Prognostic value of a novel scoring system using inflammatory response biomarkers in non-small cell lung cancer: A retrospective study

Background The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR) are reported to show a strong correlation with prognosis in patients with non-small cell lung cancer (NSCLC). We aimed to describe a novel scoring system combining these ratios, termed the inflammatory response biomarker (IRB) score, and test its prognostic value in NSCLC. Methods The data of 261 NSCLC patients who underwent thoracoscopic radical resection in a single center were retrospectively reviewed. The IRB score was defined as follows: a high NLR (> 2.12), a high PLR (92.9), and a low LMR (< 4.57) were each scored as 1; the opposite values were scored as 0. The individual scores were added to produce the IRB score (range: 0-3). Results Multivariate analyses indicated that high tumor node metastasis (TNM) stage (hazard ratio [HR] 2.721, 95% confidence interval [CI] 1.597-4.989; P < 0.001) and an IRB score >= 2 (HR 2.696, 95% CI 1.506-4.826; P = 0.001) were independent prognostic factors for poor overall survival. Furthermore, smoking history (HR 2.953, 95% CI 1.086-8.026; P = 0.034), high TNM stage (HR 3.108, 95% CI 1.911-5.056; P < 0.001), and IRB score >= 2 (HR = 2.316, 95% CI: 1.389-3.861; P = 0.001) were demonstrated to be independent prognostic factors for poor disease-free survival. Conclusion The novel scoring system combining NLR, PLR, and LMR was an independent prognostic factor in NSCLC patients undergoing thoracoscopic radical resection and was superior to these ratios alone for predicting prognosis.