Platelet/Neutrophil Count Ratio (PNR) and Fibrinogen/Lymphocyte Count Ratio (FLR) Can Be Used as Predictive Indicators of Bone Metastasis in Non-Smoking Patients with Lung Cancer, but Not in Smoking Patients.
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Abstract
Objective: The purpose of this study is to evaluate the relationship between some comprehensive indices (platelet-to-neutrophil ratio (PNR), fibrinogen-to-lymphocyte ratio (FLR), albumin-to-monocyte ratio (AMR)) and bone metastasis of lung cancer.
Methods: A total of 1535 patients with lung cancer treated in Meizhou People's Hospital from November 2017 to May 2025 were retrospectively analyzed. Clinical characteristics (age, body mass index (BMI), bone metastasis, and PNR, FLR, and AMR levels) were collected. The optimal cutoff values of PNR, FLR, and AMR were calculated through the receiver operating characteristic (ROC) curve. The relationships between PNR, FLR, AMR and bone metastasis were analyzed.
Results: There were 665 (665/1535, 43.3%) patients had bone metastasis and 870 (870/1535, 56.7%) without. The levels of PNR (54.11 (38.11, 79.59) vs 50.06 (33.55, 72.10), p=0.004), and FLR (3.88 (2.67, 6.03) vs 3.36 (2.26, 5.27), p<0.001) in patients with bone metastasis were higher, and AMR (67.22 (47.55, 97.00) vs 70.45 (50.66, 104.91), p=0.027) was lower than those in patients without bone metastasis. The levels of PNR and FLR in bone metastasis group were higher than those in non-bone metastasis group among non-smoking patients, while AMR in bone metastasis group was lower than those in non-bone metastasis group among smoking patients. ROC analyses revealed that the critical value was 75.40 and area under the ROC curve (AUC) was 0.673 for PNR as an indicator for bone metastasis, while the critical value was 4.515 and AUC was 0.659 for FLR in non-smoking patients.
Conclusion: In conclusion, lung cancer mainly occurs in elderly men, among whom approximately 43% of patients have bone metastases. PNR and FLR have good predictive value in bone metastasis of non-smoking lung cancer patients.
期刊介绍：
The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas.
A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal.
As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.
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