Marschollek Karol, Kosacka Monika, Pokryszko-Dragan Anna, Brzecka-Bonnaud Anna
Department of Neurology, Wroclaw Medical University, Wrocław, Poland.
Department of Pulmonology and Lung Oncology, Wroclaw Medical University, Wrocław, Poland.
Front Oncol. 2025 May 26;15:1582788. doi: 10.3389/fonc.2025.1582788. eCollection 2025.
Brain metastases are common and devastating complication of the lung cancer (LC) but predictive biomarkers for their risk are still lacking.
To analyze the relationships between complete blood count (CBC)-based and selected biochemical indices and occurrence of brain metastases in patients diagnosed with LC.
The study was based on retrospective analysis of medical records of 217 patients diagnosed with LC and undergoing follow-up in one specialist center. Clinical and laboratory data on admission were determined, including: neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), neutrophil-to-platelet ratio (NPR) and red cell distribution width-to-platelet ratio (RPR) and selected biochemical parameters. Relationships were evaluated between these parameters and occurrence of brain metastases, other distant metastases and death within 12 months of follow-up.
168 patients had the follow-up data for 6 months, and 128 - for 12 months. Brain metastases were detected in 41 patients and 1-year mortality rate was 17.61%. Patients who developed brain metastases during 12 months had significantly higher baseline NLR (4.66 vs 2.75, p<0.001), PLR (170.83 vs 142.42, p=0.03) and lower LMR (1.61 vs 2.33, p=0.008).In univariate analysis, higher leukocyte count (HR 1.08, p=0.016), neutrophil count (HR 1.11, p=0.0036), NLR (HR 1.09, p=0.005), d-dimer levels (HR 1.0002, p=0.0043), and lower LMR (HR 0.67, p=0.018) were significantly associated with the risk of developing brain metastases. Liver metastases were associated with lower LMR (1.69 vs 2.29, p=0.04), while metastases to the other lung - with lower PLR (126.52 vs 161.8, p=0.02) and higher LMR (2.51 vs 1.96, p=0.02) and RPR (0.184 vs 0.154, p=0.03). No significant relationships were found between CBC-based indices and mortality.
CBC-based indices could be useful and easily accessible predictive markers of brain metastases in the patients with lung cancer.
脑转移是肺癌（LC）常见且严重的并发症，但仍缺乏其风险的预测生物标志物。
分析基于全血细胞计数（CBC）和选定的生化指标与LC诊断患者脑转移发生之间的关系。
本研究基于对217例诊断为LC并在一个专科中心接受随访的患者病历的回顾性分析。确定入院时的临床和实验室数据，包括：中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）、中性粒细胞与血小板比值（NPR）、红细胞分布宽度与血小板比值（RPR）以及选定的生化参数。评估这些参数与脑转移、其他远处转移以及随访12个月内死亡发生之间的关系。
168例患者有6个月的随访数据，128例有12个月的随访数据。41例患者检测到脑转移，1年死亡率为17.61%。在12个月内发生脑转移的患者基线NLR显著更高（4.66对2.75，p<0.001）、PLR更高（170.83对142.42，p=0.03）且LMR更低（1.61对2.33，p=0.008）。在单因素分析中，白细胞计数升高（HR 1.08，p=0.016）、中性粒细胞计数升高（HR 1.11，p=0.0036）、NLR升高（HR 1.09，p=0.005）、D-二聚体水平升高（HR 1.0002，p=0.0043）以及LMR降低（HR 0.67, p=0.018）与发生脑转移的风险显著相关。肝转移与较低的LMR相关（1.69对2.29，p=0.04），而对侧肺转移与较低的PLR（126.52对161.8，p=0.02）、较高的LMR（2.51对1.96，p=0.02）和RPR（0.184对0.154，p=0.03）相关。基于CBC的指标与死亡率之间未发现显著关系。
基于CBC的指标可能是肺癌患者脑转移有用且易于获得的预测标志物。
