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An Emergency-deployable Albumin-enhanced NLR Derived by Machine Learning Improves Risk Stratification in Lung Cancer:

Yunhua Zhao¹, Jilong Wang^2,3,4,5, Yubao He⁶

¹Department of Emergency Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China.

In Vivo (Athens, Greece)

|June 30, 2026

Summary

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This summary is machine-generated.

A new albumin-enhanced neutrophil-to-lymphocyte ratio (aNLR) improves lung cancer prognosis prediction. This simple blood test offers better risk stratification than existing inflammatory markers for personalized survival assessment.

Area of Science:

Oncology
Biomarkers
Inflammation research

Background:

Systemic inflammation significantly impacts lung cancer prognosis.
Current blood-based inflammatory indices have limited ability to discriminate patient risk.
There is a need for improved prognostic tools in lung cancer management.

Purpose of the Study:

To develop a novel, albumin-enhanced inflammatory index for improved lung cancer risk stratification.
To integrate serum albumin levels with the neutrophil-to-lymphocyte ratio (NLR) using machine learning.
To validate the prognostic performance of the new index against conventional markers.

Main Methods:

Utilized a database of 1,576 lung cancer patients, split into training and validation cohorts.
Employed LASSO regression to identify key prognostic laboratory markers.

Keywords:

Lung cancer inflammatory biomarkers machine learning risk stratification serum albumin

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Developed an albumin-enhanced NLR (aNLR) score using a supervised machine-learning approach.

Assessed prognostic value through Cox models, Kaplan-Meier analysis, and time-dependent AUC.

Main Results:

LASSO identified lymphocyte count, albumin, and neutrophil count as dominant prognostic factors.
The derived aNLR score demonstrated significantly improved prognostic discrimination (C-index 0.727) compared to NLR (C-index 0.600).
High aNLR was consistently linked to worse survival, showing substantial clinical utility and improved predictive accuracy.

Conclusions:

The albumin-enhanced NLR (aNLR) offers superior prognostic discrimination in lung cancer compared to traditional inflammatory indices.
This machine-learning derived index supports more individualized survival assessment for lung cancer patients.
aNLR represents a promising, simple blood-based biomarker for clinical application in oncology.