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Background <p>Some patients with non-small cell lung cancer (NSCLC) experience early relapse within 2&#xa0;years post-surgery. Screening patients who are prone to recurrence is crucial. This study aimed to determine factors influencing early recurrence within 2&#xa0;years of surgery for stage IA–IIA NSCLC and to establish a prediction model.</p> Methods <p>We retrospectively analyzed the hematological indices and imaging indicators of patients with stage IA–IIA NSCLC who underwent surgery at our hospital, and relevant clinical data were obtained through long-term follow-up from September 2019 to September 2020. Least absolute shrinkage and selection operator (LASSO) regression and univariate and multivariate Cox regression analyses were used to identify high-risk factors influencing postoperative recurrence, establish a predictive model, and construct a nomogram associated with recurrence-free survival.</p> Results <p>Among 186 patients (90 male and 96 female), 29 (15.6%) experienced recurrence or metastasis during the follow-up period. Univariate analysis identified several significant factors, including tumor size, direct bilirubin, indirect bilirubin, albumin, globulin, serum creatinine, platelet-lymphocyte ratio, lymphocyte-monocyte ratio, prognostic nutrition index, albumin-alkaline phosphatase ratio, marginal lobulation, air bronchogram sign, pathological type of squamous cell carcinoma, tumor stage IB, and solid nodules. LASSO regression was used to further select variables and construct a multivariate Cox model showing globulin levels, air bronchogram signs, and solid nodules as independent prognostic factors for early recurrence within 2&#xa0;years in patients with stage IA–IIA NSCLC. The Cox model stratified patients into high- and low-risk groups and was validated by Kaplan–Meier survival analysis, which demonstrated that high-risk patients had a significantly lower survival rate than low-risk patients, demonstrating the robust discriminative power of the predictive model.</p> Conclusion <p>Globulin content, air bronchogram signs, and solid nodules were independent prognostic factors for early recurrence within 2&#xa0;years in patients with stage IA–IIA NSCLC. The proposed model, developed based on the above factors and the albumin-alkaline phosphatase ratio, can effectively predict recurrence risk, potentially aiding clinicians in quantifying prognostic risk, making personalized survival assessments, and devising the most effective treatment plans.</p>

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Prediction model for the early recurrence of stage IA–IIA non-small cell lung cancer based on hematological indexes and imaging features

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月7日

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  • Wei Zhao,
  • Yiyuan Sun,
  • Xin Liu,
  • Mingxiang Zhang,
  • Bohui Zhu

摘要

Background

Some patients with non-small cell lung cancer (NSCLC) experience early relapse within 2 years post-surgery. Screening patients who are prone to recurrence is crucial. This study aimed to determine factors influencing early recurrence within 2 years of surgery for stage IA–IIA NSCLC and to establish a prediction model.

Methods

We retrospectively analyzed the hematological indices and imaging indicators of patients with stage IA–IIA NSCLC who underwent surgery at our hospital, and relevant clinical data were obtained through long-term follow-up from September 2019 to September 2020. Least absolute shrinkage and selection operator (LASSO) regression and univariate and multivariate Cox regression analyses were used to identify high-risk factors influencing postoperative recurrence, establish a predictive model, and construct a nomogram associated with recurrence-free survival.

Results

Among 186 patients (90 male and 96 female), 29 (15.6%) experienced recurrence or metastasis during the follow-up period. Univariate analysis identified several significant factors, including tumor size, direct bilirubin, indirect bilirubin, albumin, globulin, serum creatinine, platelet-lymphocyte ratio, lymphocyte-monocyte ratio, prognostic nutrition index, albumin-alkaline phosphatase ratio, marginal lobulation, air bronchogram sign, pathological type of squamous cell carcinoma, tumor stage IB, and solid nodules. LASSO regression was used to further select variables and construct a multivariate Cox model showing globulin levels, air bronchogram signs, and solid nodules as independent prognostic factors for early recurrence within 2 years in patients with stage IA–IIA NSCLC. The Cox model stratified patients into high- and low-risk groups and was validated by Kaplan–Meier survival analysis, which demonstrated that high-risk patients had a significantly lower survival rate than low-risk patients, demonstrating the robust discriminative power of the predictive model.

Conclusion

Globulin content, air bronchogram signs, and solid nodules were independent prognostic factors for early recurrence within 2 years in patients with stage IA–IIA NSCLC. The proposed model, developed based on the above factors and the albumin-alkaline phosphatase ratio, can effectively predict recurrence risk, potentially aiding clinicians in quantifying prognostic risk, making personalized survival assessments, and devising the most effective treatment plans.