The advanced lung cancer inflammation index is the optimal inflammatory biomarker of overall survival in patients with lung cancer

医学 肺癌 内科学 危险系数 比例危险模型 肿瘤科 接收机工作特性 癌症 置信区间 单变量分析 多元分析 生物标志物 化学 生物化学
作者
Mengmeng Song,Qi Zhang,Chunhua Song,Tong Liu,Xi Zhang,Guo‐Tian Ruan,Meng Tang,Hailun Xie,Heyang Zhang,Yi‐Zhong Ge,Xiangrui Li,Kangping Zhang,Ming Yang,Qinqin Li,Xiaoyue Liu,Shiqi Lin,Yu Xu,Hongxia Xu,Kunhua Wang,Wei Li,Hanping Shi
出处
期刊:Journal of Cachexia, Sarcopenia and Muscle [Wiley]
卷期号:13 (5): 2504-2514 被引量:52
标识
DOI:10.1002/jcsm.13032
摘要

Malnutrition and systemic inflammatory responses are associated with poor overall survival (OS) in lung cancer patients, but it remains unclear which biomarkers are better for predicting their prognosis. This study tried to determine the best one among the existing common nutrition/inflammation-based indicators of OS for patients with lung cancer.There were 16 nutrition or systemic inflammation-based indicators included in this study. The cut-off points for the indicators were calculated using maximally selected rank statistics. The OS was evaluated using the Kaplan-Meier estimator, and univariate and multivariate Cox proportional hazard models were used to determine the relationship between the indicators and OS. A time-dependent receiver operating characteristic curves (time-ROC) and C-index were calculated to assess the predictive ability of the different indicators.There were 1772 patients with lung cancer included in this study. In univariate analysis, all 16 indicators were significantly associated with OS of the patients (all P < 0.001). Except for platelet-to-lymphocyte ratio, all other indicators were independent predictors of OS in multivariate analysis (all P < 0.05). Low advanced lung cancer inflammation index (ALI) was associated with higher mortality risk of lung cancer [hazard ratio, 1.30; 95% confidence interval (CI), 1.13-1.49]. The results of the time-AUC and C-index analyses indicated that the ALI (C-index: 0.611) had the best predictive ability on the OS in patients with lung cancer. In different sub-groups, the ALI was the best indicator for predicting the OS of lung cancer patients regardless of sex (C-index, 0.609 for men and 0.613 for women) or smoking status (C-index, 0.629 for non-smoker and 0.601 for smoker) and in patients aged <65 years (C-index, 0.613). However, the modified Glasgow prognostic score was superior to the other indicators in non-small cell lung cancer patients (C-index, 0.639) or patients aged ≥65 years (C-index, 0.610), and the glucose-to-lymphocyte ratio performed better prognostic ability in patients with small cell lung cancer (C-index, 0.601).The prognostic ability of the ALI is superior to the other inflammation/nutrition-based indicators for all patients with lung cancer.
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