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. 2025 Apr 21:18:5371-5382.
doi: 10.2147/JIR.S501513. eCollection 2025.

Predictive Value of Advanced Lung Cancer Inflammation Index and Development of a Nomogram for Prognosis in Patients with Cervical Cancer Treated with Radiotherapy

Qiong Yu #  1 , Yiwen Sun #  2 , Shuaishuai Zhang  3 , Xintian Xu  4 , Guoliang Pi  5 , Xin Jin  4
Affiliations

Predictive Value of Advanced Lung Cancer Inflammation Index and Development of a Nomogram for Prognosis in Patients with Cervical Cancer Treated with Radiotherapy

Qiong Yu et al. J Inflamm Res. .

Abstract

Purpose: As an assessment tool of nutritional status and inflammation, the advanced lung cancer inflammation index (ALI) is associated with survival in various cancers. We aimed to investigate the association between the ALI's prognostic value and survival time in patients with the stage IIB-III cervical cancer treated with radiotherapy.

Patients and methods: We retrospectively screened patients diagnosed with cervical cancer and underwent radiotherapy in a single institution between September 2013 to September 2015. The ALI was calculated as body mass index * serum albumin/neutrophil-to-lymphocyte ratio. The cut-off value of ALI was determined by the receiver operating characteristic (ROC) curves. Overall survival (OS) and progression-free survival (PFS) were evaluated using the Kaplan-Meier method and Cox proportional hazards models. A nomogram was developed using prognostic factors based on multivariate analyses.

Results: A total of 178 patients with cervical cancer were included. The cutoff value of ALI was set at 310.6 by ROC analyses. Kaplan Meier survival curves indicated that patients with low ALI had a significantly poorer OS (log-rank P<0.001) and PFS (log-rank P=0.0056) than those with high ALI. The association between ALI and OS was significant in the patients with obese/overweight and low/normal weight. The Cox regression analysis indicated that patients with low ALI were associated with a decreased OS (Hazard Ratio (HR) = 2.56, 95% Confidence Intervals (CI), 1.35-4.83; P= 0.004) and PFS (HR = 1.83; 95% CI, 1.06-3.17; P = 0.031). The nomogram on OS was created based on ALI with C-index of 0.81. Patients with high nomogram points had worse OS than those with low nomogram points (log rank P<0.0001).

Conclusion: Pretreatment ALI is an independent negative prognostic factor in patients with cervical cancer treated with radiotherapy. The ALI based nomogram can help to identify patients who may have unfavorable outcomes.

Keywords: advanced lung cancer inflammation index; cervical cancer; prognosis; survival.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier curves of survival time according to the advanced lung cancer inflammation index (ALI) for overall survival (OS) (A) and progression-free survival (PFS) (B).
Figure 2
Figure 2
Kaplan–Meier curves of survival time according to advanced lung cancer inflammation index (ALI) for overall survival (OS) in patients with overweight/obesity (A), progression-free survival (PFS) in patients with overweight/obesity (B), OS in patients with normal weight/underweight (C) and PFS in patients with normal weight/underweight (D).
Figure 3
Figure 3
Prognostic nomogram (Univariate Cox Regression) for overall survival (OS) time prediction based on advanced lung cancer inflammation index (ALI). Nomogram on OS based on ALI (A). Calibrate plot (B). ROC for nomogram points (C). Kaplan–Meier curve of OS for nomogram points (D).
Figure 4
Figure 4
Prognostic nomogram (LASSO regression) for overall survival (OS) time prediction based on advanced lung cancer inflammation index (ALI). Nomogram on OS based on ALI (A) Calibrate plot (B) ROC for nomogram points (C) Kaplan–Meier curve of OS for nomogram points (D).
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References

    1. Stelzle D, Tanaka LF, Lee KK, et al. Estimates of the global burden of cervical cancer associated with HIV. Lancet Glob Health. 2021;9(2):e161–e169. doi:10.1016/S2214-109X(20)30459-9 - DOI - PMC - PubMed
    1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2021;71(3):209–249. doi:10.3322/caac.21660 - DOI - PubMed
    1. Bewley S. HPV vaccination and cervical cancer screening. Lancet. 2022;399(10339):1939. doi:10.1016/S0140-6736(22)00110-6 - DOI - PubMed
    1. National Cancer Institute D, Surveillance Research Program. Surveillance, epidemiology, and end results (SEER) program populations (1969-2022). Available from: www.seer.cancer.gov/popdata. Accessed March 26, 2025.
    1. Hull R, Mbele M, Makhafola T, et al. Cervical cancer in low and middle-income countries. Oncol Lett. 2020;20(3):2058–2074. doi:10.3892/ol.2020.11754 - DOI - PMC - PubMed

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