Evidence mapPaperPMID 42379770Full record

ArticleIn vivo (Athens, Greece)

An Emergency-deployable Albumin-enhanced NLR Derived by Machine Learning Improves Risk Stratification in Lung Cancer: A Multicenter Cohort Study.

Yunhua Zhao, Jilong Wang, Yubao He, Yutao Wang, Muchen Ren, Sihui Liu, Tianyi Wang, Heyang Zhang, Hanping Shi

Abstract readMulticenter Study
In one paragraph

Article in In vivo (Athens, Greece). The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Yunhua Zhao *Department of Emergency Medicine, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China.
Jilong Wang *Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China.
Yubao HeBeijing Massage Hospital, Beijing, P.R. China.
Yutao WangDepartment of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China.
Muchen RenDepartment of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China.
Sihui LiuDepartment of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China.
Tianyi WangDepartment of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China.
Heyang ZhangDepartment of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, Beijing, P.R. China; zhangheyang@mail.ccmu.edu.cn.
Hanping ShiCenter for Clinical Nutrition, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, P.R. China; shihp@ccmu.edu.cn.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

aimSystemic inflammation is tightly linked to lung cancer prognosis, yet widely used blood-based indices show only modest discrimination. We aimed to develop a simple, albumin-enhanced inflammatory index to improve risk stratification. PATIENTS AND

methodsUsing the Investigation on Nutrition Status and Clinical Outcome of Common Cancer database, 1,576 patients with lung cancer with complete baseline data were randomly split into a training cohort (n=1,104) and an internal validation cohort (n=472). LASSO regression screened prognostically informative laboratory markers. Conventional inflammatory indices were compared by Harrell's C-index. A supervised machine-learning approach integrated serum albumin level with the neutrophil-to-lymphocyte ratio (NLR) to derive an albumin-enhanced NLR score (aNLR). Prognostic value was tested with Cox models (three prespecified adjustment levels), restricted cubic splines, Kaplan-Meier analysis, time-dependent area under the receiver operating characteristics curve, calibration, and decision curve analysis.

resultsLASSO highlighted lymphocyte count, albumin level, and neutrophil count as dominant factors in predicting prognosis. Among conventional indices, NLR showed the highest discrimination (C-index 0.600). The derived aNLR markedly improved performance (overall C-index 0.727; training 0.725; validation 0.731). Using an outcome-driven cutoff (0.56), high aNLR was consistently associated with worse survival (unadjusted hazard ratio=2.39, 95% confidence interval=2.21-2.58; fully adjusted hazard ratio=2.14, 95% confidence interval=1.97-2.32; both

conclusionAn albumin-enhanced NLR, created by machine-learning fusion of albumin and NLR, provides substantially better prognostic discrimination than conventional inflammatory indices and supports individualized survival assessment in lung cancer.

Indexed as

Lung NeoplasmsLymphocytesMachine LearningNeutrophilsSerum AlbuminAgedBiomarkers, TumorFemaleHumansInflammationLymphocyte CountMaleMiddle AgedPrognosisRisk AssessmentROC CurveBiomarkers, TumorSerum Albumininflammatory biomarkersLung cancermachine learningrisk stratificationserum albumin

Identifiers

PMID42379770
PMCPMC13322029

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.