The Value Of Advanced Lung Cancer Inflammation Index For Predicting Lymph Node Metastasis In Patients With Non-Small Cell Lung Cancer Less Than 2cm Of Lung Cancer

Objective:The purpose of this study is to investigate the predictive value of advanced lung cancer inflammation index for predicting lymph node metastasis in patients with non-small cell lung cancer less than 2cm of lung cancer.Methods : This study retrospectively analyzed the clinical data of patients with non-small cell lung cancer undergoing thoracotomy or thoracoscopic lung resection in the Department of thoracic surgery of Jiangsu Province from August 2021 to August2022.The optimal cut-off value for ALI was determined based on the receiver operating characteristic(ROC)curve and the area under the ROC curve(AUC),so that the collected data were divided into two groups,high ALI and low ALI groups.The basic clinicopathological features and the occurrence of lymph node metastasis between the high ALI and low ALI groups were compared by the chi-square test or Fisher’s exact test.Univariate analysis of group differences between high ALI and low ALI,and all variables with P value <0.10 in univariate analysis were included in Logistic regression models for multivariate analysis to finally identify independent risk factors for lymph node metastasis and thus predict the association between ALI and lymph node metastasis.Finally,a nomogram prediction model for the risk of lymph node metastasis in patients with NSCLC was constructed using R language software,and the model was evaluated and validated using calibration curve and decision curve analysis(DCA).P<0.05 was considered to be statistically significant.Results:At present,a total of 876 patients in this analysis were included in this study.Based on the receiver operating characteristic(ROC)curve and the area under the ROC curve(AUC),the optimal critical values of ALI is 46.15(sensitivity 66.4%,specificity54.6%).According to the optimal critical value of ALI 46.15,the subjects were divided into 491 cases of high ALI group(ALI≥46.15)and 385 cases of low ALI group(ALI<46.15).Univariate regression analysis showed that higher proportion of men(P=0.008),history of smoking(P <0.001),lower ALI(P <0.001)and size of tumor were associated with lymph node metastasis in NSCLC patients.Logistic The regression analysis showed that T stage(HR =2.257,95% CI: 1.074–5.012,P=0.025)and low ALI(HR =2.588,95% CI: 1.168–6.308,P=0.041)were significantly associated with lymph node metastasis.The metastasis lymph node rate(MLNR)was significantly higher in patients with NSCLC with ALI <46.15 than in those with ALI 46.15,that is,more prone to lymph node metastasis(P<0.001).Conclusions:ALI and T stage were independent risk factors for lymph node metastasis in NSCLC,and high T stage and low ALI were significantly associated with the development of lymph node metastasis.