Associations of systemic inflammation markers with identification of pulmonary nodule and incident lung cancer in Chinese population

Ting Tian; Jing Lu; Wei Zhao; Zhongming Wang; Hai Xu; Yuqing Ding; Wen Guo; Pei Qin; Wenfang Zhu; Ci Song; Hongxia Ma; Qun Zhang; Hongbing Shen

doi:10.1002/cam4.4606

Associations of systemic inflammation markers with identification of pulmonary nodule and incident lung cancer in Chinese population

Cancer Med. 2022 Jun;11(12):2482-2491. doi: 10.1002/cam4.4606. Epub 2022 Apr 5.

Authors

Ting Tian^{1

2}, Jing Lu^{1

2

3}, Wei Zhao¹, Zhongming Wang⁴, Hai Xu⁵, Yuqing Ding^{1

2}, Wen Guo³, Pei Qin³, Wenfang Zhu³, Ci Song^{1

2}, Hongxia Ma^{1

2}, Qun Zhang³, Hongbing Shen^{1

2

6}

Affiliations

¹ Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China.
² Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, Nanjing Medical University, Nanjing, China.
³ Health Promotion Center, Jiangsu Province Hospital and the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
⁴ Information Department, Jiangsu Province Hospital and the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
⁵ Department of Radiology, Jiangsu Province Hospital and the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
⁶ Research Units of Cohort Study on Cardiovascular Diseases and Cancers, Chinese Academy of Medical Sciences, Beijing, China.

Abstract

Objectives: Neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII), easily accessible systemic inflammation response parameters, were reported to associate with poor lung cancer prognosis. However, research on the effects of these markers on the risk of positive nodules (PNs) and lung cancer is limited.

Methods: Participants in this retrospective study were those who had their first computed tomography (CT) screening at Jiangsu Province Hospital's Health Promotion Center between January 1, 2017 and December 31, 2020. We identified PNs (≥6 mm in diameter) from free text of CT reports and lung cancer from medical records. Multivariate logistic analysis was used to assess the association between NLR, PLR, or SII and PNs or lung cancer.

Results: The detected rate of PNs was 9.60% among the 96,476 participants. Age, smoking and body mass index were possible influencing factors for PNs. We observed linear dose-effect relationship between NLR, PLR, or SII and PNs (p_non-linear > 0.05). Compared with low quintile, participants with top quintiles of NLR, PLR or SII had an increased risk of PNs, with the adjusted ORs of 1.19 (1.11-1.28), 1.11 (1.04-1.19) or 1.11 (1.03-1.18), respectively. Meanwhile, NLR showed the U-shaped relationship with lung cancer, with adjusted ORs of 1.40 (1.08-1.81) comparing highest NLR quintile to the third quintile. The high PLR and SII showed significantly associated with lung cancer with adjusted ORs of 1.29 (0.99-1.68) and 1.35 (1.04-1.74) comparing to the lowest quintile.

Conclusions: The high levels of systemic inflammation markers were associated with the risk of positive pulmonary nodules and lung cancer, which suggested systemic immune response may be an important pre-clinical feature for the early identification of diseases.

Keywords: CT scan; lung cancer; neutrophil-to-lymphocyte ratio; platelet-to-lymphocyte ratio; pulmonary nodules; systemic immune-inflammation index.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Biomarkers
China / epidemiology
Humans
Inflammation
Lung Neoplasms* / diagnosis
Lung Neoplasms* / epidemiology
Lymphocytes
Neutrophils
Prognosis
Retrospective Studies

Substances

Biomarkers