{"title":"术前炎症生物标志物对非小细胞肺癌术后肺炎和术后1个月肺部影像学变化的影响","authors":"Yingding Ruan, Wenjun Cao, Jianwei Han, Aiming Yang, Jincheng Xu, Ting Zhang","doi":"10.3389/fonc.2025.1489068","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This study examined the effectiveness of preoperative inflammatory markers in predicting the occurrence of postoperative pneumonia (POP) and clinical outcomes based on chest computed tomography (CT) images in patients who underwent surgical resection for non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>This retrospective study included NSCLC patients who underwent lung cancer surgery at The First People's Hospital of Jiande between January 2019 and October 2023. Data on demographic characteristics, preoperative inflammatory biomarkers, surgical approach and duration, postoperative outcomes, and CT findings 1 month postoperatively were collected and analyzed. The effectiveness of preoperative inflammatory markers in predicting POP and clinical outcomes 1 month after surgical resection was assessed using propensity score matching.</p><p><strong>Results: </strong>Among 568 patients, 72 (12.7%) had POP. After matching, 252 patients (POP group: 66; non-POP group: 186) were included in the analysis. The systemic immune-inflammation index (SII) and platelet-to-lymphocyte ratio (PLR) were significantly higher in the POP group than in the non-POP group (433.53 vs. 323.75, <i>P</i> = 0.001; 126.42 vs. 103.64, <i>P</i> < 0.001). The length of hospital stay and the percentage of patients who improved clinically based on chest CT findings 1 month after surgery were significantly higher in the POP group than in the non-POP group (11 days vs. 9 days, <i>P</i> = 0.008; 77.3% vs. 59.7%, <i>P</i> = 0.033). Multivariate analysis showed that PLR and the lymphocyte-to-monocyte ratio (LMR) were independent predictors of POP (AUC of 0.780 and 0.730, both at <i>P</i> < 0.001). However, there were no significant differences in postoperative radiographic outcomes among patients stratified by risk of POP.</p><p><strong>Conclusion: </strong>PLR and LMR accurately predict POP in surgical patients with NSCLC. Nonetheless, these ratios may not significantly predict radiographic outcomes 1 month after surgical resection.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1489068"},"PeriodicalIF":3.5000,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958979/pdf/","citationCount":"0","resultStr":"{\"title\":\"Impact of preoperative inflammatory biomarkers on postoperative pneumonia and one-month pulmonary imaging changes after surgery for non-small cell lung cancer.\",\"authors\":\"Yingding Ruan, Wenjun Cao, Jianwei Han, Aiming Yang, Jincheng Xu, Ting Zhang\",\"doi\":\"10.3389/fonc.2025.1489068\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This study examined the effectiveness of preoperative inflammatory markers in predicting the occurrence of postoperative pneumonia (POP) and clinical outcomes based on chest computed tomography (CT) images in patients who underwent surgical resection for non-small cell lung cancer (NSCLC).</p><p><strong>Methods: </strong>This retrospective study included NSCLC patients who underwent lung cancer surgery at The First People's Hospital of Jiande between January 2019 and October 2023. Data on demographic characteristics, preoperative inflammatory biomarkers, surgical approach and duration, postoperative outcomes, and CT findings 1 month postoperatively were collected and analyzed. The effectiveness of preoperative inflammatory markers in predicting POP and clinical outcomes 1 month after surgical resection was assessed using propensity score matching.</p><p><strong>Results: </strong>Among 568 patients, 72 (12.7%) had POP. After matching, 252 patients (POP group: 66; non-POP group: 186) were included in the analysis. The systemic immune-inflammation index (SII) and platelet-to-lymphocyte ratio (PLR) were significantly higher in the POP group than in the non-POP group (433.53 vs. 323.75, <i>P</i> = 0.001; 126.42 vs. 103.64, <i>P</i> < 0.001). The length of hospital stay and the percentage of patients who improved clinically based on chest CT findings 1 month after surgery were significantly higher in the POP group than in the non-POP group (11 days vs. 9 days, <i>P</i> = 0.008; 77.3% vs. 59.7%, <i>P</i> = 0.033). Multivariate analysis showed that PLR and the lymphocyte-to-monocyte ratio (LMR) were independent predictors of POP (AUC of 0.780 and 0.730, both at <i>P</i> < 0.001). However, there were no significant differences in postoperative radiographic outcomes among patients stratified by risk of POP.