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已发表论文
结合术后 SII 和 PIV 的预后列线图可改善非小细胞肺癌患者的长期生存预测
Authors Yu Q , Zheng L, Iqbal M, Xiang J , Tang J
Received 29 August 2025
Accepted for publication 6 November 2025
Published 22 December 2025 Volume 2025:18 Pages 17911—17926
DOI https://doi.org/10.2147/JIR.S559530
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Dr Felix Marsh-Wakefield
Qian Yu,1,2 Leliang Zheng,3 Majid Iqbal,3 Juanjuan Xiang,2,3 Jingqun Tang1,2
1Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410013, People’s Republic of China; 2Hunan Key Laboratory of Early Diagnosis and Precise Treatment of Lung Cancer, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410013, People’s Republic of China; 3NHC Key Laboratory of Carcinogenesis and the Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute, School of Basic Medical Science, Central South University, Changsha, Hunan, People’s Republic of China
Correspondence: Jingqun Tang, Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China, Email tangjq@csu.edu.cn
Purpose: Systemic inflammation plays a crucial role in the progression and prognosis of non-small cell lung cancer (NSCLC), yet the prognostic value of perioperative inflammatory markers remains underexplored.
Patients and methods: We retrospectively analyzed 243 patients who underwent resection (2015– 2019) at The Second Xiangya Hospital. Five inflammatory indices—neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV)—were calculated from pre- and postoperative blood counts, and their changes (Δ values) were derived. Prognostic markers were identified using receiver operating characteristic (ROC) curve analysis, Cox regression, least absolute shrinkage and selection operator (LASSO), and stepwise selection. A nomogram was developed in a training cohort and internally validated using a 70/30 hold-out split from the same center.
Results: Postoperative SII and PIV, along with their perioperative changes (ΔSII and ΔPIV), showed superior prognostic performance compared to preoperative values. The final nomogram (POST_SII, POST_PIV, clinical tumor-node-metastasis stage, smoking history, preoperative albumin, age, and gender) achieved a concordance index (C-index) of 0.85 in the training cohort, with area under the curve (AUCs) of 0.86, 0.89, and 0.94 at 1-, 3-, and 5-year, and a C-index of 0.80 with AUCs of 0.74, 0.85, and 0.90 in the validation cohort. The model surpassed TNM and clinical models and showed greater net clinical benefit in decision-curve analysis.
Conclusion: Postoperative SII and PIV are strong inflammatory predictors of survival after NSCLC resection. A nomogram integrating these markers with clinical variables provides accurate, individualized risk stratification.
Keywords: nomogram, survival prediction, systemic immune-inflammation index, pan-immune-inflammation value, postoperative prognosis
1Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410013, People’s Republic of China; 2Hunan Key Laboratory of Early Diagnosis and Precise Treatment of Lung Cancer, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410013, People’s Republic of China; 3NHC Key Laboratory of Carcinogenesis and the Key Laboratory of Carcinogenesis and Cancer Invasion of the Chinese Ministry of Education, Cancer Research Institute, School of Basic Medical Science, Central South University, Changsha, Hunan, People’s Republic of China
Correspondence: Jingqun Tang, Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People’s Republic of China, Email tangjq@csu.edu.cn
Purpose: Systemic inflammation plays a crucial role in the progression and prognosis of non-small cell lung cancer (NSCLC), yet the prognostic value of perioperative inflammatory markers remains underexplored.
Patients and methods: We retrospectively analyzed 243 patients who underwent resection (2015– 2019) at The Second Xiangya Hospital. Five inflammatory indices—neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and pan-immune-inflammation value (PIV)—were calculated from pre- and postoperative blood counts, and their changes (Δ values) were derived. Prognostic markers were identified using receiver operating characteristic (ROC) curve analysis, Cox regression, least absolute shrinkage and selection operator (LASSO), and stepwise selection. A nomogram was developed in a training cohort and internally validated using a 70/30 hold-out split from the same center.
Results: Postoperative SII and PIV, along with their perioperative changes (ΔSII and ΔPIV), showed superior prognostic performance compared to preoperative values. The final nomogram (POST_SII, POST_PIV, clinical tumor-node-metastasis stage, smoking history, preoperative albumin, age, and gender) achieved a concordance index (C-index) of 0.85 in the training cohort, with area under the curve (AUCs) of 0.86, 0.89, and 0.94 at 1-, 3-, and 5-year, and a C-index of 0.80 with AUCs of 0.74, 0.85, and 0.90 in the validation cohort. The model surpassed TNM and clinical models and showed greater net clinical benefit in decision-curve analysis.
Conclusion: Postoperative SII and PIV are strong inflammatory predictors of survival after NSCLC resection. A nomogram integrating these markers with clinical variables provides accurate, individualized risk stratification.
Keywords: nomogram, survival prediction, systemic immune-inflammation index, pan-immune-inflammation value, postoperative prognosis