The prognostic significance of the neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio in giant cell tumor of the extremities | BMC Cancer | Full Text

The prognostic significance of the neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio in giant cell tumor of the extremities | BMC Cancer | Full Text



BMC Cancer

The prognostic significance of the neutrophil-to-lymphocyte ratio and the platelet-to-lymphocyte ratio in giant cell tumor of the extremities

• Zhenhao Chen†,
• Guanglei Zhao†,
• Feiyan ChenEmail author,
• Jun XiaEmail author and
• Li Jiang

†Contributed equally

BMC Cancer201919:329

https://doi.org/10.1186/s12885-019-5511-x

©  The Author(s). 2019

• Received: 1 November 2018
• Accepted: 25 March 2019
• Published: 8 April 2019

Open Peer Review reports

Abstract

Background

In this study, the influence of the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) on the prognosis of giant cell tumor (GCT) of the extremities were investigated.

Methods

The clinical parameters of 163 patients who were diagnosed with GCT of the extremities between July 2008 and January 2018 were retrospectively analyzed. Optimal cutoff values of NLR and PLR were determined using receiver operating characteristic (ROC) analysis. According to optimal cutoff values, patients were divided into high NLR and low NLR groups or high PLR and low PLR groups. Kaplan-Meier and log-rank methods were used to compare the recurrence-free survival (RFS) between the high and low NLR groups, and between the high and low PLR groups. Univariate analysis was performed to determine the influence of age, gender, neutrophil count, lymphocyte count, platelet count, white blood cell count, tumor size, surgical approach and Campanacci stage on the prognosis of giant cell tumor of bone. The main predictors of RFS were determined by Cox multivariate regression analysis.

Results

The optimal cutoff value of NLR in giant cell tumor of the extremities was 2.32, which was used to classify patients into high and low NLR groups. The optimal cutoff value of PLR was 116.81, and was used to classify patients into high and low PLR groups. Campanacci stage, tumor maximum diameter, alkaline phosphatase, and C-reactive protein (CRP) were significantly associated with the high NLR and PLR. Cox multivariate regression analysis revealed that the Campanacci stage (HR = 3.28, 95% CI: 1.24~8.69) and NLR (HR = 4.18, 95% CI: 1.83~9.57) were independent prognostic factors for giant cell tumor of the extremities.

Conclusion

As a novel inflammatory index, NLR has some predictive power for the prognosis of patients with giant cell tumor of the extremities.

Keywords

• Neutrophil-to-lymphocyte ratio
• Platelet-to-lymphocyte ratio
• Giant cell tumor
• Prognosis