Mariean Claudia Raluca, Tiucă Oana Mirela, Al-Akel Cristina Flavia, Cotoi Ovidiu Simion
Doctoral School of Medicine and Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania.
Pathophysiology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Targu Mures, Romania.
Life (Basel). 2025 Jun 16;15(6):963. doi: 10.3390/life15060963.
Since lung cancer remains a health problem worldwide and is the leading cause of cancer death, finding new tools that can help in the early identification of high-risk patients remains a key target.
A retrospective descriptive study of 70 patients diagnosed with lung cancer at the Clinical County Hospital Mureș was conducted. Information regarding the histopathological type of the tumor, the TNM stage at diagnosis, and the CBC-derived inflammatory status was obtained for all the included patients. Skeletal muscle area was measured at the level of the third lumbar vertebra (L3SMA), based on the patients' native CT scans, to identify sarcopenia. These four primary characteristics (the histopathological type of the tumor, the TNM stage, the systemic inflammatory status, and the sarcopenic changes) were integrated into a new severity score: the histology, sarcopenia, and lung inflammation score (HISLIS). Subsequently, based on the HISLIS score, the patients were divided into three severity grades (high, medium, and low).
Our results showed that patients diagnosed in late advanced TNM stages (III or IV) had the highest severity grade. The severity grade strongly correlated with the systemic inflammatory biomarkers, with the highest severity grades being associated with an increased inflammatory status. In addition, sarcopenic patients were diagnosed in more advanced TNM stages, exhibited higher HISLIS levels, and had a higher degree of systemic inflammation than non-sarcopenic patients. Sarcopenic patients also showed an impaired hematological profile, with hemoglobin (Hb) and hematocrit (Ht) levels being significantly decreased in sarcopenic patients.
Future prospective studies are needed to validate the HISLIS and integrate it into the routine clinical and paraclinical assessment of lung cancer patients, as it could represent a triage tool for the early identification of patients at higher risk of unfavorable outcomes. Combining critical information regarding the tumors' characteristics, such as TNM stage and histological characteristics, together with biological and imaging-derived information like the CBC-derived inflammatory status and the associated degree of sarcopenia, could lead to a complex approach and a personalized therapeutic regimen for this highly deadly condition.
由于肺癌仍是全球范围内的一个健康问题，且是癌症死亡的主要原因，因此寻找有助于早期识别高危患者的新工具仍然是一个关键目标。
对穆列什县临床医院诊断为肺癌的70例患者进行了一项回顾性描述性研究。获取了所有纳入患者的肿瘤组织病理学类型、诊断时的TNM分期以及基于全血细胞计数得出的炎症状态信息。根据患者的原始CT扫描，在第三腰椎水平测量骨骼肌面积（L3SMA），以确定肌肉减少症。将这四个主要特征（肿瘤的组织病理学类型、TNM分期、全身炎症状态和肌肉减少症变化）整合为一个新的严重程度评分：组织学、肌肉减少症和肺部炎症评分（HISLIS）。随后，根据HISLIS评分将患者分为三个严重程度等级（高、中、低）。
我们的结果表明，诊断为晚期TNM分期（III或IV期）的患者严重程度等级最高。严重程度等级与全身炎症生物标志物密切相关，最高严重程度等级与炎症状态增加相关。此外，肌肉减少症患者被诊断为更晚期的TNM分期，表现出更高的HISLIS水平，并且比非肌肉减少症患者具有更高程度的全身炎症。肌肉减少症患者还表现出血液学指标受损，肌肉减少症患者的血红蛋白（Hb）和血细胞比容（Ht）水平显著降低。
未来需要进行前瞻性研究以验证HISLIS，并将其纳入肺癌患者的常规临床和辅助临床评估中，因为它可能代表一种用于早期识别预后不良风险较高患者的分诊工具。将有关肿瘤特征的关键信息（如TNM分期和组织学特征）与生物学和影像学衍生信息（如基于全血细胞计数得出的炎症状态和相关的肌肉减少症程度）相结合，可能会为这种高度致命的疾病带来一种综合方法和个性化治疗方案。
