I Abuelbeh, O Abu-Shawer, M Abu-Shawer, M Alkderat, M Safi, A Alwazani, A Alkhatib, B Abu-Hussain, M Aladawi, S Ismail, T Altamimi, Taher Abu Hejleh
{"title":"外周血免疫细胞计数对IV期非小细胞肺癌(NSCLC)脑转移存在的预测价值","authors":"I Abuelbeh, O Abu-Shawer, M Abu-Shawer, M Alkderat, M Safi, A Alwazani, A Alkhatib, B Abu-Hussain, M Aladawi, S Ismail, T Altamimi, Taher Abu Hejleh","doi":"10.1055/s-0042-1749613","DOIUrl":null,"url":null,"abstract":"<p><p><b>Background</b> High neutrophil-lymphocyte ratio (NLR) is associated with poor survival in lung cancer. This study evaluates whether NLR is associated with baseline brain metastasis in stage IV non-small cell lung cancer (NSCLC). <b>Methods</b> Medical records of stage IV NSCLC patients treated at King Hussein Cancer Center (Amman-Jordan) between 2006 and 2016 were reviewed. Patients with baseline brain imaging and complete blood count (CBC) were included. Receiver operating characteristic (ROC) curve was used to identify the optimal cutoff value for the association between NLR and baseline brain metastasis. Association between age, gender, location of the primary tumor, histology, and NLR was assessed using univariate and multivariate logistic regression analyses. <b>Results</b> A total of 722 stage IV NSCLC patients who had baseline brain imaging were included. Median age was 59 years. Baseline brain metastasis was present in 280 patients (39.3%). Nine patients had inconclusive findings about brain metastasis. The ROC curve value of 4.3 was the best fitting cutoff value for NLR association with baseline brain metastasis. NLR ≥ 4.3 was present in 340 patients (48%). The multivariate analyses showed that high baseline NLR (≥ 4.3) was significantly associated with higher odds of baseline brain metastasis (odds ratio [OR]: 1.6, 95% confidence interval [CI]: 1.2-2.2; <i>p</i> = 0.0042). Adenocarcinoma histology was also associated with baseline brain metastasis (OR: 0.4, 95% CI: 0.25-0.6; <i>p</i> = 0.001). <b>Conclusion</b> High NLR is associated with baseline brain metastasis in advanced-stage NSCLC. In the era of immunotherapy and targeted therapies, whether high NLR predicts response of brain metastasis to treatment is unknown.</p>","PeriodicalId":32889,"journal":{"name":"Avicenna Journal of Medicine","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2022-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/57/be/10-1055-s-0042-1749613.PMC9272452.pdf","citationCount":"1","resultStr":"{\"title\":\"The Predictive Value of Peripheral Immune Cell Counts for the Presence of Brain Metastases in Stage IV Non-Small-Cell Lung Cancer (NSCLC).\",\"authors\":\"I Abuelbeh, O Abu-Shawer, M Abu-Shawer, M Alkderat, M Safi, A Alwazani, A Alkhatib, B Abu-Hussain, M Aladawi, S Ismail, T Altamimi, Taher Abu Hejleh\",\"doi\":\"10.1055/s-0042-1749613\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Background</b> High neutrophil-lymphocyte ratio (NLR) is associated with poor survival in lung cancer. This study evaluates whether NLR is associated with baseline brain metastasis in stage IV non-small cell lung cancer (NSCLC). <b>Methods</b> Medical records of stage IV NSCLC patients treated at King Hussein Cancer Center (Amman-Jordan) between 2006 and 2016 were reviewed. Patients with baseline brain imaging and complete blood count (CBC) were included. Receiver operating characteristic (ROC) curve was used to identify the optimal cutoff value for the association between NLR and baseline brain metastasis. Association between age, gender, location of the primary tumor, histology, and NLR was assessed using univariate and multivariate logistic regression analyses. <b>Results</b> A total of 722 stage IV NSCLC patients who had baseline brain imaging were included. Median age was 59 years. Baseline brain metastasis was present in 280 patients (39.3%). Nine patients had inconclusive findings about brain metastasis. The ROC