Usefulness of baseline immature reticulocyte fraction to mature reticulocyte fraction ratio (IMR) as A prognostic predictor for patients with small cell lung cancer

作者全名："Zhang, Xingmei; Ren, Hanxiao; Tian, Jiangchuan; Yang, Chaoguo; Luo, Huaichao"

作者地址："[Zhang, Xingmei; Ren, Hanxiao; Yang, Chaoguo] Chengdu Univ Tradit Chinese Med, Coll Med Technol, Chengdu 610042, Sichuan, Peoples R China; [Zhang, Xingmei; Luo, Huaichao] Univ Elect Sci & Technol China, Affiliated Canc Hosp, Sichuan Canc Hosp & Inst, Sichuan Canc Ctr,Sichuan Clin Res Ctr Canc,Dept Cl, Chengdu 610041, Peoples R China; [Tian, Jiangchuan] Chongqing Med Univ, Coll Lab Med, Chongqing Med Lab Microfluidics & SPRi Engn Res Ct, Chinese Minist Educ,Key Lab Clin Lab Diagnost, Chongqing 400016, Peoples R China; [Tian, Jiangchuan] Guangan Peoples Hosp, Dept Lab Med, Guangan 638000, Sichuan, Peoples R China; [Luo, Huaichao] Univ Elect Sci & Technol China, Sichuan Canc Hosp & Inst, Sichuan Canc Ctr, Sch Med,Dept Clin Lab, 55 Sect 4 South Peoples Rd, Chengdu 610041, Peoples R China"

通信作者："Yang, CG (通讯作者)，Chengdu Univ Tradit Chinese Med, Coll Med Technol, Chengdu 610042, Sichuan, Peoples R China.; Luo, HC (通讯作者)，Univ Elect Sci & Technol China, Sichuan Canc Hosp & Inst, Sichuan Canc Ctr, Sch Med,Dept Clin Lab, 55 Sect 4 South Peoples Rd, Chengdu 610041, Peoples R China."

来源：HELIYON

ESI学科分类：　

WOS号：WOS:001146341000001

JCR分区：Q2

影响因子：4

年份：2024

卷号：10

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Small-cell lung cancer (SCLC); reticulocytes; Immature reticulocyte fraction; Prognosis

摘要："<bold>Background: </bold>Small cell lung cancer (SCLC) has a strong invasive ability and a high degree of malignancy, so accurate prognosis prediction is crucial for making the most favorable treatment decision.Unfortunately, there is a scarcity of prognostic indicators specific to SCLC. Reticulocyte levels in blood parameters have been linked to the prognosis of various malignancies. Given SCLC's aggressive characteristics, identifying reliable prognostic markers, such as reticulocyte counts, becomes pivotal in enhancing prognostic accuracy and guiding effective therapeutic strategies.<bold>Objective: </bold>This study aimed to evaluate the predictive power of the immature reticulocyte fraction (IRF) to mature reticulocyte fraction (MRF) ratio (IMR) for survival outcomes in patients with SCLC.<bold>Materials and methods: </bold>A retrospective analysis was conducted on 192 patients with small cell lung cancer (SCLC). The median values of various prognostic indicators, such as IMR, IRF, MRF, reticulocyte count (RET), SII (systemic immune-inflammatory index), were utilized as cutoff points, categorizing patients into high and low groups. The Kaplan-Meier method, univariate, multivariate analyses Cox regression, and C-index were used to analyze the prognostic factors for overall survival (OS).<bold>Results: </bold>In our cohort, 138 (71.9 %) were male, 119 (62 %) were smokers, and 82 (57.3 %) were older than 60 years old. The median survival time was 18.15 months.Higher mortality was observed in the high IMR and high IRF groups, while the high MRF group exhibited lower mortality. At the same time, mortality was lower in the high MRF group. Univariate analysis showed that smoking history (P = 0.006), tumor stage (P = 0.002), chemotherapy cycle (P = 0.014), IMR (P = 0.01), and many other factors significantly affected the prognosis of SCLC. Multivariate analysis demonstrated that elevated IMR was an independent adverse predictor of OS (P = 0.039, HR = 0.330). Spearman test confirmed that the prognostic indicators IRF, IMR, and SII were positively correlated with the overall survival rate of patients with SCLC. Kaplan-Meier analysis showed that the OS rate of patients with high IMR was significantly worse (P = 0.0096). In addition, we found that IMR was superior to IRF in distinguishing patients with different outcomes in the low and high groups (P < 0.05). Our novel integration index, combining IMR with the TNM stage system and SII index, exhibited superior prognostic value compared to the original index. Additionally, the combination of prognostic indicators IMR and SII significantly stratified stage I-II SCLC patients (P < 0.05).<bold>Conclusions: </bold>The prognostic index based on peripheral blood IMR stands out as an independent predictor for SCLC patients pre-treatment. Its accessibility through routine blood analysis facilitates immediate clinical application without requiring prolonged scientific research validation. The integration of IMR with the TNM score enhances survival prediction and risk stratification. Notably, when combined with the SII score, the new IMR index demonstrates significant improvements in prognostication for stage I-II small cell lung cancer."

基金机构：Natural Science Foundation of Sichuan Province [22NSFSC0850]

基金资助正文：<B>Funding</B> This study was supported by grants from the Natural Science Foundation of Sichuan Province (Grant No. 22NSFSC0850) .