Abstract
OBJECTIVE: To evaluate whether systemic inflammatory biomarkers - neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic immune-inflammation index (SII) - have prognostic value in patients with non-small cell lung carcinoma (NSCLC). METHODS: In this retrospective study, NLR, PLR, and SII levels were examined in 183 NSCLC cases. Correlations between these biomarkers and 3-year overall survival (OS) and progression-free survival (PFS) were assessed. Receiver operating characteristic (ROC) curves were used to evaluate predictive performance. Point-biserial correlation was applied to explore associations between each biomarker and 3-year OS/PFS, followed by multivariate analyses to identify independent prognostic factors. RESULTS: The 3-year OS and PFS were 74.86% and 65.03%, respectively. Survivors and patients without progression had significantly lower NLR, PLR, and SII values than non-survivors and those with progression. ROC curve analysis showed moderate predictive accuracy for individual biomarkers (area under the curve [AUC]: 0.714-0.808 for OS; 0.635-0.754 for PFS), whereas their combination substantially enhanced prognostic discrimination (AUC=0.906 for OS; AUC=0.812 for PFS) (P<0.001). Further investigation demonstrated an inverse correlation between NLR, PLR, SII and 3-year OS/PFS (P<0.01). Multivariate analysis identified high NLR (≥3.57, OR=9.923), PLR (≥216.00, OR=9.978), and SII (≥969.50, OR=4.913) were independently associated with worse survival outcomes (P<0.05). CONCLUSION: NLR, PLR, and SII are valuable predictors of survival in NSCLC. Integrating these biomarkers further improves prognostic accuracy.