{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T04:01:45Z","timestamp":1748059305200,"version":"3.41.0"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T00:00:00Z","timestamp":1747958400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Zigong Brain Science Research Institute Collaborative Innovation Category","award":["2023-NKY-01-03, 2024-NKY-01-03"],"award-info":[{"award-number":["2023-NKY-01-03, 2024-NKY-01-03"]}]},{"name":"Zigong Psychiatric Research Center scientific research project","award":["2022ZD01, 2022ZD03"],"award-info":[{"award-number":["2022ZD01, 2022ZD03"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Geriatr"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Objectives<\/jats:title>\n            <jats:p>We evaluated the utility of routine laboratory test-related sarcopenia indices as predictors of mortality in older patients with primary lung cancer undergoing the first chemotherapy course.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design<\/jats:title>\n            <jats:p>Retrospective cohort study.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting<\/jats:title>\n            <jats:p>West China Hospital, Chengdu, China.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Participants<\/jats:title>\n            <jats:p>This study enrolled primary lung cancer patients\u2009\u2265\u200960 years of age undergoing their first chemotherapy course.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Measurements<\/jats:title>\n            <jats:p>Data on individual patients were obtained from the medical records, while information on survival outcomes was gathered through telephone-based follow-up or local government databases. Using available routine hematological and biochemical test results, this study calculated three sarcopenia-related indices for each patient. These indices included the AST\/ALT ratio, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR). We assessed the relationships between these indices and death using Cox proportional hazards models.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>The study included 926 primary lung cancer patients (71.5% male; median age: 65 years) who underwent their first course of chemotherapy. During the follow-up period (median: 28 months), 563 patients (60.8%) died. In the overall population, there was a significantly higher likelihood of all-cause mortality in patients with an NLR\u2009\u2265\u20092.88 (HR\u2009=\u20091.60, 95% CI\u2009=\u20091.36\u20131.90, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) or a PLR\u2009\u2265\u2009125.11 (HR\u2009=\u20091.39, 95% CI\u2009=\u20091.17\u20131.64, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) compared to those with values below these thresholds. However, after adjustment for potential confounding factors, no association was found between NLR or PLR and mortality. After stratification by sex, it was found that both NLR and PLR values were associated with an increased risk of mortality among women (NLR: HR\u2009=\u20092.1, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001; PLR: HR\u2009=\u20092.42, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>NLR and PLR, are indicators of sarcopenia and can be easily derived from routine laboratory testing data. These indices can significantly predict mortality in older female patients with primary lung cancer at the start of chemotherapy. Therefore, there is potential practical value in using these indices for assessing patient risk prior to chemotherapy.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12877-025-05951-4","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T04:48:57Z","timestamp":1747975737000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of the utility of different laboratory test-related sarcopenia indices as predictors of lung cancer mortality"],"prefix":"10.1186","volume":"25","author":[{"given":"Xiaoyan","family":"Chen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shuyue","family":"Luo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisha","family":"Hou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Yang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qiukui","family":"Hao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"issue":"1","key":"5951_CR1","doi-asserted-by":"publisher","first-page":"12","DOI":"10.3322\/caac.21820","volume":"74","author":"RL Siegel","year":"2024","unstructured":"Siegel RL, Giaquinto AN, Jemal A. Cancer statistics, 2024. CA Cancer J Clin. 2024;74(1):12\u201349.","journal-title":"CA Cancer J Clin"},{"issue":"4","key":"5951_CR2","doi-asserted-by":"publisher","first-page":"249","DOI":"10.6004\/jnccn.2204.0023","volume":"22","author":"GJ Riely","year":"2024","unstructured":"Riely GJ, et al. Non-Small cell lung cancer, version 4.2024, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2024;22(4):249\u201374.","journal-title":"J Natl Compr Canc Netw"},{"issue":"10191","key":"5951_CR3","doi-asserted-by":"publisher","first-page":"2636","DOI":"10.1016\/S0140-6736(19)31138-9","volume":"393","author":"AJ Cruz-Jentoft","year":"2019","unstructured":"Cruz-Jentoft AJ, Sayer AA. Sarcopenia Lancet. 