</p><p><strong>Conclusion: </strong>PLR and LMR accurately predict POP in surgical patients with NSCLC. Nonetheless, these ratios may not significantly predict radiographic outcomes 1 month after surgical resection.</p>\",\"PeriodicalId\":12482,\"journal\":{\"name\":\"Frontiers in Oncology\",\"volume\":\"15 \",\"pages\":\"1489068\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-03-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11958979/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3389/fonc.2025.1489068\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3389/fonc.2025.1489068","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"ONCOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景：本研究探讨了术前炎症标志物在预测非小细胞肺癌（NSCLC）手术切除患者术后肺炎（POP）发生和基于胸部计算机断层扫描（CT）图像的临床结果方面的有效性。方法：本回顾性研究纳入2019年1月至2023年10月在建德市第一人民医院接受肺癌手术的非小细胞肺癌患者。收集和分析人口统计学特征、术前炎症生物标志物、手术入路和手术时间、术后结局和术后1个月CT表现的数据。术前炎症标志物在预测POP和手术切除后1个月临床结果中的有效性采用倾向评分匹配法进行评估。结果：568例患者中，72例（12.7%）有POP。配对后252例患者(POP组66例；非pop组186例)纳入分析。POP组全身免疫炎症指数（SII）和血小板/淋巴细胞比（PLR）显著高于非POP组(433.53 vs 323.75, P = 0.001；126.42比103.64,P < 0.001)。术后1个月，POP组住院时间和胸部CT表现临床改善的患者比例显著高于非POP组(11天vs 9天，P = 0.008；77.3% vs. 59.7%, P = 0.033)。多因素分析显示，PLR和淋巴细胞/单核细胞比（LMR）是POP的独立预测因子（AUC分别为0.780和0.730,P < 0.001）。然而，在按POP风险分层的患者中，术后放射学结果没有显著差异。结论：PLR和LMR能准确预测非小细胞肺癌手术患者的POP。尽管如此，这些比值可能不能显著预测手术切除后1个月的影像学结果。
Impact of preoperative inflammatory biomarkers on postoperative pneumonia and one-month pulmonary imaging changes after surgery for non-small cell lung cancer.
Background: This study examined the effectiveness of preoperative inflammatory markers in predicting the occurrence of postoperative pneumonia (POP) and clinical outcomes based on chest computed tomography (CT) images in patients who underwent surgical resection for non-small cell lung cancer (NSCLC).
Methods: This retrospective study included NSCLC patients who underwent lung cancer surgery at The First People's Hospital of Jiande between January 2019 and October 2023. Data on demographic characteristics, preoperative inflammatory biomarkers, surgical approach and duration, postoperative outcomes, and CT findings 1 month postoperatively were collected and analyzed. The effectiveness of preoperative inflammatory markers in predicting POP and clinical outcomes 1 month after surgical resection was assessed using propensity score matching.
Results: Among 568 patients, 72 (12.7%) had POP. After matching, 252 patients (POP group: 66; non-POP group: 186) were included in the analysis. The systemic immune-inflammation index (SII) and platelet-to-lymphocyte ratio (PLR) were significantly higher in the POP group than in the non-POP group (433.53 vs. 323.75, P = 0.001; 126.42 vs. 103.64, P < 0.001). The length of hospital stay and the percentage of patients who improved clinically based on chest CT findings 1 month after surgery were significantly higher in the POP group than in the non-POP group (11 days vs. 9 days, P = 0.008; 77.3% vs. 59.7%, P = 0.033). Multivariate analysis showed that PLR and the lymphocyte-to-monocyte ratio (LMR) were independent predictors of POP (AUC of 0.780 and 0.730, both at P < 0.001). However, there were no significant differences in postoperative radiographic outcomes among patients stratified by risk of POP.
Conclusion: PLR and LMR accurately predict POP in surgical patients with NSCLC. Nonetheless, these ratios may not significantly predict radiographic outcomes 1 month after surgical resection.
期刊介绍：
Cancer Imaging and Diagnosis is dedicated to the publication of results from clinical and research studies applied to cancer diagnosis and treatment. The section aims to publish studies from the entire field of cancer imaging: results from routine use of clinical imaging in both radiology and nuclear medicine, results from clinical trials, experimental molecular imaging in humans and small animals, research on new contrast agents in CT, MRI, ultrasound, publication of new technical applications and processing algorithms to improve the standardization of quantitative imaging and image guided interventions for the diagnosis and treatment of cancer.
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