Objective To investigate the prognostic value of inflammatory prognostic index (IPI) based on C reactive protein (CRP),neutrophil lymphocyte ratio (NLR) and serum albumin (ALB) in non-small cell lung cancer patients (NSCLC).Methods A retrospective review of 519 NSCLC diagnosed from January 2009 to December 2014 was conducted with clinical and laboratory data.The IPI was calculated as IPI =CRP x NLR/ALB.Receiver operating characteristic curve (ROC) cut-off values were used to divide all patients into two groups.Kaplan-Meiser,univariate and multivariate COX regression and forest plot analysis were performed to assess the prognostic value of NSCLC.Results 74 patients were lost follow-up in all NSCLC patients.The rest NSCLC patients (n =445) were divided into two groups (the high IPI group,n =217 vs.the low IPI group,n =228) according ROC cut-off value of 15.Tumor stage,tumor size,primary tumor,regional lymph node,distant metastases,and Karnofsky performance status scores (KPS) had significant differences between the two groups (P ＜ 0.05).Median overall survival was better in the low IPI group (30 months) than the high IPI group (9 months,x2 =130.8,P ＜0.001).Tumor stage,tumor size,distant metastases,KPS,NLR,ALB,CRP,and IPI were independent prognostic factors for NSCLC overall survival by COX regression analysis (P ＜ 0.05).Subgroup analysis showed the IPI was a significant prognostic factor in all clinical variables.Conclusion The IPI is the independent prognostic factor of NSCLC,and the easily accessible inexpensive IPI could be useful for clinical practice.%目的 探讨C反应蛋白(C reaction protein,CRP)、中性粒细胞-淋巴细胞比率(neutrophiL/Lymphocyte ratio,NLR)和血清白蛋白(serum albumin,ALB)为基础的炎症预后指数(inflammatory prognostic index,IPI)评估非小细胞肺癌(non-small cell lung cancer,NSCLC)预后的价值.方法 回顾分析2009年1月至2014年12月收治的519例NSCLC患者临床和实验室检查资料,计算IPI=CRP×NLR/ALB.运用受试者特征曲线(receiver operating characteristic curve,ROC曲线)截断值分组NSCLC患者,采用Kaplan-Meiser法、单因素和多因素COX回归分析、森林图亚组分析NSCLC患者生存预后.结果 519例NSCLC患者失访74例.根据IPI的ROC截断值15将445例NSCLC患者分为高IPI组(n =217)和低IPI组(n =228).两组肿瘤分期、肿瘤大小、原发肿瘤、区域性淋巴结、远处转移、行为状态评分(Karnofsky performance status scores,KPS)具有统计学差异(P＜0.05).低IPI组中位生存期(30个月)显著高于高IPI组(9个月,x2=130.8,P＜0.001).COX回归分析肿瘤分期、肿瘤大小、远处转移、KPS、NLR、ALB、CRP、IPI是影响NSCLC生存预后的独立危险因素(P＜0.05).亚组分析显示IPI是预测NSCLC患者生存预后最佳因素.结论 IPI是NSCLC患者生存预后独立风险因素;简易、廉价的IPI可用于临床实践.
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