Correlation of immune inflammatory indices and nutritional risk index with prognosis in patients with non-small cell lung cancer

Zhongmiao Shi; Dawei Zheng; Xiaowan Tang; Youyi Du

Correlation of immune inflammatory indices and nutritional risk index with prognosis in patients with non-small cell lung cancer

Am J Transl Res. 2023 Jun 15;15(6):4100-4109. eCollection 2023.

Authors

Zhongmiao Shi¹, Dawei Zheng², Xiaowan Tang³, Youyi Du⁴

Affiliations

¹ Department of Cardio-Thoracic Surgery, Shaoxing Shangyu Hospital of Traditional Chinese Medicine Shaoxing 312300, Zhejiang, China.
² Department of Respiratory, Nanyang Central Hospital Nanyang 473000, Henan, China.
³ Department of Medical Oncology, Taizhou First People's Hospital Taizhou 318000, Zhejiang, China.
⁴ Department of Respiratory Medicine, Lishui Central Hopistal Lishui 323000, Zhejiang, China.

PMID: 37434819
PMCID: PMC10331693

Abstract

Objective: To investigate the relationship of lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and nutritional risk index (NRI) with the prognosis of non-small cell lung cancer (NSCLC).

Methods: The clinical data of 400 NSCLC patients undergoing surgery at Shaoxing Shangyu Hospital of Traditional Chinese Medicine from January 2019 to June 2022 were collected for this retrospective analysis. The optimal cutoff values for NLR, PLR, LMR and NRI were determined using receiver operating characteristic (ROC) curves. The patients were grouped according to the optimal cutoff values, and the clinicopathological characteristics were compared between groups. The Kaplan-Meier survival curve and Cox risk model were used to identify the independent risk factors affecting the prognosis of patients with NSCLC. A nomogram risk prediction model was constructed and its effectiveness was verified.

Results: ROC curve analysis revealed that the area under the curve (AUC) values for NLR, PLR, LMR and NRI in predicting overall survival of NSCLC patients were 0.827, 0.753, 0.719 and 0.770, respectively. The optimal cutoff values for NLR, PLR, LMR and NRI were 2.49, 126.32, 3.02 and 89, respectively. Survival analysis found that the survival time was shorter in patients with NLR>2.49, PLR>126.32, LMR>3.02 and NRI≤89. Results from Cox model indicated that TNM staging, NLR>2.49, LMR>3.02, NRI≤89, surgical method, intraoperative blood loss, postoperative complication, and adjuvant chemotherapy were risk factors affecting the prognosis of NSCLC patients. A nomogram was constructed based on the results of multivariate analysis. The AUC of the nomogram was 0.967 (95% CI: 0.943-0.992) and 0.948 (95% CI: 0.874-1) in the training set and the test set, respectively. The C-index was 0.90 and 0.89, respectively. The calibration curve demonstrated good agreement between the predicted values of the nomogram and the actual observed values.

Conclusion: NLR, LMR and NRI are significant predictors of the prognosis of patients with NSCLC. NLR>2.49, LMR>3.02, and NRI≤89 are risk factors for the prognosis of NSCLC patients.

Keywords: LMR; NLR; NRI; NSCLC; relevance.