3018 – DETERMINING THE VARIATIONS OF THE NEUTROPHIL TO LYMPHOCYTE RATIO (NLR) IN CANCER PATIENTS - A PROSPECTIVE STUDY

Abstract

Background

:Neutrophil-Lymphocyte Ratio (NLR), a simple marker to assess immune response (IR) is derived by dividing absolute neutrophil count (ANC) by absolute lymphocyte count (ALC) obtained through a routine complete blood cell count (CBC). Neutrophils, an integral part of the innate IR, are tumour promoting and immune suppressive role. Neutrophilia is usually accompanied by relative lymphocytopenia representing a significant decline in cell-mediated adaptive IR consequently promoting metastasis.

Methods

CBC and Histopathology reports of carcinomas patients in a 2-year period. The ANC and ALC obtained were used to calculate the NLR. Inclusion Criteria: patients with cancer and NLR calculated from the CBC prior to surgery. Exclusion criteria: Cancer patients with any infection or inflammatory process , febrile patients and those on chemotherapy

Results

58 patients (33 females and 25 males) Mean age patients in males and females were 54.2 and 56.78 respectively. In male and female patients with NLR above 10, the most prevalent cancer was in the rectum and the buccal mucosa, respectively. Male patients with stages T0N0M0- T2N1M0 had lower NLR values in the 3.428 to 9.44 range. Male patients with T3N0M0-T4N1M0 stage had an NLR range of 2.54 to 6.38. In the female patients with NLR above 10, two have tongue cancer with staging from T2N0M0-T4bN2M0 and one buccal mucosal cancer patient with T4N2cM0. The lower values of the NLR is more prevalent in female patients with breast cancer.

Conclusion

Rectosigmoid cancer had the highest NLR. Buccal mucosa and tongue cancers had lower NLR, with few outliers. The lowest NLR was seen in breast cancer patients, showing a possible gender correlation. Regarding prognosis, our data suggests that age and gender of the patient, anatomic location and the TNM of the cancer are significant.