Background/Objectives: 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.Methods: 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.Results: 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,p= 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,p= 0.026). Low hemoglobin (<12 g/dL) had a non-significant effect (HR 1.38, 95% CI 0.97–1.96,p= 0.074). PD-L1 ≥ 50% and chemo-immunotherapy correlated with longer PFS. Findings were consistent in the treatment-start anchored sensitivity analysis.Conclusions: These exploratory findings suggest that inexpensive hematologic markers can complement clinical assessment in advanced-stage NSCLC; prospective multi-center validation is warranted.
背景/目的：中性粒细胞与淋巴细胞比值(NLR)作为全身性炎症标志物，在非小细胞肺癌(NSCLC)中具有预后价值，但其在常规诊疗中的纵向动态变化特征尚不明确。本研究在一个东欧单中心队列中评估了NLR与血红蛋白的基线水平及12个月动态变化。 方法：本回顾性研究纳入2022年5月至2024年4月在罗马尼亚某三级医疗中心经组织学确诊的180例成年NSCLC患者，随访至2025年4月30日。从电子健康记录中提取基线人口统计学特征、肿瘤特征、分子谱、实验室参数及治疗方案。主要终点为无进展生存期(PFS)，次要终点为总生存期(OS)，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以治疗起始时间为锚点的敏感性分析。 结果：该队列（中位年龄67.8岁，68.9%为IV期）接受的治疗包括化疗联合免疫治疗(58.9%)、免疫单药治疗(26.7%)、化疗单药治疗(9.4%)或支持治疗(5.0%)。中位PFS为8.2个月，中位OS为14.5个月。高基线NLR（≥3，58.9%）显著增加疾病进展风险（HR 1.60，95% CI 1.10–2.32，p=0.014），并呈现OS缩短趋势（HR 1.45，95% CI 0.99–2.12）。12个月内NLR升高（62.2%）进一步增加进展风险（HR 1.52，95% CI 1.05–2.20，p=0.026）。低血红蛋白（<12 g/dL）的影响未达统计学显著性（HR 1.38，95% CI 0.97–1.96，p=0.074）。PD-L1表达≥50%和化疗联合免疫治疗与更长的PFS相关。以治疗起始时间为锚点的敏感性分析结果与主分析一致。 结论：这些探索性结果表明，在晚期NSCLC中，低成本血液学标志物可作为临床评估的补充工具，但需开展前瞻性多中心研究进行验证。
Inflammation-Based Prognostication in Advanced-Stage NSCLC: A Retrospective Cohort Study
肿瘤(癌症)患者之家