Cai Angshu, Zha Bowen, Zhang Chen, Guo Shuying, Wang Guiqi, He Shun
Department of Endoscopy, National Clinical Research Center for Cancer/Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, People's Republic of China.
Discov Oncol. 2025 Jul 17;16(1):1356. doi: 10.1007/s12672-025-03165-z.
This study aims to provide a simple indicator for predicting the prognosis of cancer survivors and offer reference and guidance for management strategies to ultimately improve their long-term prognosis.
Based on data from the 1999-2019 National Health and Nutrition Examination Survey, we included 3436 cancer survivors in this study. Participants were defined as cancer survivors if they had been previously diagnosed with cancer by a doctor or health professional. The neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and systemic inflammatory response index (SIRI) were used as systemic inflammatory markers. Survival status was determined by linking it with National Death Index records. Associations between systemic inflammatory markers and cancer survivor prognoses were evaluated using weighted Cox regression, Kaplan-Meier survival curves, and restricted cubic spline curves.
All three systemic inflammatory markers were significantly associated with cancer survivor prognoses after adjusting for confounders. NLR and SIRI were positively associated with all-cause mortality (ACM), while LMR was negatively associated with ACM in cancer survivors. The hazard ratios and 95% confidence interval were 1.10 (1.07-1.14), 1.16 (1.10-1.21) and 0.91 (0.87-0.95) respectively. In addition, a significant nonlinear correlation was observed between LMR and the prognosis of cancer survivors (P for nonlinear < 0.05).
NLR, SIRI, and LMR were independent predictors of prognosis in cancer survivors. NLR and SIRI were positively associated with ACM, while LMR was negatively associated with ACM.
Systemic inflammatory markers may help predict outcomes and inform care strategies for cancer survivors.
本研究旨在提供一种简单指标来预测癌症幸存者的预后，并为管理策略提供参考和指导，以最终改善他们的长期预后。
基于1999 - 2019年美国国家健康与营养检查调查的数据，本研究纳入了3436名癌症幸存者。如果参与者曾被医生或健康专业人员诊断患有癌症，则被定义为癌症幸存者。中性粒细胞与淋巴细胞比值（NLR）、淋巴细胞与单核细胞比值（LMR）和全身炎症反应指数（SIRI）被用作全身炎症标志物。通过与国家死亡指数记录相链接来确定生存状态。使用加权Cox回归、Kaplan-Meier生存曲线和受限立方样条曲线评估全身炎症标志物与癌症幸存者预后之间的关联。
在调整混杂因素后，所有三种全身炎症标志物均与癌症幸存者的预后显著相关。NLR和SIRI与全因死亡率（ACM）呈正相关，而LMR与癌症幸存者的ACM呈负相关。风险比和95%置信区间分别为1.10（1.07 - 1.14）、1.16（1.10 - 1.21）和0.91（0.87 - 0.95）。此外，观察到LMR与癌症幸存者的预后之间存在显著的非线性相关性（非线性P < 0.05）。
NLR、SIRI和LMR是癌症幸存者预后的独立预测因素。NLR和SIRI与ACM呈正相关，而LMR与ACM呈负相关。
全身炎症标志物可能有助于预测癌症幸存者的预后并为护理策略提供依据。
