The predictive value of systemic inflammation response index and albumin-globin ratio for prognosis in non-small cell lung cancer

Introduction We investigated whether inflammatory markers would be significant prognostic factors for survival in patients with non-small-cell lung cancer (NSCLC). Method A total of 748 NSCLC patients were evaluated. The relationships of inflammatory markers with clinicopathologic characteristics and prognosis were analyzed by the chi-squared test and Cox regression methods. The Restricted Cubic Splines(RCS) was used to flexibly model the relationships of inflammatory markers and the overall survival of NSCLC. Survival patterns were identified using the means of the Kaplan–Meier curves. Results Both systemic inflammation response index (SIRI) and albumin-to-globulin ratio (AGR) were independently associated with overall survival (OS) in multivariate analysis [hazard ratio (HR): 1.647, 95% confidence interval (CI): 1.257–1.904; HR: 0.780, 95% CI: 0.632–0.962]. Restricted Cubic Spline analysis indicated that SIRI were non-linear with the overall survival of NSCLC ( P for non-linear  = 0.004 ), while the AGR showed a linear relationship with the overall survival of NSCLC ( P for non-linear  = 0.258 ). Stratified analysis indicated that the favorable prognostic effect of SIRI was more evident in those aged 60 years or older, adenocarcinoma, Squamous cell carcinoma and Tumor size>3cm( P  < 0.05). In addition, overall survival differed significantly between patients with SIRI-AGR score grades 3 (HR: 1.974; 95% CI: 1.486–2.622). Time-dependent ROC analysis showed that the SIRI-AGR score could correctly predict the outcome of NSCLC patients was about 0.70. Conclusion This study demonstrated that the SIRI-AGR score was an independent prognostic factor of NSCLC and could serve as an excellent prognostic indicator for NSCLC.