Noda Yuki, Matsudaira Hideki, Kato Daiki, Shibazaki Takamasa, Mori Shohei, Nakada Takeo, Yabe Mitsuo, Hirano Jun, Hoya Yoshiyuki, Ohtsuka Takashi
Department of Surgery, Machida Municipal Hospital, Tokyo, Japan.
Division of Thoracic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
J Thorac Dis. 2024 Nov 30;16(11):7490-7498. doi: 10.21037/jtd-24-987. Epub 2024 Nov 29.
Lung cancer is among the most common types of cancers worldwide, and surgery can be a curative treatment option for this condition. However, some patients experience postoperative recurrence. Hence, predicting early postoperative recurrence to improve patient prognosis is important. This study aimed to determine the usefulness of nutritional inflammation indexes in predicting the prognosis of early recurrence after lung cancer surgery.
A retrospective cohort study was conducted on 310 patients with primary lung cancer who underwent lung lobectomy at Jikei University Hospital from January 1, 2013, to December 31, 2017. The prognostic nutrition index (PNI), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and modified Glasgow prognostic score (mGPS) were calculated. The patients were classified into the high and low groups based on the receiver operating characteristic (ROC) curves. Furthermore, the association between these indexes and postoperative recurrence was analyzed via univariate analysis and using the Kaplan-Meier method.
The mean age of the patients was 67.0 years, and the male-to-female ratio was 199:111. The mean observation period was 30.6 months. Patients with a low NLR and mGPS had a significantly longer 5-year recurrence-free survival than those with a high NLR and mGPS (P=0.045 and 0.02, respectively). Patients with a low PNI had a significantly higher 1-year recurrence rate than those with a high PNI (P=0.007).
The PNI is associated with 1-year recurrence, and NLR and mGPS are considerably associated with 5-year postoperative recurrence in patients with lung cancer. Hence, these nutritional inflammatory indices can be useful in predicting postoperative recurrence.
肺癌是全球最常见的癌症类型之一，手术是治疗这种疾病的一种治愈性选择。然而，一些患者会出现术后复发。因此，预测术后早期复发以改善患者预后很重要。本研究旨在确定营养炎症指标在预测肺癌手术后早期复发预后中的作用。
对2013年1月1日至2017年12月31日在慈惠会医科大学医院接受肺叶切除术的310例原发性肺癌患者进行了一项回顾性队列研究。计算了预后营养指数（PNI）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）和改良格拉斯哥预后评分（mGPS）。根据受试者工作特征（ROC）曲线将患者分为高分组和低分组。此外，通过单因素分析和使用Kaplan-Meier方法分析了这些指标与术后复发之间的关联。
患者的平均年龄为67.0岁，男女比例为199:111。平均观察期为30.6个月。NLR和mGPS低水平的患者5年无复发生存期明显长于NLR和mGPS高水平的患者（分别为P=0.045和0.02）。PNI低水平的患者1年复发率明显高于PNI高水平的患者（P=0.007）。
PNI与1年复发相关，NLR和mGPS与肺癌患者术后5年复发密切相关。因此，这些营养炎症指标可用于预测术后复发。
