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. 2025 Apr 30;14(4):1340-1350.
doi: 10.21037/tlcr-2025-171. Epub 2025 Apr 27.

Predictive value of the monocyte-to-high-density lipoprotein ratio in the prognosis of non-small cell lung cancer patients after surgery

Yi Liu #  1 , Wen-Long Zhang #  2 , Song-Ping Cui  1 , Aimée J P M Franssen  3 , Erik R de Loos  3 , Yuichiro Ueda  4 , Takahiro Homma  5 , James Shahoud  6 , Qing Zhao  1 , Yang Gu  1 , Yi-Li Fu  1 , Bin Hu #  1
Affiliations

Predictive value of the monocyte-to-high-density lipoprotein ratio in the prognosis of non-small cell lung cancer patients after surgery

Yi Liu et al. Transl Lung Cancer Res. .

Abstract

Background: Due to the poor prognosis of non-small cell lung cancer (NSCLC) patients, precise and reliable biomarkers are urgently needed to predict the prognosis in NSCLC patients after radical lung surgery. Hence, this study sought to investigate the correlation between the monocyte-to-high-density lipoprotein ratio (MHR) and overall survival (OS) in NSCLC patients after surgery.

Methods: This retrospective study analyzed clinical data, including MHR, from NSCLC patients undergoing radical surgery. OS was calculated to evaluate the prognosis of the NSCLC patients. The association between the MHR and OS was analyzed. A receiver operating characteristic (ROC) curve analysis was conducted to evaluate the 3- and 5-year predictive value of the MHR for prognosis after surgery.

Results: In total, 256 patients were enrolled in this study. All patients had a follow-up for more than 5 years. The prognosis of the patients with a higher MHR (>0.3) was worse than that of the patients with a lower MHR (≤0.3) (P<0.001). The univariate Cox survival analysis showed that the MHR, surgery time, tumor (pT) stage, lymph node (pN) stage, and sex were all significantly associated with the risk of death in patients with NSCLC. The multivariate Cox survival analysis showed that the MHR [hazard ratio (HR) =24.837, 95% confidence interval (CI): 7.265-84.911], T stage, N stage, and surgery time were prognostic factors for NSCLC patients after surgery. The stratified analysis, which excluded patients with tumors in situ, showed that the MHR (HR =27.097, 95% CI: 8.081-90.877), surgery time, and pN stage significantly increased the risk of death in NSCLC patients. The area under the ROC curve (AUCROC) values of the MHR in predicting the 3- and 5-year survival of the NSCLC patients after surgery were 0.758 and 0.760, respectively.

Conclusions: The MHR was found to be an independent predictor of OS in NSCLC patients after radical surgery. Early monitoring and reducing the MHR may be of great significance in preventing disease recurrence and improving patient prognosis.

Keywords: Non-small cell lung cancer (NSCLC); monocyte-to-high-density lipoprotein ratio (MHR); overall survival (OS); prognosis; radical surgery.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://tlcr.amegroups.com/article/view/10.21037/tlcr-2025-171/coif). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flow chart of patient selection. MHR, monocyte-to-high-density lipoprotein ratio; NSCLC, non-small cell lung cancer.
Figure 2
Figure 2
Kaplan-Meier survival analysis stratified by MHR. Patients in the low-MHR group demonstrated significantly improved survival compared to the high-MHR group (P<0.001). MHR, monocyte-to-high-density lipoprotein ratio.
Figure 3
Figure 3
ROC curve analysis of the prediction of death based on the MHR. (A) ROC curve analysis of the prediction of death at 3 years based on the MHR. (B) ROC curve analysis of the prediction of death at 5 years based on the MHR. AUC, area under the curve; CI, confidence interval; ROC, receiver operating characteristic; MHR, monocyte-to-high-density lipoprotein ratio.
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