curve value of 4.3 was the best fitting cutoff value for NLR association with baseline brain metastasis. NLR ≥ 4.3 was present in 340 patients (48%). The multivariate analyses showed that high baseline NLR (≥ 4.3) was significantly associated with higher odds of baseline brain metastasis (odds ratio [OR]: 1.6, 95% confidence interval [CI]: 1.2-2.2; <i>p</i> = 0.0042). Adenocarcinoma histology was also associated with baseline brain metastasis (OR: 0.4, 95% CI: 0.25-0.6; <i>p</i> = 0.001). <b>Conclusion</b> High NLR is associated with baseline brain metastasis in advanced-stage NSCLC. In the era of immunotherapy and targeted therapies, whether high NLR predicts response of brain metastasis to treatment is unknown.</p>\",\"PeriodicalId\":32889,\"journal\":{\"name\":\"Avicenna Journal of Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2022-07-03\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/57/be/10-1055-s-0042-1749613.PMC9272452.pdf\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Avicenna Journal of Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1055/s-0042-1749613\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/4/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Avicenna Journal of Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1055/s-0042-1749613","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/4/1 0:00:00","PubModel":"eCollection","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 1
摘要
背景:高中性粒细胞-淋巴细胞比率(NLR)与肺癌的低生存率相关。本研究评估NLR是否与IV期非小细胞肺癌(NSCLC)的基线脑转移相关。方法回顾2006年至2016年在约旦侯赛因国王癌症中心(King Hussein Cancer Center, Amman-Jordan)治疗的四期非小细胞肺癌患者的医疗记录。包括基线脑成像和全血细胞计数(CBC)的患者。采用受试者工作特征(ROC)曲线确定NLR与基线脑转移之间关系的最佳截断值。使用单变量和多变量logistic回归分析评估年龄、性别、原发肿瘤位置、组织学和NLR之间的关系。结果共纳入722例基线脑成像的IV期NSCLC患者。中位年龄为59岁。280例(39.3%)患者存在基线脑转移。9例患者有脑转移不确定的结果。ROC曲线值为4.3是NLR与基线脑转移相关性的最佳拟合临界值。NLR≥4.3的患者340例(48%)。多因素分析显示,高基线NLR(≥4.3)与高基线脑转移几率显著相关(优势比[OR]: 1.6, 95%可信区间[CI]: 1.2-2.2;P = 0.0042)。腺癌组织学也与基线脑转移相关(OR: 0.4, 95% CI: 0.25-0.6;P = 0.001)。结论高NLR与晚期非小细胞肺癌基线脑转移相关。在免疫治疗和靶向治疗的时代,高NLR是否预示着脑转移对治疗的反应尚不清楚。
The Predictive Value of Peripheral Immune Cell Counts for the Presence of Brain Metastases in Stage IV Non-Small-Cell Lung Cancer (NSCLC).
Background High neutrophil-lymphocyte ratio (NLR) is associated with poor survival in lung cancer. This study evaluates whether NLR is associated with baseline brain metastasis in stage IV non-small cell lung cancer (NSCLC). Methods Medical records of stage IV NSCLC patients treated at King Hussein Cancer Center (Amman-Jordan) between 2006 and 2016 were reviewed. Patients with baseline brain imaging and complete blood count (CBC) were included. Receiver operating characteristic (ROC) curve was used to identify the optimal cutoff value for the association between NLR and baseline brain metastasis. Association between age, gender, location of the primary tumor, histology, and NLR was assessed using univariate and multivariate logistic regression analyses. Results A total of 722 stage IV NSCLC patients who had baseline brain imaging were included. Median age was 59 years. Baseline brain metastasis was present in 280 patients (39.3%). Nine patients had inconclusive findings about brain metastasis. The ROC curve value of 4.3 was the best fitting cutoff value for NLR association with baseline brain metastasis. NLR ≥ 4.3 was present in 340 patients (48%). The multivariate analyses showed that high baseline NLR (≥ 4.3) was significantly associated with higher odds of baseline brain metastasis (odds ratio [OR]: 1.6, 95% confidence interval [CI]: 1.2-2.2; p = 0.0042). Adenocarcinoma histology was also associated with baseline brain metastasis (OR: 0.4, 95% CI: 0.25-0.6; p = 0.001). Conclusion High NLR is associated with baseline brain metastasis in advanced-stage NSCLC. In the era of immunotherapy and targeted therapies, whether high NLR predicts response of brain metastasis to treatment is unknown.