Lo Buglio Aurelio, Bellanti Francesco, Carapellese Rosanna Maria, Villani Rosanna, Sangineto Moris, Romano Antonino Davide, Vendemiale Gianluigi, Serviddio Gaetano
Department of Medical and Surgical Sciences, University of Foggia, 71122 Foggia, Italy.
Int J Mol Sci. 2025 May 5;26(9):4375. doi: 10.3390/ijms26094375.
Chronic inflammation is increasingly recognized as a key driver of tumorigenesis, affecting both the tumor microenvironment and host response. In this context, circulating inflammatory proteins may provide valuable insights into cancer activity. This study evaluated the diagnostic performance of the inflammatory protein ratio (IPR), a composite index derived from serum protein electrophoresis, in detecting active cancer among hospitalized patients. We retrospectively analyzed clinical and laboratory data from 312 adult patients admitted to the Internal Medicine and Aging Department at Policlinico Foggia, Italy, between November 2023 and July 2024. Patients were stratified according to the presence of active cancer, defined by NICE criteria. The diagnostic accuracy of the IPR was compared with that of conventional inflammatory markers, including C-reactive protein (CRP) and the neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), monocyte-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII). The IPR showed the highest diagnostic performance, with a sensitivity of 88.1%, a specificity of 75.2%, and an area under the receiver operating characteristic curve (AUC) of 0.868. Its negative predictive value reached 97.6%, underscoring its potential as a rule-out tool for malignancy in hospitalized patients. These findings support the IPR as a promising and cost-effective inflammation-based biomarker for cancer detection, warranting further validation in prospective and molecularly characterized cohorts.
慢性炎症日益被认为是肿瘤发生的关键驱动因素，影响肿瘤微环境和宿主反应。在此背景下，循环炎症蛋白可能为癌症活动提供有价值的见解。本研究评估了炎症蛋白比率（IPR）（一种源自血清蛋白电泳的综合指标）在检测住院患者活动性癌症中的诊断性能。我们回顾性分析了2023年11月至2024年7月期间意大利福贾综合医院内科和老年病科收治的312例成年患者的临床和实验室数据。根据由英国国家卫生与临床优化研究所（NICE）标准定义的活动性癌症的存在情况对患者进行分层。将IPR的诊断准确性与传统炎症标志物的诊断准确性进行比较，传统炎症标志物包括C反应蛋白（CRP）、中性粒细胞与淋巴细胞比率（NLR）、血小板与淋巴细胞比率（PLR）、单核细胞与淋巴细胞比率（MLR）以及全身免疫炎症指数（SII）。IPR显示出最高的诊断性能，敏感性为88.1%，特异性为75.2%，受试者操作特征曲线下面积（AUC）为0.868。其阴性预测值达到97.6%，突出了其作为住院患者恶性肿瘤排除工具的潜力。这些发现支持IPR作为一种有前景且具有成本效益的基于炎症的癌症检测生物标志物，值得在前瞻性队列和分子特征队列中进一步验证。
