国际肿瘤学杂志

国际肿瘤学杂志 ›› 2026, Vol. 53 ›› Issue (7): 420-425.doi: 10.3760/cma.j.cn371439-20250911-00068

• 论著 • 上一篇    下一篇

炎症负荷指数对非小细胞肺癌术后骨转移的预测价值

洪燕芬, 魁国菊, 禹乐, 赖铭鸿, 黄江宾()   

  1. 第九〇九医院（厦门大学附属东南医院）病理科， 漳州 363000
  • 收稿日期:2025-09-11 出版日期:2026-07-08 发布日期:2026-06-25
  • 通讯作者: 黄江宾，Email： huangjiangbin7@163.com
  • 作者简介:第一联系人：

    洪燕芬：数据收集、论文撰写；魁国菊、禹乐、赖铭鸿：数据整理、统计学分析、论文修改；黄江宾：研究指导、论文修改

Predictive value of inflammatory burden index on postoperative bone metastasis in non-small cell lung cancer

Hong Yanfen, Kui Guoju, Yu Le, Lai Minghong, Huang Jiangbin()   

  1. Department of Pathology， 909th Hospital （Dongnan Hospital of Xiamen University）， Zhangzhou 363000， China
  • Received:2025-09-11 Online:2026-07-08 Published:2026-06-25
  • Contact: Huang Jiangbin， Email： huangjiangbin7@163.com

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摘要：

目的 探讨炎症负荷指数（IBI）对非小细胞肺癌（NSCLC）患者术后骨转移的预测价值。 方法 回顾性分析第九〇九医院2020年1月至2021年12月收治的136例NSCLC患者临床资料，根据是否发生骨转移分为骨转移组（n=46）和无骨转移组（n=90）。收集患者一般资料和临床资料。采用多因素logistic回归分析NSCLC患者术后发生骨转移的危险因素。采用受试者操作特征（ROC）曲线评估IBI对NSCLC术后发生骨转移的预测效能，并确定最佳预测界值。绘制Kaplan-Meier曲线，对比不同IBI患者NSCLC术后骨转移发生率差异。 结果 两组患者年龄、性别、肺癌家族史、吸烟史一般资料比较差异均无统计学意义（均P>0.05）。骨转移组患者中性粒细胞计数（t=3.62，P=0.001）、C反应蛋白（t=2.73，P=0.007）、IBI（t=5.18，P<0.001）均高于无骨转移组，癌胚抗原（CEA）≥5 ng/ml（χ2=12.41，P<0.001）、肿瘤最大径≥5 cm（χ2=8.57，P=0.003）、有淋巴结转移（χ2=7.92，P=0.005）、TNM分期Ⅲ期（χ2=10.13，P=0.001）患者占比均高于无骨转移组，淋巴细胞计数低于无骨转移组（t=-2.60，P=0.010）。多因素分析显示，IBI（OR=6.00，95%CI为1.85~8.41，P=0.004）、CEA≥5 ng/ml（OR=3.50，95%CI为1.31~9.34，P=0.012）、肿瘤最大径≥5 cm（OR=5.04，95%CI为1.47~7.32，P=0.010）、有淋巴结转移（OR=7.64，95%CI为2.38~11.53，P=0.001）、TNM分期Ⅲ期（OR=3.08，95%CI为1.08~8.76，P=0.035）均是NSCLC患者术后发生骨转移的独立危险因素。ROC曲线分析显示，IBI预测NSCLC患者术后发生骨转移的曲线下面积为0.75（95%CI为0.66~0.84），特异性为0.78，敏感性为0.91，最佳预测界值为8.51。Kaplan-Meier曲线分析显示，IBI≥8.51患者NSCLC术后3年骨转移发生率为45.16%，高于IBI<8.51患者的9.30%（χ2=15.29，P<0.001）。 结论 IBI是NSCLC患者术后发生骨转移的独立影响因素，对NSCLC患者术后3年发生骨转移具有一定的预测价值。

关键词: 癌，非小细胞肺, 肿瘤转移, 预测, 炎症负荷指数

Abstract:

Objective To investigate the predictive value of inflammatory burden index （IBI） on postoperative bone metastasis in patients with non-small cell lung cancer （NSCLC）. Methods A retrospective analysis was conducted on the clinical data of 136 NSCLC patients admitted to the 909th Hospital from January 2020 to December 2021. The patients were divided into bone metastasis group （n=46） and non-bone metastasis group （n=90） according to the presence or absence of bone metastasis. General and clinical data of the patients were collected. Multivariate logistic regression analysis was used to identify risk factors for postoperative bone metastasis in NSCLC patients. Receiver operator characteristic （ROC） curve was plotted to analyze the predictive efficacy of IBI for postoperative bone metastasis in NSCLC and determine the optimal cut-off value. Kaplan-Meier curve was drawn to compare the difference in the incidence of postoperative bone metastasis in NSCLC patients with different IBI levels. Results There were no statistically significant differences in general data such as age， gender， family history of lung cancer， and smoking history between the two groups （all P>0.05）. The levels of neutrophil count （t=3.62， P=0.001）， C-reactive protein （t=2.73， P=0.007）， and IBI （t=5.18， P<0.001） in the bone metastasis group were higher than those in the non-bone metastasis group. The proportions of carcinoembryonic antigen （CEA） ≥5 ng/ml （χ2=12.41， P<0.001）， maximum tumor diameter ≥5 cm （χ2=8.57， P=0.003）， lymph node metastasis （χ2=7.92， P=0.005）， and TNM stage Ⅲ （χ2=10.13， P=0.001） in the bone metastasis group were higher than those in the non-bone metastasis group， while the level of lymphocyte count was lower than that in the non-bone metastasis group （t=-2.60， P=0.010）. Multivariate analysis showed that IBI （OR=6.00， 95%CI： 1.85-8.41， P=0.004）， CEA ≥5 ng/ml （OR=3.50， 95%CI： 1.31-9.34， P=0.012）， maximum tumor diameter ≥5 cm （OR=5.04， 95%CI： 1.47-7.32， P=0.010）， lymph node metastasis （OR=7.64， 95%CI： 2.38-11.53， P=0.001）， and TNM stage Ⅲ （OR=3.08， 95%CI： 1.08-8.76， P=0.035） were independent risk factors for postoperative bone metastasis in NSCLC patients. ROC curve analysis showed that the area under the curve of IBI for predicting postoperative bone metastasis in NSCLC patients was 0.75 （95%CI： 0.66-0.84）， with a specificity of 0.78， a sensitivity of 0.91， and the optimal cut-off value was 8.51. Kaplan-Meier risk curve analysis showed that the 3-year incidence of bone metastasis after surgery in NSCLC patients with IBI ≥ 8.51 was 45.16%， which was significantly higher than the 9.30% in patients with IBI < 8.51 （χ2=15.29， P<0.001）. Conclusions The IBI is an independent influencing factor for postoperative bone metastasis in patients with NSCLC， and it has certain predictive value for the occurrence of bone metastasis in NSCLC patients 3 years after surgery.

Key words: Carcinoma， non-small-cell lung, Neoplasm metastasis, Forecasting, Inflammatory burden index