Objective  To investigate the correlation between preoperative blood platelet-to-lymphocyte ratio (PLR) and clinicopathological features, as well as the effect of PLR on the prognosis of non-small cell lung cancer (NSCLC) patients after surgical resection.

  Methods  Retrospective analysis was performed for 255 cases with histologically confirmed NSCLC that underwent curative resection from January 2004 to December 2007. All patients were classified into two groups based on the median value of PLR. The relationship between PLR and clinicopathological features was studied. Univariate and multivariate analyses were performed to assess the prognostic effect of preoperative PLR.

  Results  The median value of preoperative PLR was 130 (range: 45.45 to 272.66). Based on the cut-off value of 130, all patients were divided into two groups: low PLR (≤130, n=127) and high PLR (>130, n=128). PLR was correlated with tumor site, T stage, and clinical stage. Five-year survival rates of low and high PLR patients were 49.6% and 33.6%, respectively, which indicated a statistically significant difference (χ²=12.577, P < 0.001) between the two groups. Univariate analysis showed that smoking status, histological differentiation, clinical stage, T stage, N stage, postoperative adjuvant therapy and PLR were associated with survival (P < 0.05 for all). Multivariate analysis identified N stage, postoperative adjuvant therapy, and PLR as independent prognostic factors of all the patients. In addition, stratified analysis showed that the five-year survival rate of the low PLR group was higher than that of the high PLR group with or without lymph node metastasis, and the differences were statistically significant (P=0.020 and 0.037).

  Conclusion  An elevated blood preoperative PLR indicates poor prognosis in NSCLC patients. Preoperative PLR is an independent prognostic factor of NSCLC after curative resection.