Using the Systemic Inflammatory Response Index and the Prognostic Nutritional Index in Predicting Subsequent Bone...

Area of Science:

• Oncology
• Medical Diagnostics
• Biomarkers

Background:

• Bone metastases (BM) are a common complication in non-small cell lung cancer (NSCLC).
• Identifying predictive factors for BM is crucial for patient management and prognosis.
• The systemic inflammatory response index (SIRI) and prognostic nutritional index (PNI) reflect systemic inflammation and nutritional status, respectively, and may be associated with cancer progression.

Purpose of the Study:

• To identify risk factors for bone metastases (BM) in non-small cell lung cancer (NSCLC) patients.
• To develop and validate a scoring system using SIRI and PNI to predict subsequent BM in NSCLC patients.

Main Methods:

• Retrospective analysis of 418 NSCLC patients.
• Calculation of preoperative SIRI and PNI values.
• Receiver operating characteristic (ROC) curve analysis to determine optimal cut-off values for SIRI and PNI.
• Development of the SIRI-PNI scoring system.
• Univariate and multivariate logistic regression to identify independent risk factors for BM.

Main Results:

• 142 out of 418 patients (33.97%) developed BM.
• Optimal cut-off values: SIRI 539.0 (AUC=0.877) and PNI 44.8 (AUC=0.801).
• The SIRI-PNI scoring system (scores 0-2) showed significant differences between BM and non-BM groups (P < 0.05).
• Clinical stage IV (OR=11.91, P < 0.0001) and SIRI-PNI score of 2 (P < 0.0001) were independent risk factors for BM.

Conclusions:

• Advanced clinical stage (IV) and a high SIRI-PNI score (2 points) are significant prognostic indicators for BM development in NSCLC.
• The preoperative SIRI-PNI scoring system aids in the early identification of high-risk NSCLC patients for bone metastases.