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The value of CRP-albumin-lymphocyte index (CALLY index) as a prognostic biomarker in patients with non-small cell lung cancer

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Abstract

Objective

The C-reactive protein-albumin-lymphocyte (CALLY) index is a new index related to inflammation, immunity, and nutrition. We investigated whether it can predict the prognosis of patients with non-small cell lung cancer (NSCLC) and developed a prognostic model including CALLY index.

Research methods and procedures

Data from patients with NSCLC who were followed up in the INSCOC database from May 2013 to December 2018 were retrospectively analyzed. Simple random sampling by splitting these patients into training (n = 1307) and validation cohorts (n = 557) resulted in a sample size ratio of 7:3. Using the results of COX regression analysis of the training cohort, a nomogram model for predicting 3- and 5-year overall survival (OS) was established and validated internally. The calibration and clinical decision curve were used to evaluate the prediction accuracy and clinical application ability of the nomogram and compared with the TNM staging system for lung cancer.

Results

Sex, TNM stage, surgical treatment, BMI, CALLY, and HGS were independent risk factors for the prognosis of NSCLC patients. The OS of NSCLC patients with a low CALLY index score was significantly worse than that of patients with a high CALLY index (P < 0.001). The CALLY-based nomogram had a good predictive prognostic power, with a C-index of 0.697. Compared with the traditional TNM staging system, our prognostic nomogram had better resolution and accuracy in predicting the 3-year and 5-year OS. Decision curve analysis showed that this prognostic model has a clinical application value.

Conclusions

The CALLY index is a valuable biomarker for evaluating the prognosis of patients with lung cancer. The nomogram based on the CALLY index is highly effective in predicting OS in patients with NSCLC. The results of this study provide a reference tool for clinicians to guide the personalized treatment of patients with lung cancer.

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Data Availability

All data needed to evaluate the conclusions of the study are presented in this paper and/or the Supplementary Materials. Additional data related to this study are requested from the authors.

Abbreviations

CALLY:

CRP-albumin-lymphocyte index

CONUT:

Controlling Nutritional Status score

COPD:

Chronic obstructive pulmonary disease

HGS:

Hand grip strength

NLR:

Neutrophil/lymphocyte ratio

NSCLC:

Non-small cell lung cancer

PLR:

Platelet/lymphocyte ratio

PNI:

Prognostic nutritional index

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Acknowledgements

We would like to express our sincere thanks to the INSCOC project members for their substantial work on data collection and patient follow-up.

Funding

This work was supported by the National Key Research and Development Program (2022YFC2009600) to Dr. Hanping Shi.

Author information

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China

    Xiao-Yue Liu, Guo-Tian Ruan, Tong Liu, Hai-Lun Xie, Yi-Zhong Ge, Meng-Meng Song, Li Deng & Han-Ping Shi

  2. National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China

    Xiao-Yue Liu, Xi Zhang, Qi Zhang, Guo-Tian Ruan, Tong Liu, Hai-Lun Xie, Yi-Zhong Ge, Meng-Meng Song, Li Deng & Han-Ping Shi

  3. Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, 100038, China

    Xiao-Yue Liu, Xi Zhang, Qi Zhang, Guo-Tian Ruan, Tong Liu, Hai-Lun Xie, Yi-Zhong Ge, Meng-Meng Song, Li Deng & Han-Ping Shi

  4. Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China

    Xiao-Yue Liu, Xi Zhang, Qi Zhang, Guo-Tian Ruan, Tong Liu, Hai-Lun Xie, Yi-Zhong Ge, Meng-Meng Song, Li Deng & Han-Ping Shi

Authors
  1. Xiao-Yue Liu
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  2. Xi Zhang
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Contributions

Han-Ping Shi and Li Deng: funding acquisition and resources; Qi Zhang, Xi Zhang, and Guo-Tian Ruan: conceptualization; Xiao-Yue Liu, Hai-Lun Xie, Yi-Zhong Ge, and Meng-Meng Song: data curation and visualization; Xiao-Yue Liu: writing—original draft; and Tong Liu: writing—review and editing. All authors critically revised the manuscript, agreed to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.

Corresponding author

Correspondence to Han-Ping Shi.

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The authors declare no competing interests.

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Liu, XY., Zhang, X., Zhang, Q. et al. The value of CRP-albumin-lymphocyte index (CALLY index) as a prognostic biomarker in patients with non-small cell lung cancer. Support Care Cancer 31, 533 (2023). https://doi.org/10.1007/s00520-023-07997-9

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