Yang Ming, Zhang Qi, Ge Yi-Zhong, Tang Meng, Hu Chun-Lei, Wang Zi-Wen, Zhang Xi, Song Meng-Meng, Ruan Guo-Tian, Zhang Xiao-Wei, Liu Tong, Xie Hai-Lun, Zhang He-Yang, Zhang Kang-Ping, Li Qin-Qin, Li Xiang-Rui, Liu Xiao-Yue, Lin Shi-Qi, Shi Han-Ping
Department of Gastrointestinal Surgery / Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.
Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China.
Front Nutr. 2022 May 10;9:871301. doi: 10.3389/fnut.2022.871301. eCollection 2022.
Non-small cell lung cancer (NSCLC) is among the most prevalent malignancies worldwide. Previous studies have shown that the status of inflammation, nutrition and immune are closely related to overall survival (OS) of patients with NSCLC, but little is known about their interactive and combined roles. Hence, we chose glucose to lymphocyte ratio (GLR) and modified Glasgow Prognosis Score (mGPS) as prognostic factors and assessed the prognostic values of them for patients with NSCLC.
Baseline clinicopathologic and laboratory characteristics of 862 patients with NSCLC were obtained from a multicenter prospective cohort. The Cox proportional hazard regression models were used to determine prognostic values of the clinical factors. A nomogram was also constructed integrating the clinical factors with clinical significance or independent prognostic values. Concordance index (C-index) was utilized to evaluate the prediction accuracy of the TNM stage and the nomogram.
Multivariate analyses demonstrated that GLR [Hazard ratio (HR) = 1.029, 95% confidence interval (CI) = 1.004-1.056, = 0.023] and mGPS (score of 1: HR = 1.404, 95% CI = 1.143-1.726, = 0.001; score of 2: HR = 1.515, 95% CI = 1.159-1.980, = 0.002) were independent prognostic factors for patients with NSCLC. The C-indexes of the TNM stage and the nomogram were 0.642 (95% CI = 0.620-0.663) and 0.694 (95% CI = 0.671-0.717), respectively.
GLR and mGPS were independent prognostic factors for patients with NSCLC. Moreover, our constructed nomogram might be superior in predicting prognosis of patients with NSCLC compared with the TNM stage.
非小细胞肺癌（NSCLC）是全球最常见的恶性肿瘤之一。既往研究表明，炎症、营养和免疫状态与NSCLC患者的总生存期（OS）密切相关，但对它们的交互作用和联合作用知之甚少。因此，我们选择血糖与淋巴细胞比值（GLR）和改良格拉斯哥预后评分（mGPS）作为预后因素，并评估它们对NSCLC患者的预后价值。
从一个多中心前瞻性队列中获取了862例NSCLC患者的基线临床病理和实验室特征。采用Cox比例风险回归模型确定临床因素的预后价值。还构建了一个列线图，将具有临床意义或独立预后价值的临床因素整合在一起。一致性指数（C-index）用于评估TNM分期和列线图的预测准确性。
多因素分析表明，GLR[风险比（HR）=1.029，95%置信区间（CI）=1.004-1.056，P=0.023]和mGPS（评分为1：HR=1.404，95%CI=1.143-1.726，P=0.001；评分为2：HR=1.515，95%CI=1.159-1.980，P=0.002）是NSCLC患者的独立预后因素。TNM分期和列线图的C-index分别为0.642（95%CI=0.620-0.663）和0.694（95%CI=0.671-0.717）。
GLR和mGPS是NSCLC患者的独立预后因素。此外，我们构建的列线图在预测NSCLC患者预后方面可能优于TNM分期。
