Predictive Value of Neuron Specific Enolase, Neutrophil-to-Lymphocyte-Ratio and Lymph Node Metastasis for Distant Metastasis in Small Cell Lung Cancer

Lung Cancer

Clin Respir J. 2020 Aug 4. doi: 10.1111/crj.13242. Online ahead of print.


OBJECTIVE: To investigate the value ofneuron specific enolase (NSE), neutrophil-to-lymphocyte ratio (NLR), andlymph nodemetastasis in predicating distant metastasis in patients with limited-stage small cell lung cancer (LD-SCLC).

METHODS: Clinicalpathological data of LD-SCLC patients in the First Affiliated Hospital of Wenzhou Medical University between August2009 and October 2017 were retrospectively analyzed. The age, gender, smoking, TNM, NSE, NLR, chemotherapy cycle, radiotherapy, surgery and new metastasis of lymph nodes of 47 cases with distant metastasis and 47 cases without distant metastasis in 1 year were compared. Finally, factors influencingdistant metastasis were determined as thepredictors. The receiver operating characteristic (ROC) curve model was established based onlogistic regression analysis of the factors obtained.

RESULTS: Distant metastasis mainly involved brain (17/47), liver (17/47), and bone (17/47). Univariate analysis showed that patients with new lymph node metastasis, high NSE, pre-treatment hilar lymph node metastasis and NLR were more prone to have distant metastasis. Multivariate analysis showed that new lymph node metastasis, high NSE, NLR and pre-treatment hilar lymph node metastasis were independent predictors. The predictive model established using these predictorshad an AUC of 0.872(95%CI: 0.803-0.941), a sensitivity of 76.60%, and a speciality of 80.85%.

CONCLUSION: The new lymph node metastasis, NLR and NSE are predictors of distant metastasis, and thus may have a profound impact on treatment decision-making.Patients with lowerNLR and NSE expression levelsand less new metastasis of lymph nodes have a lower distant metastasis rate.