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Artikel Background Lung cancer remains the most common malignancy worldwide, being the leading cause of cancer-related death, in both men and women, with most patients presenting advanced-stage disease at diagnostic, with metastatic cancer lung response at therapy 12.

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Disease stage according to tumour nodes metastasis TNM classification, histology, gender, age and performance status are the most widely accepted prognostic factors, but not sufficiently effective for clinical use 3. Thus, during recent years, an increasing number of studies have focused on novel and potential effective prognostic factors which may allow clinicians to use more appropriate therapeutic strategies.

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Systemic inflammation through its cellular, molecular effectors and pathways plays an important role in the development and progression of many types of cancer, including lung cancer, and represents an open way for discovering accessible and feasible prognostic biomarkers for clinical use in an attempt to refine stratification of patients to personalised treatment and predict survival.

On the other hand, tumour cells also contribute to the tumour microenvironment, producing various cytokines and chemokines that metastatic cancer lung inflammatory cells: a diverse leukocyte population neutrophils, mast cells, dendritic cells, macrophages and eosinophils as well as lymphocytes 5.

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Neutrophils which are recruited into the tumour process, mainly by tumour necrosis factor alpha TNFαhave a complex role in tumourigenesis by inhibiting apoptosis, promoting angiogenesis, cell proliferation and facilitating the formation of metastases. There are two possible mechanisms through which neutrophils induce cell proliferation.

The second is neutrophil elastase ability to overactivate the phosphoinositide 3-kinase PI3K pathway the most commonly activated signalling pathway in human cancer with strong proliferative effects on lung cancer 67. The role of lymphocytes in cancer growth was also highlighted in many studies.


Tumour lymphocytic infiltration may suppress or promote tumour progression, depending on dominant subsets of lymphocytes. Platelets are also recognised to be involved in the immune and inflammatory response, participating in regulation of mechanisms underlying a broad range of diseases, as cardiovascular disease, diabetes, sepsis and malignancies. Activated platelets can contribute to tumour growth and invasiveness of cancer cells by releasing cytokines involved in angiogenesis vascular endothelial growth factor: VEGF and platelet-derived growth factor: PDGFpromoting the formation of metastatic cancer lung capillary-like structure by endothelial cells, helping tumoral cells to escape immune surveillance by interacting with fibrin and formation of platelet-fibrin-tumour metastatic cancer lung and enhancing tumour metastasis 3.

These findings could explain the metastatic cancer lung between elevated platelets and poor prognosis in malignant tumours, including lung cancer reported by several studies.

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As mentioned above, there are several inflammatory cells with individual prognostic value, but an increasing body of evidence indicates that the levels of neutrophils, platelets and lymphocytes may function as a combined factor, which may more accurately reflect the inflammatory response, compared with a single factor. Metastatic cancer lung, the neutrophil-to-lymphocyte ratio NLR and platelet-to-lymphocyte ratio PLR have been developed as novel indicators of inflammation and potential prognostic biomarkers in many solid tumours, including lung cancer The aim of this study was to assess the relation between metastatic cancer lung affordable biomarkers of systemic inflammation, as NLR, PLR and erythrocytes sedimentation rate ESRTNM staging and negative metastatic cancer lung of patients with lung cancer.

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The analysed data age, gender, body mass index [BMI], haemogram-derived parameters, leukocyte count, neutrophil count, lymphocyte count, platelet count [NLR and PLR], erythrocyte sedimentation rate: ESR, histopathological type and TNM tumour stage were obtained from the medical file of the patients. The informed consent signed at admission by patients allows us to use anonymised medical data for research diferență între ciuperci viruși bacterieni și paraziți publication purposes.

The NLR and PLR ratios were calculated absolute number of neutrophils and platelets divided by the lymphocytes number, as measured in the peripheral blood sample.

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Each group was divided into two subsets: survivors As, Bs and deceased Ad, Bd patients. The NLR and PLR were calculated for each subset group and the values ware compared between the survivor and deceased patients.

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Statistical analysis of the data was performed using SPSS version Distribution of data was assessed using the Shapiro—Wilk test. The diagrams used are bar charts.

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Results and discussion A total of consecutive patients diagnosed with lung cancer were included in this study. The median age was 67 years 37—88with the predominance of males History of smoking active or former smokers was encountered in The majority of patients were diagnosed with NSCLC and the most common histological subtype was adenocarcinoma The median value of NLR was 3.

The baseline characteristics of the patients included in the two groups are shown in Table 1. Table 1 Characteristic of the patients with resectable Group A and nonresectable Group B lung cancer patients.