Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio are predictive of chemotherapeutic response and prognosis in epithelial ovarian cancer patients treated with platinum-based chemotherapy
Affiliations: Department of Obstetrics and Gynecology, Shanghai General Hospital of Nanjing Medical University, Shanghai, China
Correspondence:
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Corresponding author: Youji Feng, Department of Obstetrics and Gynecology, Shanghai General Hospital of Nanjing Medical University, NO. 100, Haining Road, Hongkou District, Shanghai 200080, China. E-mail:youjifeng2015@163.com
Abstract: The aim of present study was to investigate the role of
preoperative neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte
ratio (PLR) used as prognostic markers for predicting chemotherapeutic
response and survival outcomes in patients with epithelial ovarian
cancer (EOC) who are receiving platinum-based chemotherapy. A total of 344
patients diagnosed with EOC who are receiving platinum-based chemotherapy
from 2005 to 2010 in the hospital were enrolled. NLR and PLR were calculated
from complete blood cell count taken before operation. The patients were
divided into platinum-resistant (P-R) group and platinum-sensitive (P-S) group
according to chemotherapeutic response. Clinicopathologic variables and
outcomes were retrospectively collected and compared among groups. We used
receiver operating characteristic (ROC) curves to calculate optimal cut-off
values for NLR and PLR to predict chemotherapeutic response and prognosis.
The AUC, sensitivity, specificity of NLR > 3.02 to predict platinum
resistance were 0.819, 75.0% and 81.45%, respectively. The
corresponding values of PLR > 207 were 0.727, 60.42% and 85.48%,
respectively. Patients with lower value of NLR (NLR < 3.02) or PLR (PLR < 207)
had a longer progression-free survival (PFS) and overall survival (OS). In
multivariate analysis, NLR and PLR showed a significant association with
PFS (hazard ratio [HR], 1.733; 95%CI, 1.225-2.453, P = 0.002 and HR, 1.952;
95%CI, 1.430-2.662, P < 0.001) and OS (HR, 1.616; 95%CI, 1.138-2.297,
P = 0.007, and HR, 2.167; 95%CI, 1.565-3.000, P < 0.001). These results
suggest that the assessment of NLR and PLR could assist the identification
of patients with poor prognosis and had potential clinical value in
predicting platinum resistance in patients with EOC.
Keywords: Neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, epithelial ovarian cancer, platinum resistance, prognosis
