Golban Carina, Blaga Cristina-Miriam, Varga Norberth-Istvan, Negru Alina Gabriela, Hutanu Delia, Saftescu Sorin, Negru Serban Mircea
Doctoral School, Department of General Medicine, "Victor Babes" University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania.
Department of Cardiology, "Victor Babeș" University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania.
Cancers (Basel). 2025 Sep 5;17(17):2910. doi: 10.3390/cancers17172910.
: Neutrophil-to-lymphocyte ratio (NLR), a marker of systemic inflammation, has prognostic value in non-small cell lung cancer (NSCLC), but its longitudinal performance in routine care is unclear. We evaluated baseline and 12-month changes in NLR and hemoglobin in a single-center, Eastern European cohort. : In this retrospective study, 180 adults with histologically confirmed NSCLC, diagnosed May 2022-April 2024 at a Romanian tertiary center, were followed until 30 April 2025. Baseline demographics, tumor characteristics, molecular profiles, laboratory parameters, and treatments were extracted from electronic health records. Progression-free survival (PFS) was the primary endpoint, overall survival (OS) the secondary, analyzed using Kaplan-Meier curves and Cox proportional hazards models. An additional treatment-start-anchored sensitivity analysis in treated patients was conducted. : The cohort (median age 67.8 years, 68.9% stage IV) received chemo-immunotherapy (58.9%), immunotherapy (26.7%), chemotherapy (9.4%), or supportive care (5.0%). Median for PFS was 8.2 months and for OS 14.5 months. A high baseline NLR (≥3, 58.9%) increased progression risk (HR 1.60, 95% CI 1.10-2.32, = 0.014), with a trend for worse OS (HR 1.45, 95% CI 0.99-2.12). A 12-month NLR increase (62.2%) further elevated progression risk (HR 1.52, 95% CI 1.05-2.20, = 0.026). Low hemoglobin (<12 g/dL) had a non-significant effect (HR 1.38, 95% CI 0.97-1.96, = 0.074). PD-L1 ≥ 50% and chemo-immunotherapy correlated with longer PFS. Findings were consistent in the treatment-start anchored sensitivity analysis. : These exploratory findings suggest that inexpensive hematologic markers can complement clinical assessment in advanced-stage NSCLC; prospective multi-center validation is warranted.
中性粒细胞与淋巴细胞比值（NLR）是全身炎症的一个标志物，在非小细胞肺癌（NSCLC）中具有预后价值，但其在常规护理中的纵向表现尚不清楚。我们评估了一个东欧单中心队列中NLR和血红蛋白的基线水平及12个月的变化情况。
在这项回顾性研究中，对2022年5月至2024年4月在罗马尼亚一家三级中心确诊为组织学证实的NSCLC的180名成年人进行随访，直至2025年4月30日。从电子健康记录中提取基线人口统计学、肿瘤特征、分子谱、实验室参数和治疗方法。无进展生存期（PFS）是主要终点，总生存期（OS）是次要终点，采用Kaplan-Meier曲线和Cox比例风险模型进行分析。对接受治疗的患者进行了一项额外的以治疗开始为锚点的敏感性分析。
该队列（中位年龄67.8岁，68.9%为IV期）接受了化学免疫疗法（58.9%）、免疫疗法（26.7%）、化疗（9.4%）或支持性护理（5.0%）。PFS的中位数为8.2个月，OS的中位数为14.5个月。基线NLR高（≥3，58.9%）会增加进展风险（HR 1.60，95%CI 1.10 - 2.32，P = 0.014），OS有变差的趋势（HR 1.45，95%CI 0.99 - 2.12）。12个月时NLR升高（62.2%）会进一步提高进展风险（HR 1.52，95%CI 1.05 - 2.20，P = 0.026）。血红蛋白低（<12 g/dL）的影响不显著（HR 1.38，95%CI 0.97 - 1.96，P = 0.074）。PD-L1≥50%和化学免疫疗法与更长的PFS相关。在以治疗开始为锚点的敏感性分析中，结果一致。
这些探索性结果表明，廉价的血液学标志物可以在晚期NSCLC中补充临床评估；有必要进行前瞻性多中心验证。
