Clinical significance of neutrophil to lymphocyte ratio in patients with non-small cell lung cancer complicated with obstructive sleep apnea hypopnea syndrome

Objective To investigate the expression of neutrophil to lymphocyte ratio (NLR) and its relationship with obstructive sleep apnea hypoventilation syndrome (OSAHS) in non-small cell lung cancer patients with OSAHS.

Methods Thirty-one initially diagnosed as non-small-cell lung cancer patients combined with OSAHS were selected as combination group, and 31 patients with simple non-small-cell lung cancer and 31 healthy people were selected as simple group and control group, respectively. The differences in NLR, platelet to lymphocyte ratio (PLR) among groups were compared. Correlations of NLR and PLR with indicators related to sleep apnea in the combined group, and effects of OSAHS on NLR and PLR levels of patients with different lung cancer stages were analyzed.

Results NLR levels in the combined group and the simple group were (4.95±3.36) and (3.61±1.48), respectively, which were higher than (1.87±0.48) in the control group (P < 0.01). The level of NLR in the combined group was higher than that in the simple group (P < 0.05). The PLR levels of the combined group and the simple group were higher than those of the control group (P < 0.05 or P < 0.01). There was no significant difference in PLR level between the combined group and the simple group (P > 0.05). A partial correlation analysis showed that after adjusting for age and BMI, NLR had a positive correlation with sleep apnea hypopnea index (AHI) (r=0.567, P=0.002)and a negative correlation with minimum arterial oxygen saturation (SaO₂) in non-small cell lung cancer combined with OSAHS patients(r=-0.340, P=0.048). The levels of NLR and PLR in patients complicated with OSAHS in stage Ⅰ to Ⅲ lung cancer group were higher than those in patients without OSAHS (P < 0.05). The levels of NLR and PLR in patients complicated with OSAHS were also higher than those in patients without OSAHS in stage Ⅳ lung cancer group, but the differences were not statistically significant (P > 0.05).

Conclusion NLR levels are significantly increased in patients with non-small cell lung cancer combined with OSAHS compared with the controls and patients with simple non-small cell lung cancer, and there are correlations of NLR level with AHI and the minimum SaO₂.