Using the combined C-reactive protein and controlling nutritional status index for elderly non-small cell lung cancer.

IF 2.1 3区医学 Q3 RESPIRATORY SYSTEM Journal of thoracic disease Pub Date : 2024-07-30 Epub Date: 2024-07-22 DOI:10.21037/jtd-24-435

Ryohei Miyazaki, Masaya Tamura, Takashi Sakai, Naoki Furukawa, Marino Yamamoto, Hironobu Okada

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Abstract

Background: We found that conventional controlling nutritional status (CONUT) score can serve as a sensitive prognostic marker. Some prognostic indicators do include C-reactive protein (CRP), such as the CRP-lymphocyte ratio (CLR), CRP-albumin-lymphocyte index (CALLY), and CRP-albumin ratio (CAR). However, CRP has not been combined with the CONUT score, which we believe could result in a more sensitive marker. This study evaluated the combined use of the CONUT score and CRP to predict prognostic outcomes in elderly non-small cell lung cancer (NSCLC) patients undergoing surgical resection.

Methods: This study involved the retrospective analysis of 114 NSCLC patients who were over 80 years old and underwent curative resection. The summation of the CRP score and CONUT score was defined as the combined CRP and controlling nutritional status (C-CONUT) score. The capacity of CRP, CONUT score, and C-CONUT score to predict overall survival (OS) was evaluated via receiver operating characteristics (ROC) curves. Prognostic markers for OS were then identified using the Cox proportional hazards regression model.

Results: The ROC curves identified the C-CONUT score as the most reliable marker of prognosis (area under the curve =0.745). Forty-seven patients were included in the high C-CONUT (≥3) group, while 67 patients were included in the low C-CONUT (0 to 2) group. Worse prognosis rates were observed in the high C-CONUT group in comparison to the low C-CONUT group in terms of OS (five-year OS: 39.8% versus 87.4%, P<0.001). Lymphatic invasion (P<0.001), histological findings (P=0.02), and C-CONUT score [hazard ratio (HR): 5.07, 95% confidence interval (CI): 2.39-10.8, P<0.001] were identified as exclusive markers for OS prognosis in the multivariate analysis.

Conclusions: Our current findings indicate that C-CONUT score may serve as an innovative prognostic marker in the elderly NSCLC population.

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使用 C 反应蛋白和营养状况控制综合指数检测老年非小细胞肺癌。

背景：我们发现，常规控制营养状况（CONUT）评分可作为敏感的预后指标。一些预后指标确实包括 C 反应蛋白（CRP），如 CRP-淋巴细胞比值（CLR）、CRP-白蛋白-淋巴细胞指数（CALLY）和 CRP-白蛋白比值（CAR）。然而，CRP 尚未与 CONUT 评分相结合，而我们认为，CONUT 评分可以产生更灵敏的标志物。本研究评估了联合使用 CONUT 评分和 CRP 预测接受手术切除的老年非小细胞肺癌（NSCLC）患者的预后结果：本研究对 114 名 80 岁以上接受根治性切除术的 NSCLC 患者进行了回顾性分析。CRP 评分和 CONUT 评分的总和被定义为 CRP 和控制营养状况（C-CONUT）综合评分。通过接收器操作特征曲线（ROC）评估了CRP、CONUT评分和C-CONUT评分预测总生存期（OS）的能力。然后使用 Cox 比例危险回归模型确定 OS 的预后标志物：ROC曲线确定C-CONUT评分是最可靠的预后指标（曲线下面积=0.745）。47例患者被纳入高C-CONUT（≥3）组，67例患者被纳入低C-CONUT（0至2）组。与低C-CONUT组相比，高C-CONUT组的OS预后较差（五年OS：39.8%对87.4%，五年OS：39.8%对87.4%，五年OS：39.8%对87.4%）：5年OS：39.8%对87.4%，PC结论：我们目前的研究结果表明，C-CONUT 评分可作为老年 NSCLC 患者的创新预后指标。

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来源期刊

Journal of thoracic disease RESPIRATORY SYSTEM-

CiteScore

4.60

自引率

4.00%

发文量

254

期刊介绍： The Journal of Thoracic Disease (JTD, J Thorac Dis, pISSN: 2072-1439; eISSN: 2077-6624) was founded in Dec 2009, and indexed in PubMed in Dec 2011 and Science Citation Index SCI in Feb 2013. It is published quarterly (Dec 2009- Dec 2011), bimonthly (Jan 2012 - Dec 2013), monthly (Jan. 2014-) and openly distributed worldwide. JTD received its impact factor of 2.365 for the year 2016. JTD publishes manuscripts that describe new findings and provide current, practical information on the diagnosis and treatment of conditions related to thoracic disease. All the submission and reviewing are conducted electronically so that rapid review is assured.