Preoperative Neutrophil-to-lymphocyte Ratio is Valuable in Identifying the Micropapillary Component in Stage IA Lung Adenocarcinoma: A Retrospective Study

Background : Biomarkers for identifying the solid or micropapillarycomponents in stage IA lung adenocarcinoma are urgently needed. Our study examined whether preoperative systemic inflammatory markers were valuable in identifying the solid or micropapillary components in stage IA lung adenocarcinoma and their association with prognosis. Methods : Clinicopathological data of 640 patients with stage IA lung adenocarcinoma between January 2012 and December 2018 were retrospectively analyzed. Independent predictors of specific components were determined by logistic regression analysis. Correlations between systemic inflammatory markers and the cumulative incidence of recurrence were also assessed. Results : The preoperative neutrophil-to-lymphocyte ratio of the “micropapillary positive” group was significantly higher than that of the “micropapillary negative” group (P=0.006). None of the systemic inflammation markers showed significant differences between the groups with or without a solid component (P≥0.05). Multivariate analysis confirmed that preoperative neutrophil-to-lymphocyte ratio (odds ratio [OR]=1.272; 95% confidence interval [CI], 1.047–1.544; P=0.015), tumor size (OR=1.982; 95% CI, 1.480–2.652; P<0.001), and carcinoembryonic antigen level (OR=1.095; 95% CI, 1.035–1.159; P=0.002) were independent predictive factors for the micropapillary component in stage IA lung adenocarcinoma. None of the systemic inflammatory markers showed a significant correlation with thecumulative incidence of recurrence in stage IA lung adenocarcinoma. Conclusions : The preoperative neutrophil-to-lymphocyte ratio independently predicted the existence of a micropapillary component in stage IA lung adenocarcinoma. Future investigations should explore the use of this ratio in combination with other clinicopathological parameters to help clinicians develop optimal surgical strategies. Furthermore, none of the systemic inflammatory markers showed significant associations with the cumulative incidence of recurrence in stage IA lung adenocarcinoma, which warrants additional in-depth analyses in future studies.