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. 2021 May 27;12(15):4497-4504.
doi: 10.7150/jca.58094. eCollection 2021.

Clinical significance of C-Reactive Protein to Lymphocyte Count Ratio as a prognostic factor for Survival in Non-small Cell Lung Cancer Patients undergoing Curative Surgical Resection

Jae-Joon Hwang  1 , Joon Young Hur  2 , Wankyu Eo  3 , Soomin An  4 , Dae Hyun Kim  5 , Sookyung Lee  6
Affiliations

Clinical significance of C-Reactive Protein to Lymphocyte Count Ratio as a prognostic factor for Survival in Non-small Cell Lung Cancer Patients undergoing Curative Surgical Resection

Jae-Joon Hwang et al. J Cancer. .

Abstract

Purpose: We assessed the clinical feasibility of C-reactive protein to lymphocyte ratio (CLR) as a determinant of survival in patients with non-small cell lung cancer (NSCLC) undergoing curative surgical resection. Methods: A retrospective study was conducted on patients with stage I and II NSCLC undergoing curative resection. Demographic and clinical variables, including CLR, were collected and analyzed. The Cox proportional hazards model was used to calculate hazard ratios for overall survival (OS) and cancer-specific survival (CSS). The Mann-Whitney U test was used to compare differences between two independent groups. Results: The median age of the patients was 69.0 years, and male patients comprised 63.9% of all patients. A total of 164 (75.9%) patients were categorized as having stage I disease and 52 (24.1%) as having stage II disease. Using the multivariate Cox model, age (hazard ratio [HR] 1.08, p<0.001), lymphatic invasion (HR 3.12, p=0.004), stage (HR 5.10, p<0.001), and CLR (HR 1.01, p=0.003) were significant determinants of OS. In addition, age (HR 1.11, p=0.002), lymphatic invasion (HR 3.16, p=0.010), stage (HR 6.89, p<0.001), and CLR (HR 1.05, p=0.002) were significant determinants of CSS. Conclusions: Our findings show that CLR could be a determinant of survival in NSCLC patients undergoing curative surgical resection.

Keywords: C-Reactive Protein; Carcinoma, Non-Small Cell Lung; Lymphocyte Count; Prognosis; Pulmonary Surgical Procedures.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interest exists.

Figures

Figure 1
Figure 1
Decision curve analysis to calculate the clinical net benefit of each model for overall survival (A) and cancer-specific survival (B). The baseline model includes three covariates (i.e., age, lymphatic invasion, and stage), and the full model includes four covariates (i.e., age, lymphatic invasion, stage, and CLR). All, a line that all patients are surviving; None, a line that no patient is surviving.
Figure 2
Figure 2
The bootstrap cross-validation estimates of the C-index at different time points to assess and compare the discriminative power of two regression models for overall survival (A) and cancer-specific survival (B). The baseline model includes three covariates (i.e., age, lymphatic invasion, and stage), and the full model includes four covariates (i.e., age, lymphatic invasion, stage, and CLR).
Figure 3
Figure 3
Correlation coefficients between patient characteristic and C-reactive protein to lymphocyte ratios. Alb, serum albumin level; BMI, body mass index; CLR, C-reactive protein to lymphocyte ratio; Hb, hemoglobin concentration.
See this image and copyright information in PMC

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