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

doi:10.3760/cma.j.cn371439-20250911-00058

Abstract

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

Hong Yanfen, Kui Guoju, Yu Le, Lai Minghong, Huang Jiangbin. Predictive value of inflammatory burden index on postoperative bone metastasis in non-small cell lung cancer[J]. Journal of International Oncology, 2026, 53(7): 420-425.

Figures/Tables 5

References 25

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一般资料	骨转移组（n=46）	无骨转移组（n=90）	t/χ²值	P值
年龄（岁，$\overline{x}\pm s$）	57.65±5.70	57.56±4.62	0.10	0.919
性别（例）
男	26	50	0.01	0.915
女	20	40	0.01	0.915
肺癌家族史（例）
有	8	14	0.08	0.783
无	38	76	0.08	0.783
吸烟史（例）
有	11	17	0.47	0.493
无	35	73	0.47	0.493

临床资料	骨转移组（n=46）	无骨转移组（n=90）	t/χ²值	P值	临床资料	骨转移组（n=46）	无骨转移组（n=90）	t/χ²值	P值
WBC（×10⁹/L）^a	7.67±1.72	7.87±1.17	-0.73	0.468	肿瘤最大径（cm）^b
NEU（×10⁹/L）^a	7.08±1.27	6.30±1.02	3.62	0.001	<5	30	78	8.57	0.003
LYM（×10⁹/L）^a	2.11±0.40	2.29±0.38	-2.60	0.010	≥5	16	12	8.57	0.003
CRP（mg/L）^a	3.65±0.72	3.29±0.70	2.73	0.007	肿瘤部位^b
IBI（mg/L）^a	12.63±3.87	9.30±2.83	5.18	<0.001	左肺	14	38	1.79	0.181
CEA（ng/ml）^b					右肺	32	52	1.79	0.181
<5	15	58	12.41	<0.001	分化程度^b
≥5	31	32	12.41	<0.001	低分化	25	55	0.58	0.448
CA19-9（U/ml）^b					中高分化	21	35	0.58	0.448
<37	26	50	0.01	0.915	淋巴结转移^b
≥37	20	40	0.01	0.915	有	17	14	7.92	0.005
NSE（ng/ml）^b					无	29	76	7.92	0.005
<17	35	69	0.01	0.940	TNM分期^b
≥17	11	21	0.01	0.940	Ⅰ~Ⅱ期	29	78	10.13	0.001
LDH（U/L）^b					Ⅲ期	17	12	10.13	0.001
<245	40	79	0.02	0.891	化疗^b
≥245	6	11	0.02	0.891	有	12	16	1.29	0.257
ALP（U/L）^b					无	34	74	1.29	0.257
<164	42	81		>0.999	放疗^b
≥164	4	9		>0.999	有	6	10	0.11	0.741
PS评分（分）^b					无	40	80	0.11	0.741
0	14	34			靶向治疗^b
1	26	37	3.10	0.212	有	8	13	0.20	0.653
2	6	19			无	38	77	0.20	0.653
病理类型^b					免疫治疗^b
腺癌	25	60			有	9	13	0.59	0.443
鳞状细胞癌	17	23	2.12	0.347	无	37	77	0.59	0.443
其他	4	7

变量	β值	SE值	Wald χ²值	OR值	95%CI	P值
NEU	1.73	1.27	1.85	5.64	0.74~9.78	0.230
LYM	-1.19	0.71	2.82	0.30	0.08~1.13	0.093
CRP	0.25	0.40	0.39	1.28	0.59~2.77	0.535
IBI	1.79	1.22	2.17	6.00	1.85~8.41	0.004
CEA（≥5 ng/ml/<5 ng/ml）	1.25	0.50	6.25	3.50	1.31~9.34	0.012
肿瘤最大径（≥5 cm/<5 cm）	1.62	0.63	6.61	5.04	1.47~7.32	0.010
淋巴结转移（有/无）	2.03	0.60	11.64	7.64	2.38~11.53	0.001
TNM分期（Ⅲ期/Ⅰ~Ⅱ期）	1.12	0.53	4.43	3.08	1.08~8.76	0.035