2019;393(10191):2636\u201346.","journal-title":"Sarcopenia Lancet"},{"issue":"3","key":"5951_CR4","doi-asserted-by":"publisher","first-page":"485","DOI":"10.1002\/jcsm.12411","volume":"10","author":"SSY Yeung","year":"2019","unstructured":"Yeung SSY, et al. Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2019;10(3):485\u2013500.","journal-title":"J Cachexia Sarcopenia Muscle"},{"issue":"1","key":"5951_CR5","doi-asserted-by":"publisher","first-page":"100016","DOI":"10.1016\/j.jnha.2023.100016","volume":"28","author":"H Zhou","year":"2024","unstructured":"Zhou H, Ding X, Luo M. The association between sarcopenia and functional disability in older adults. J Nutr Health Aging. 2024;28(1):100016.","journal-title":"J Nutr Health Aging"},{"key":"5951_CR6","doi-asserted-by":"crossref","unstructured":"Zhang Y et al. Sarcopenia is a prognostic factor of adverse effects and mortality in patients with tumour: A systematic review and Meta-Analysis. J Cachexia Sarcopenia Muscle, 2024.","DOI":"10.1002\/jcsm.13629"},{"issue":"3","key":"5951_CR7","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1016\/j.jamda.2019.12.012","volume":"21","author":"LK Chen","year":"2020","unstructured":"Chen LK, et al. Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment. J Am Med Dir Assoc. 2020;21(3):300\u20137. e2.","journal-title":"J Am Med Dir Assoc"},{"issue":"9","key":"5951_CR8","doi-asserted-by":"publisher","first-page":"Jc103","DOI":"10.7326\/J22-0062","volume":"175","author":"R Ramaswamy","year":"2022","unstructured":"Ramaswamy R. In frail older adults with sarcopenia, a multicomponent intervention vs. education reduced mobility disability at 26 mo. Ann Intern Med. 2022;175(9):Jc103.","journal-title":"Ann Intern Med"},{"key":"5951_CR9","doi-asserted-by":"publisher","first-page":"785045","DOI":"10.3389\/fendo.2021.785045","volume":"12","author":"M Yin","year":"2021","unstructured":"Yin M, et al. Diagnostic performance of clinical laboratory indicators with sarcopenia: results from the West China health and aging trend study. Front Endocrinol (Lausanne). 2021;12:785045.","journal-title":"Front Endocrinol (Lausanne)"},{"key":"5951_CR10","doi-asserted-by":"publisher","first-page":"736640","DOI":"10.3389\/fonc.2021.736640","volume":"11","author":"Q Hu","year":"2021","unstructured":"Hu Q, et al. High Neutrophil-to-Lymphocyte ratio and Platelet-to-Lymphocyte ratio are associated with sarcopenia risk in hospitalized renal cell carcinoma patients. Front Oncol. 2021;11:736640.","journal-title":"Front Oncol"},{"key":"5951_CR11","doi-asserted-by":"publisher","first-page":"72","DOI":"10.1016\/j.avsg.2020.05.027","volume":"72","author":"M Pizzimenti","year":"2021","unstructured":"Pizzimenti M, et al. Usefulness of Platelet-to-Lymphocyte ratio as a marker of sarcopenia for critical limb threatening ischemia. Ann Vasc Surg. 2021;72:72\u20138.","journal-title":"Ann Vasc Surg"},{"key":"5951_CR12","doi-asserted-by":"publisher","first-page":"843610","DOI":"10.3389\/fendo.2022.843610","volume":"13","author":"Y He","year":"2022","unstructured":"He Y, et al. High serum AST\/ALT ratio and low serum INS*PA product are risk factors and can diagnose sarcopenia in Middle-Aged and older adults. Front Endocrinol (Lausanne). 2022;13:843610.","journal-title":"Front Endocrinol (Lausanne)"},{"issue":"1","key":"5951_CR13","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1177\/17085381211059383","volume":"31","author":"N Sel\u00e7uk","year":"2023","unstructured":"Sel\u00e7uk N, et al. Sarcopenia is a risk factor for major adverse cardiac events after surgical revascularization for critical limb ischemia. Vascular. 2023;31(1):64\u201371.","journal-title":"Vascular"},{"issue":"3","key":"5951_CR14","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1111\/cei.13505","volume":"202","author":"MP Petrova","year":"2020","unstructured":"Petrova MP, et al. Sarcopenia and high NLR are associated with the development of hyperprogressive disease after second-line pembrolizumab in patients with non-small-cell lung cancer. Clin Exp Immunol. 2020;202(3):353\u201362.","journal-title":"Clin Exp Immunol"},{"issue":"5","key":"5951_CR15","doi-asserted-by":"publisher","first-page":"2075","DOI":"10.1007\/s00520-015-2997-x","volume":"24","author":"SI Go","year":"2016","unstructured":"Go SI, et al. Sarcopenia and inflammation are independent predictors of survival in male patients newly diagnosed with small cell lung cancer. Support Care Cancer. 