203P - Could neutrophil-to-lymphocyte ratio be predictor of brain metastases in non small cell lung cancer?

Date 15 April 2016
Event European Lung Cancer Conference 2016 (ELCC) 2016
Session Poster lunch
Topics Translational Research
Non-Small Cell Lung Cancer
Basic Principles in the Management and Treatment (of cancer)
Presenter Marina Serdarevic
Citation Journal of Thoracic Oncology (2016) 11 (supplement 4): S57-S166. S1556-0864(16)X0004-4
Authors M. Serdarevic1, S. Kukulj1, I. Nikolic2, I. Taradi3, Z. Romic3, M. Samarzija4
  • 1Department For Lung Tumors, KBC Zagreb--Jordanovac Clinic for Lung Diseases, 10000 - Zagreb/HR
  • 2Clinic For Thoracic Surgery, Clinical Hospital Dubrava, 10000 - Zagreb/HR
  • 3Laboratory Department, Clinical Hospital Dubrava, 10000 - Zagreb/HR
  • 4Post Intensive Care Unit, KBC Zagreb--Jordanovac Clinic for Lung Diseases, 10000 - Zagreb/HR



Recent studies have shown that the presence of systematic inflammation correlates with poor survival in various cancers. Many cancers arise from sites of infection, chronic irritation and inflammation. Neutrophils and T and B lymphocytes have been suggested to play significant role in tumor inflammation. Neutrophils stimulate tumor angiogenesis and some studies have determined that low lymphocyte counts may be associated with shorter survival in various cancers. Platelets are also part of inflammatory response and thrombocytosis is common in patients with solid tumors. Recent studies have shown the elevated neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are poor prognostic factors for non small cell lung cancer (NSCLC). In our previous study it has been shown that higher PLR values were associated with occurrence of brain metastases.


The aim of this study was to examine whether NLR could be a marker to differentiate NSCLC patients with brain metastases from patients with locally advanced and metastatic NSCLC but without brain metastases. Retrospectively 70 lung cancer patients with brain metastases at the time of diagnosis and 70 lung cancer with locally advanced and metastatic NSCLC but without verified or clinical signs of brain metastases were included in the study. NLR was defined as the absolute neutrophil count divided by the absolute lymphocyte count. The neutrophil and lymphocyte counts of peripheral blood were measured with hematology analyzer before chemotherapy. The Mann–Whitney U test was used to compare the parameters.


NRL values were significantly higher in group of patients with brain metastases (NRL: 6.05 vs 4.6, p = 0.023). Absolute lymphocyte count was higher in group of patients with locally advanced and metastatic NSCLC but without brain metastases (Ly: 1.77 vs 1.60, p = 0.008). No statistically significant difference was determined in neutrophil count between two groups.


The NRL is broadly available and cheap marker which could be used to highlight patients that should be screened for metastases especially brain metastases. Longer prospective studies are required to confirm these findings.

Clinical trial identification

Legal entity responsible for the study

Clinical University Hospital Zagreb


Clinical University Hospital Zagreb


All authors have declared no conflicts of interest.