Does advanced lung inflammation index (ALI) have prognostic significance in metastatic non-small cell lung cancer?

Clin Respir J. 2018 Jun;12(6):2013-2019. doi: 10.1111/crj.12768. Epub 2018 Feb 9.

Abstract

Background: Lung cancer is the most commonly diagnosed and death-related cancer type and is more frequent in males. Non-small-cell lung cancer (NSCLC) accounts for about 85% of all case. In this study, it was aimed to research the relationship between advanced lung inflammation index (ALI) and the primary mass maximum standardized uptake value (SUVmax) and C-reactive protein (CRP) at initial diagnosis and the prognostic value of ALI in determining the survival in metastatic NSCLC.

Methods: A total of 112 patients diagnosed as stage 4 non-small-lung cancer in our hospital between January 2006 and December 2013 were included in this study. ALI was calculated as body mass index (BMI) × serum albumin/neutrophil-to-lymphocyte ratio (NLR). The patients were divided into two groups as ALI < 18 (high inflammation) and ALI ≥ 18 (low inflammation). The log-rank test and Cox proportional hazard model were used to identify predictors of mortality.

Results: Evaluation was made of 94 male and 18 female patients with a mean age of 59.7 ± 9.9 years. A statistically significant negative relationship was determined between ALI and CRP values (P < .001), but no relationship was found between ALI and SUVmax values (P = .436). The median survival time in patients with ALI < 18 was 12 months and, in those with ALI ≥ 18, it was 16 months (P = .095).

Conclusion: ALI is an easily calculated indicator of inflammation in lung cancer patients. Values <18 can be considered to predict a poor prognosis.

Keywords: advanced lung cancer; advanced lung inflammation index; prognosis.

MeSH terms

  • Biomarkers, Tumor / metabolism
  • C-Reactive Protein / metabolism*
  • Carcinoma, Non-Small-Cell Lung / diagnosis
  • Carcinoma, Non-Small-Cell Lung / metabolism
  • Carcinoma, Non-Small-Cell Lung / secondary*
  • Female
  • Follow-Up Studies
  • Humans
  • Inflammation / diagnosis*
  • Inflammation / metabolism
  • Lung Neoplasms / metabolism
  • Lung Neoplasms / mortality
  • Lung Neoplasms / pathology*
  • Lymphocytes / pathology
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasm Staging*
  • Neutrophils / pathology
  • Positron Emission Tomography Computed Tomography
  • Prognosis
  • Retrospective Studies
  • Survival Rate / trends
  • Turkey / epidemiology

Substances

  • Biomarkers, Tumor
  • C-Reactive Protein