94% of researchers rate our articles as excellent or good
Learn more about the work of our research integrity team to safeguard the quality of each article we publish.
Find out more
ORIGINAL RESEARCH article
Front. Oncol.
Sec. Thoracic Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1489068
This article is part of the Research Topic Deciphering Macrophage Polarization/Transition in Human Inflammatory Disease and Cancer View all 3 articles
Impact of Preoperative Inflammatory Biomarkers on Postoperative Pneumonia and One-Month Pulmonary Imaging Changes after Surgery for Non-small Cell Lung Cancer
Provisionally accepted- 1 First People’s Hospital of Jiande, Hangzhou, China
- 2 Affiliated Zhongshan Hospital of Dalian University, Dalian, Liaoning Province, China
- 3 Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, China
Background: This study examined the effectiveness of preoperative inflammatory markers in predicting the occurrence of postoperative pneumonia (POP) and clinical outcomes based on chest computed tomography (CT) images in patients who underwent surgical resection for non-small cell lung cancer (NSCLC).Methods: This retrospective study included NSCLC patients who underwent lung cancer surgery at The First People's Hospital of Jiande between January 2019 and October 2023. Data on demographic characteristics, preoperative inflammatory biomarkers, surgical approach and duration, postoperative outcomes, and CT findings 1 month postoperatively were collected and analyzed. The effectiveness of preoperative inflammatory markers in predicting POP and clinical outcomes 1 month after surgical resection was assessed using propensity score matching.Results: Among 568 patients, 72 (12.7%) had POP. After matching, 252 patients (POP group: 66; non-POP group: 186) were included in the analysis. The systemic immune-inflammation index (SII) and platelet-to-lymphocyte ratio (PLR) were significantly higher in the POP group than in the non-POP group (433.53 vs. 323.75, P = 0.001; 126.42 vs. 103.64, P < 0.001). The length of hospital stay and the percentage of patients who improved clinically based on chest CT findings 1 month after surgery were significantly higher in the POP group than in the non-POP group (11 days vs. 9 days, P = 0.008; 77.3% vs. 59.7%, P = 0.033). Multivariate analysis showed that PLR and the lymphocyte-to-monocyte ratio (LMR) were independent predictors of POP (AUC of 0.780 and 0.730, both at P < 0.001). However, there were no significant differences in postoperative radiographic outcomes among patients stratified by risk of POP.PLR and LMR accurately predict POP in surgical patients with NSCLC.Nonetheless, these ratios may not significantly predict radiographic outcomes 1 month after surgical resection.
Keywords: Preoperative inflammatory biomarkers, Postoperative pneumonia, Chest computed tomography, Surgery, non-small cell lung cancer AUC, area under the curve, CT, computed tomography, LMR, lymphocyte-to-monocyte ratio, NLR, neutrophil-to-lymphocyte ratio
Received: 31 Aug 2024; Accepted: 27 Feb 2025.
Copyright: © 2025 Ruan, Cao, Han, Yang, Xu and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Ting Zhang, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, Zhejiang Province, China
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.