[Prognostic role of neutrophil-to-lymphocyte ratio determined by complete blood count in malignant diseases].

Introduction: Chronic low grade and intensity inflammation is considered to be a predisposing factor in the development and progression of malignancies. White blood cells play a key role in the process of inflammation. Based on numerous data of the literature, the author demonstrates some results of important meta-analyses and validation studies, which revealed the association between baseline elevated neutrophil-to-lymphocyte ratio (NLR) and the poor prognosis of the malignant diseases. Method and results: The author demonstrates the results of his observations of advanced cancer patients (n = 75) treated at his institution. NLR cut-off value, hazard ratio, confidence interval and p-value were determined by validated procedure (fitting Cox-model to NLR, survival and cenzored values, and point with the most significant split was defined by log-rank test). Hedges' g value was used for the determination of the effect of magnitude. Discussion: Based on the data of the literature, NLR above cut-off value correlates with poor survival. Based on the author's own results, in the case of NLR>4.34, survival of the patients above the cut-off value (n = 22) was also significantly shorter compared to the patients below the cut-off value (n = 53) (HR 2.3; 95% CI 1.37-3.85; p = 0.0012). The effect of magnitude was large (0.8). Conclusion: Poor prognostic importance of elevated NLR is supported by the author's results in accordance with the literary data. Based on NLR values, modification of the therapeutic intensity can also be considered.