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晚期肺癌炎症指数在特发性肺纤维化患者中的预后作用

The Prognostic Role of Advanced Lung Cancer Inflammation Index in Patients with Idiopathic Pulmonary Fibrosis.

作者信息

Bozkuş Fulsen, Keskin Olgun

机构信息

Department of Chest Disease, University of Health Sciences, Antalya Training and Research Hospital, 07050 Antalya, Turkey.

出版信息

J Clin Med. 2024 Oct 2;13(19):5874. doi: 10.3390/jcm13195874.

Abstract

: The advanced lung cancer inflammation index (ALI) is an innovative and thorough measure designed to assess both inflammation and nutritional status. It includes parameters such as albumin, body mass index (BMI), and the neutrophil-to-lymphocyte ratio (NLR). This research seeks to evaluate the prognosis of idiopathic pulmonary fibrosis (IPF) patients by integrating both inflammation and nutritional status, distinguishing it from conventional inflammation biomarkers. : This study included 102 patients with IPF. Clinical data were extracted from the patients' medical records. NLR and ALI scores were calculated based on data collected at the initiation of antifibrotic treatment using the following formulas: Neut/Lym for NLR and albumin × BMI/NLR for ALI. : ALI values were assessed across various IPF patient subgroups based on gender-age-physiology (GAP) stages (1, 2, and 3), forced vital capacity (FVC) (median split: <70% vs. ≥70%), diffusing capacity for carbon monoxide (DLCO) (<51% vs. ≥51%), 6-Minute Walk Test (6MWT) (<350 vs. ≥350), and the Charlson comorbidity index (CCI) (≤1 vs. >1). Significant differences in ALI were observed with respect to GAP stages, FVC, DLCO, and 6MWT categories ( = 0.000 for all), but not for CCI categories ( = 0.233). Receiver operating characteristic (ROC) curve analysis revealed that ALI had a sensitivity of 63.6% and a specificity of 98.9% at a threshold of 11.2 (AUC = 0.945, 95% CI 0.892-0.998, < 0.000). : Our findings indicate that ALI levels are significantly associated with disease severity and mortality in IPF patients.

摘要

晚期肺癌炎症指数(ALI)是一项旨在评估炎症和营养状况的创新且全面的指标。它包括白蛋白、体重指数(BMI)和中性粒细胞与淋巴细胞比值(NLR)等参数。本研究旨在通过综合炎症和营养状况来评估特发性肺纤维化(IPF)患者的预后,使其有别于传统的炎症生物标志物。:本研究纳入了102例IPF患者。临床数据从患者病历中提取。根据抗纤维化治疗开始时收集的数据,使用以下公式计算NLR和ALI评分:NLR为中性粒细胞/淋巴细胞,ALI为白蛋白×BMI/NLR。:根据性别 - 年龄 - 生理学(GAP)分期(1、2和3期)、用力肺活量(FVC)(中位数分割:<70% 与≥70%)、一氧化碳弥散量(DLCO)(<51% 与≥51%)、6分钟步行试验(6MWT)(<350与≥350)以及Charlson合并症指数(CCI)(≤1与>1),对不同IPF患者亚组的ALI值进行评估。观察到ALI在GAP分期、FVC、DLCO和6MWT类别方面存在显著差异(所有均P = 0.000),但在CCI类别方面无显著差异(P = 0.233)。受试者工作特征(ROC)曲线分析显示,在阈值为11.2时,ALI的敏感性为63.6%,特异性为98.9%(AUC = 0.945,95%CI 0.892 - 0.998,P < 0.000)。:我们的研究结果表明,ALI水平与IPF患者的疾病严重程度和死亡率显著相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/89b3/11477896/33e577cf0db2/jcm-13-05874-g001.jpg

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本文引用的文献

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Neutrophil-lymphocyte ratio being associated with mortality risk in patients receiving antifibrotic therapy.
Respir Med. 2024 Mar;223:107542. doi: 10.1016/j.rmed.2024.107542. Epub 2024 Feb 7.
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Neutrophil-lymphocyte ratio in patients with idiopathic pleuroparenchymal fibroelastosis.
BMJ Open Respir Res. 2023 Dec 11;10(1):e001763. doi: 10.1136/bmjresp-2023-001763.
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The prognostic value of advanced lung cancer inflammation index (ALI) in elderly patients with heart failure.
Front Cardiovasc Med. 2022 Nov 11;9:934551. doi: 10.3389/fcvm.2022.934551. eCollection 2022.
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Blood monocyte counts as a prognostic biomarker and predictor in Chinese patients with idiopathic pulmonary fibrosis.
Front Med (Lausanne). 2022 Nov 8;9:955125. doi: 10.3389/fmed.2022.955125. eCollection 2022.
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Neutrophil lymphocyte ratio as an indicator for disease progression in Idiopathic Pulmonary Fibrosis.
BMJ Open Respir Res. 2022 Jun;9(1). doi: 10.1136/bmjresp-2022-001202.

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