Objective: Immunotherapies are commonly employed for the treatment of non-small-cell lung cancer (NSCLC). However, predictive biomarkers still need to be improved to predict responses to these agents. The lymphocyte–albumin (LA) laboratory index has not been evaluated before in this patient group. The aim of this study was to analyze the relation between the LA index and the survival rate of metastatic NSCLC patients who had immunotherapy after at least one round of chemotherapy. Methods: The research included 227 patients diagnosed with metastatic NSCLC, who were administered nivolumab after at least one round of chemotherapy. The LA index was calculated by multiplying lymphocyte count and albumin concentration. The optimal threshold values for the index were established by the examination of the ROC curve for both overall survival (OS) and progression-free survival (PFS). Oncological data were obtained retrospectively from patient files, and survival analyses were performed. Results: The median follow-up was 7.9 months. Progression was observed in 129 (56.9%) patients. A total of 97 (42.7%) patients died during the follow-up. The cutoff values of the LA index to predict OS and PFS were determined as 52.87 and 57.67, respectively. The low-LA group had significantly lowered OS and PFS compared to the high-LA group. LA was found to be an independent prognostic factor for PFS (hazard ratio 4.47; 95% confidence interval, 2.73–7.34;p< 0.001) and OS (hazard ratio 6.24; 95% confidence interval, 3.46–11.25;p< 0.001) in the multivariate regression analysis. Conclusions: In this study, we observed that the LA index independently predicts OS and PFS in immunotherapy-treated metastatic NSCLC patients. Its ease of application, low cost, and noninvasive nature make it a potential guide for clinicians in predicting treatment responses and survival.
目的：免疫疗法常用于治疗非小细胞肺癌（NSCLC），但目前仍需改进预测性生物标志物以评估患者对免疫治疗的反应。淋巴细胞-白蛋白（LA）实验室指标此前尚未在该患者群体中进行评估。本研究旨在分析LA指数与接受至少一轮化疗后使用免疫治疗的转移性NSCLC患者生存率之间的关系。方法：本研究纳入227例确诊为转移性NSCLC的患者，这些患者在至少接受一轮化疗后接受了纳武利尤单抗治疗。LA指数通过淋巴细胞计数与白蛋白浓度的乘积计算得出。通过绘制总生存期（OS）和无进展生存期（PFS）的受试者工作特征曲线确定LA指数的最佳临界值。肿瘤学数据通过回顾性分析患者档案获得，并进行生存分析。结果：中位随访时间为7.9个月。129例（56.9%）患者出现疾病进展，97例（42.7%）患者在随访期间死亡。预测OS和PFS的LA指数临界值分别确定为52.87和57.67。与高LA组相比，低LA组患者的OS和PFS显著降低。多因素回归分析显示，LA是PFS（风险比4.47；95%置信区间2.73–7.34；p<0.001）和OS（风险比6.24；95%置信区间3.46–11.25；p<0.001）的独立预后因素。结论：本研究发现，LA指数可独立预测接受免疫治疗的转移性NSCLC患者的OS和PFS。该指标操作简便、成本低廉且无创，有望为临床医生预测治疗反应和患者生存提供参考依据。
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