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Inflammation Marker May Predict Mesothelioma Prognosis

The ratio of neutrophils to lymphocytes – a way of measuring inflammation in the body of people with malignant pleural mesothelioma – may help doctors predict how well they will respond to treatment.

That is the conclusion of mesothelioma researchers at China’s Sichuan University. In a new article in the journal Oncotarget, the team observed that NLR has been associated with survival in other types of cancer but it’s value as a prognostic indicator in pleural mesothelioma is still unclear.

Neutrophils and Lymphocytes in Mesothelioma

Neutrophils are the most abundant type of white blood cells and a key part of the immune system. Lymphocytes are the primary type of white blood cells found in lymph. They include natural killer cells, T cells and B cells.

NLR is used in many types of diseases as a marker of inflammation. It is calculated by dividing the number of neutrophils in a blood sample by the number of lymphocytes. In several other types of cancer and in cardiovascular disease, a higher NLR has been associated with a worse prognosis.

Measuring Mesothelioma Prognosis

To determine the value of NLR in managing patients with malignant mesothelioma, researchers analyzed a total of 11 studies including 1533 malignant pleural mesothelioma patients. As predicted, the higher the NLR, the worse patients did.

A higher NLR was also found to be linked to which mesothelioma subtype a person had, but not to their gender, age or performance (overall health) score.

“These findings indicate the elevated NLR score could be a potential prognostication factor for malignant pleural mesothelioma patients and might be associated with histology as an efficient clinical index to stratify patients,” writes  lead researcher Nan Chin of the West China School of Medicine.

Value of Prognostic Indicators

Immune system cells have been at the top of the list for mesothelioma prognostic indicators for some time. Just last month, an article in the British Journal of Cancer found  a close association between certain types of neutrophils and lymphocytes and mesothelioma survival.

Understanding the key immunological drivers behind malignant mesothelioma is vital to immunotherapy, one of the most promising new approaches to treating mesothelioma.

As many as 2500 Americans are diagnosed with either pleural or peritoneal mesothelioma every year. There is currently no cure and few effective treatment options.


Chin, N, et al, “Prognostic Significance of Neutrophils to Lymphocytes Ratio in Patients with Malignant Pleural Mesothelioma: A Meta-Analysis”, February 2017, Oncotarget

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