Inflammation-based Neutrophil-to-Lymphocyte Ratio(NLR) as a Prognostic Biomarker for Patients With High-Risk Neuroblastoma

Background: Neutrophil-to-lymphocyte ratio (NLR) has been proven to be a prognostic biomarker in many malignancies. However, the prognostic significance of NLR in patients with high-risk neuroblastoma has not been reported. This study aims to evaluate the correlation between NLR and prognosis of patients with high-risk neuroblastoma. Methods: : We retrospectively analysed a cohort of 41 patients with high-risk neuroblastoma between January 2011 and December 2020. The optimal cut-off points of prognostic biomarkers were determined by drawing receiver operating characteristic (ROC) curves. According to the cut-off value, the patients were divided into low NLR group and high NLR group. The chi-square test was used to compare the clinicopathological parameters between the two NLR groups. The prognostic value of NLR was assessed using the Kaplan-Meier and univariable and multivariable Cox models. Results: Patients with high NLR were significantly related to poorer clinical characteristics and survival rate in high-risk subgroup neuroblastoma. In the univariate and multivariate Cox analyses, high NLR was an independent prognostic factor for patients with high-risk neuroblastoma (hazard ratio (HR) 5.066, 95% confidence interval (CI): 1.303-19.699, P=0.019 ). Conclusions: : Our study demonstrated that NLR was an independent prognostic biomarker for high-risk neuroblastoma. As NLR is easily calculated by widely available tests without additional costs, it can help guide subsequent therapeutic strategies for patients with high-risk neuroblastoma.