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Background <p>The C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index is a new scoring system that evaluates both inflammatory and nutritional status. We aimed to investigate the clinical significance of the CALLY index as a prognostic biomarker in resected non-small-cell lung cancer (NSCLC).</p> Methods <p>We classified 581 and 634 patients with NSCLC clinical stages I–IIIA who underwent surgery between 2013 and 2018 as the discovery and validation cohorts, respectively. The CALLY index was calculated using the following formula: (serum albumin × lymphocytes) / (CRP × 10<sup>4</sup>). The cutoff value of the CALLY index in the discovery cohort was determined using a time-dependent receiver operating characteristic curve analysis. Patients were classified into CALLY-high and CALLY-low groups, and associations between the CALLY index and clinicopathological factors and prognosis was evaluated.</p> Results <p>In the discovery cohort, 329 (56.6%) and 252 (43.3%) patients were classified as CALLY-high and CALLY-low, respectively; in the validation cohort, 353 (55.7%) and 281 (44.3%) patients were classified as CALLY-high and CALLY-low, respectively. In both cohorts, the CALLY-low group was associated with older age, male sex, smoking, and advanced cancer stage. Multivariable analysis in both cohorts showed that CALLY-low was an independent poor prognostic factor for recurrence-free survival: hazard ratio (HR) 1.4; 95% confidence interval (CI) 1.02–2.02 and HR 1.4; 95% CI 1.02–1.87, respectively. It was also an independent poor prognostic factor for overall survival: HR 2.1; 95% CI 1.31–3.25 and HR 1.6; 95% CI 1.11–2.29, respectively.</p> Conclusion <p>The CALLY index is a useful prognostic predictor in resected NSCLC.</p>

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The Prognostic Impact of C-Reactive Protein-Albumin-Lymphocyte Index (Cally Index) in Patients with Surgically Resected Non-Small-Cell Lung Cancer

  • 期刊论文

  • 发表日期：

    2025年11月1日

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  • Kazuhiro Mizota,
  • Fumihiko Kinoshita,
  • Bassi Giacomo,
  • Takayuki Tokunaga,
  • Asato Hashinokuchi,
  • Kyoto Matsudo,
  • Taichi Nagano,
  • Keisuke Kosai,
  • Takaki Akamine,
  • Takatoshi Fujishita,
  • Shinichiro Shimamatsu,
  • Mikihiro Kohno,
  • Masafumi Yamaguchi,
  • Tomoyoshi Takenaka,
  • Tomoharu Yoshizumi

摘要

Background

The C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index is a new scoring system that evaluates both inflammatory and nutritional status. We aimed to investigate the clinical significance of the CALLY index as a prognostic biomarker in resected non-small-cell lung cancer (NSCLC).

Methods

We classified 581 and 634 patients with NSCLC clinical stages I–IIIA who underwent surgery between 2013 and 2018 as the discovery and validation cohorts, respectively. The CALLY index was calculated using the following formula: (serum albumin × lymphocytes) / (CRP × 104). The cutoff value of the CALLY index in the discovery cohort was determined using a time-dependent receiver operating characteristic curve analysis. Patients were classified into CALLY-high and CALLY-low groups, and associations between the CALLY index and clinicopathological factors and prognosis was evaluated.

Results

In the discovery cohort, 329 (56.6%) and 252 (43.3%) patients were classified as CALLY-high and CALLY-low, respectively; in the validation cohort, 353 (55.7%) and 281 (44.3%) patients were classified as CALLY-high and CALLY-low, respectively. In both cohorts, the CALLY-low group was associated with older age, male sex, smoking, and advanced cancer stage. Multivariable analysis in both cohorts showed that CALLY-low was an independent poor prognostic factor for recurrence-free survival: hazard ratio (HR) 1.4; 95% confidence interval (CI) 1.02–2.02 and HR 1.4; 95% CI 1.02–1.87, respectively. It was also an independent poor prognostic factor for overall survival: HR 2.1; 95% CI 1.31–3.25 and HR 1.6; 95% CI 1.11–2.29, respectively.

Conclusion

The CALLY index is a useful prognostic predictor in resected NSCLC.