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Prognostic significance of the lymphocyte-to-neutrophil ratio in percutaneous fine-needle aspiration biopsy specimens of advanced nonsmall cell lung carcinoma

  1. Yasuharu Nakahara M.D.1,†,*,
  2. Yoshiro Mochiduki M.D.2,
  3. Yoshihiro Miyamoto M.D.3,
  4. Yukiko Nakahara M.D.2,
  5. Yoshitaka Katsura Ph.D.4

Article first published online: 26 JUL 2005

DOI: 10.1002/cncr.21290

Issue

Cancer

Cancer

Volume 104, Issue 6, pages 1271–1280, 15 September 2005

Additional Information

How to Cite

Nakahara, Y., Mochiduki, Y., Miyamoto, Y., Nakahara, Y. and Katsura, Y. (2005), Prognostic significance of the lymphocyte-to-neutrophil ratio in percutaneous fine-needle aspiration biopsy specimens of advanced nonsmall cell lung carcinoma. Cancer, 104: 1271–1280. doi: 10.1002/cncr.21290

Author Information

  1. 1

    Department of Respiratory Medicine, National Hospital Organization Himeji Medical Center, Himeji-city, Japan

  2. 2

    Department of General Medicine, National Hospital Organization Himeji Medical Center, Himeji-city, Japan

  3. 3

    Department of Respiratory Surgery, National Hospital Organization Himeji Medical Center, Himeji-city, Japan

  4. 4

    Department of Pathology, National Hospital Organization Himeji Medical Center, Himeji-city, Japan

  1. †

    Fax: (011) 81-792-23-8310

*Department of Respiratory Medicine, National Hospital Organization Himeji Medical Center, 68 Honmachi, Himeji-city 670-8520, Japan

Publication History

  1. Issue published online: 31 AUG 2005
  2. Article first published online: 26 JUL 2005
  3. Manuscript Accepted: 25 APR 2005
  4. Manuscript Revised: 2 APR 2005
  5. Manuscript Received: 1 FEB 2005

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Keywords:

  • lung neoplasms;
  • nonsmall cell lung carcinoma;
  • prognosis;
  • fine-needle aspiration biopsy;
  • cytology;
  • tumor-infiltrating lymphocytes;
  • multivariate analysis

Abstract

BACKGROUND

The prognostic significance of tumor-infiltrating lymphocytes (TILs) in surgically resected carcinomas was reported. To apply this to inoperable nonsmall cell lung carcinomas (NSCLC) of Stage IIIB–IV, the authors estimated the occurrence of TILs using percutaneous fine-needle aspiration biopsy specimens, and tested the validity of this method.

METHODS

The authors defined the L-N index as [LS/(LS + NS) − LB/(LB + NB)], in which LS and NS denoted lymphocyte and neutrophil counts in the aspiration smear, and LB and NB denoted lymphocyte and neutrophil counts in the peripheral blood specimen. The cutoff value was set at twice the standard deviation of the L-N index of 41 smears contaminated with abundant blood. Retrospectively, the authors compared the survival rate of the group with a high L-N index (lymphocyte-dominant group) (n = 12) with the survival rate of the group with a low L-N index (lymphocyte-nondominant group) (n = 60). Then, they performed a prospective study and compared the survival rates of these 2 groups (n=21 and n = 54). The Cox proportional hazards model was used to determine the effect of the L-N index as a continuous variable and other prognostic factors. The correlation (r) between the L-N index-based grouping (L-N grouping) and the histologic grade of TILs was studied among resected lung tumor specimens (n = 164).

RESULTS

In the retrospective and prospective studies, the survival rate was significantly higher in the lymphocyte-dominant group than in the lymphocyte-nondominant group (P = 0.0019 and P = 0.0001). Using multivariate analysis, the L-N index was an independent prognostic factor. A significant correlation was noted between L-N grouping and histologic grade of TILs (r = 0.476).

CONCLUSIONS

The L-N index of aspiration smears was found to be an independent prognostic factor for patients with advanced-stage NSCLC. L-N grouping was correlated with the histologic assessment of TILs. Cancer 2005. © 2005 American Cancer Society.

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