International Journal of Clinical Oncology

, Volume 24, Issue 2, pp 168–178 | Cite as

Prognostic significance of neutrophil/lymphocyte ratio (NLR) and correlation with PET–CT metabolic parameters in small cell lung cancer (SCLC)

  • Cem MiriliEmail author
  • Isa Burak Guney
  • Semra Paydas
  • Gulsah Seydaoglu
  • Tuba Korkmaz Kapukaya
  • Ali Ogul
  • Serkan Gokcay
  • Mahmut Buyuksimsek
  • Abdullah Evren Yetisir
  • Bilgin Karaalioglu
  • Mert Tohumcuoglu
Original Article



The aim of this study is to detect the prognostic significance of neutrophil/lymphocyte ratio (NLR) in SCLC and to evaluate the relation with 18F-FDG PET–CT metabolic parameters (PET–CT MPs).


Demographic parameters, laboratory values including NLR and other clinical variables were analyzed in 112 patients with small cell lung cancer (SCLC) and 54 of these patients had results of metabolic parameters detected with 18 FDG PET–CT [including SUVmax, SUVmean, metabolic tumor volume (MTV), whole body MTV (WBMTV), TLG (total lesion glycolysis), whole body TLG (WBTLG)] were evaluated for survival analyses.


Mean and median overall survival (OS) and progression-free survival (PFS) were found to be significantly longer in cases with NLR < 4 compared with NLR > 4 in totally. Also stage, performance status, response to first-line therapy, LDH, and lymphocyte count were found to be prognostic for OS and PFS. MTV, WBMTV and WBTLG were found to be prognostic for both OS and PFS, while SUVmax found to be significant for OS. Patients with NLR ≥ 4, MTV ≥ 60.1, WBMTV ≥ 120 and WBTLG ≥ 1000 points had lower OS and PFS. A moderate positive correlation was found between NLR and SUVmean (r: 0.36), SUVmax (r: 0.34), TLG (r: 0.39), MTV (r: 0.51), WBMTV (r: 0.40), and WBTLG (r: 0.46).


There is relationship between PET–CT metabolic parameters and NLR in SCLC. Highest correlation was found with NLR and MTV, WBMTV, and WBTLG, and evaluation of NLR together with these parameters predicts survival times and tumor biology more clearly in SCLC.


Small cell lung cancer (SCLC) Neutrophil/lymphocyte ratio (NLR) PET–CT Metabolic tumor volume (MTV) Whole body metabolic tumor volume (WBMTV) Whole body total lesion glycolysis (WBTLG) 



This article has been approved of as an Oral Presentation in 7. Turkish Society of Medical Oncology Congress (21–25 March 2018).



Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Japan Society of Clinical Oncology 2018

Authors and Affiliations

  • Cem Mirili
    • 1
    Email author
  • Isa Burak Guney
    • 2
  • Semra Paydas
    • 1
  • Gulsah Seydaoglu
    • 3
  • Tuba Korkmaz Kapukaya
    • 4
  • Ali Ogul
    • 1
  • Serkan Gokcay
    • 1
  • Mahmut Buyuksimsek
    • 1
  • Abdullah Evren Yetisir
    • 1
  • Bilgin Karaalioglu
    • 1
  • Mert Tohumcuoglu
    • 1
  1. 1.Department of Medical OncologyÇukurova University Faculty of MedicineAdanaTurkey
  2. 2.Department of Nuclear MedicineÇukurova University Faculty of MedicineAdanaTurkey
  3. 3.Department of BiostatisticsÇukurova University Faculty of MedicineAdanaTurkey
  4. 4.Department of Internal MedicineÇukurova University Faculty of MedicineAdanaTurkey

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