur J Clin Microbiol Infect Dis. 2006; 25(8):481-91. DOI: 10.1007/s10096-006-0168-1. View

11.

Sakin A, Sahin S, Yasar N, Demir C, Arici S, Geredeli C . The Relation between Hemogram Parameters and Survival in Extensive-Stage Small Cell Lung Cancer. Oncol Res Treat. 2019; 42(10):506-515. DOI: 10.1159/000501595. View

12.

Walter M, Meier C, Radimerski T, Iten F, Kranzlin M, Muller-Brand J . Procalcitonin levels predict clinical course and progression-free survival in patients with medullary thyroid cancer. Cancer. 2009; 116(1):31-40. DOI: 10.1002/cncr.24738. View

13.

Russwurm S, Stonans I, Stonane E, Wiederhold M, Luber A, Zipfel P . Procalcitonin and CGRP-1 mrna expression in various human tissues. Shock. 2001; 16(2):109-12. DOI: 10.1097/00024382-200116020-00004. View

14.

Liu D, Huang Y, Li L, Song J, Zhang L, Li W . High neutrophil-to-lymphocyte ratios confer poor prognoses in patients with small cell lung cancer. BMC Cancer. 2017; 17(1):882. PMC: 5740933. DOI: 10.1186/s12885-017-3893-1. View

15.

Patout M, Salaun M, Brunel V, Bota S, Cauliez B, Thiberville L . Diagnostic and prognostic value of serum procalcitonin concentrations in primary lung cancers. Clin Biochem. 2014; 47(18):263-7. DOI: 10.1016/j.clinbiochem.2014.09.002. View

16.

Liew P, Kubes P . The Neutrophil's Role During Health and Disease. Physiol Rev. 2019; 99(2):1223-1248. DOI: 10.1152/physrev.00012.2018. View

17.

Suzuki R, Lin S, Wei X, Allen P, Welsh J, Byers L . Prognostic significance of pretreatment total lymphocyte count and neutrophil-to-lymphocyte ratio in extensive-stage small-cell lung cancer. Radiother Oncol. 2018; 126(3):499-505. PMC: 5856620. DOI: 10.1016/j.radonc.2017.12.030. View

18.

Grivennikov S, Greten F, Karin M . Immunity, inflammation, and cancer. Cell. 2010; 140(6):883-99. PMC: 2866629. DOI: 10.1016/j.cell.2010.01.025. View