2016;24(5):2075\u201384.","journal-title":"Support Care Cancer"},{"issue":"8","key":"5951_CR16","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1038\/s41577-020-0378-2","volume":"20","author":"MD Park","year":"2020","unstructured":"Park MD. Sex differences in immune responses in COVID-19. Nat Rev Immunol. 2020;20(8):461.","journal-title":"Nat Rev Immunol"},{"issue":"3","key":"5951_CR17","doi-asserted-by":"publisher","first-page":"309","DOI":"10.1111\/acel.12326","volume":"14","author":"C Giefing-Kr\u00f6ll","year":"2015","unstructured":"Giefing-Kr\u00f6ll C, et al. How sex and age affect immune responses, susceptibility to infections, and response to vaccination. Aging Cell. 2015;14(3):309\u201321.","journal-title":"Aging Cell"},{"key":"5951_CR18","doi-asserted-by":"publisher","first-page":"100152","DOI":"10.1016\/j.crphar.2022.100152","volume":"4","author":"HT Rakshith","year":"2023","unstructured":"Rakshith HT. Raghavendra Naveen N. Sex differences in drug effects and\/or toxicity in oncology. Curr Res Pharmacol Drug Discov. 2023;4:100152.","journal-title":"Curr Res Pharmacol Drug Discov"},{"issue":"1","key":"5951_CR19","doi-asserted-by":"publisher","first-page":"312","DOI":"10.1111\/imr.12444","volume":"273","author":"LW Treffers","year":"2016","unstructured":"Treffers LW, et al. Neutrophils in cancer. Immunol Rev. 2016;273(1):312\u201328.","journal-title":"Immunol Rev"},{"key":"5951_CR20","doi-asserted-by":"publisher","first-page":"104380","DOI":"10.1016\/j.critrevonc.2024.104380","volume":"199","author":"N Tuerhong","year":"2024","unstructured":"Tuerhong N, et al. Interactions between platelets and the cancer immune microenvironment. Crit Rev Oncol Hematol. 2024;199:104380.","journal-title":"Crit Rev Oncol Hematol"},{"issue":"3","key":"5951_CR21","doi-asserted-by":"publisher","first-page":"819","DOI":"10.1002\/eji.201343664","volume":"44","author":"F Sabbione","year":"2014","unstructured":"Sabbione F, et al. Neutrophils suppress \u0393\u03b4 T-cell function. Eur J Immunol. 2014;44(3):819\u201330.","journal-title":"Eur J Immunol"},{"issue":"7","key":"5951_CR22","doi-asserted-by":"publisher","first-page":"765","DOI":"10.1038\/cr.2015.62","volume":"25","author":"ZG Fridlender","year":"2015","unstructured":"Fridlender ZG, Albelda SM, Granot Z. Promoting metastasis: neutrophils and T cells join forces. Cell Res. 2015;25(7):765\u20136.","journal-title":"Cell Res"},{"issue":"7556","key":"5951_CR23","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1038\/nature14282","volume":"522","author":"SB Coffelt","year":"2015","unstructured":"Coffelt SB, et al. IL-17-producing \u0393\u03b4 T cells and neutrophils conspire to promote breast cancer metastasis. Nature. 2015;522(7556):345\u20138.","journal-title":"Nature"},{"issue":"1","key":"5951_CR24","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1002\/jcsm.12783","volume":"13","author":"F Petermann-Rocha","year":"2022","unstructured":"Petermann-Rocha F, et al. Global prevalence of sarcopenia and severe sarcopenia: a systematic review and meta-analysis. J Cachexia Sarcopenia Muscle. 2022;13(1):86\u201399.","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"5951_CR25","doi-asserted-by":"crossref","unstructured":"Couderc AL et al. Pre-Therapeutic sarcopenia among Cancer patients: an Up-to-Date Meta-Analysis of prevalence and predictive value during Cancer treatment. Nutrients, 2023. 15(5).","DOI":"10.3390\/nu15051193"},{"issue":"7","key":"5951_CR26","doi-asserted-by":"publisher","first-page":"1270","DOI":"10.1093\/annonc\/mdu022","volume":"25","author":"AG Pallis","year":"2014","unstructured":"Pallis AG, et al. Management of elderly patients with NSCLC; updated expert\u2019s opinion paper: EORTC elderly task force, lung Cancer group and international society for geriatric oncology. Ann Oncol. 2014;25(7):1270\u201383.","journal-title":"Ann Oncol"},{"issue":"3","key":"5951_CR27","doi-asserted-by":"publisher","first-page":"380","DOI":"10.1200\/JCO.2009.23.5440","volume":"28","author":"KM Clough-Gorr","year":"2010","unstructured":"Clough-Gorr KM, et al. Older breast cancer survivors: geriatric assessment domains are associated with poor tolerance of treatment adverse effects and predict mortality over 7 years of follow-up. J Clin Oncol. 2010;28(3):380\u20136.","journal-title":"J Clin Oncol"},{"issue":"6","key":"5951_CR28","doi-asserted-by":"publisher","first-page":"2743","DOI":"10.1002\/jcsm.13618","volume":"15","author":"Y Zhu","year":"2024","unstructured":"Zhu Y, et al. Prognostic value of systemic inflammation, nutritional status and sarcopenia in patients with amyotrophic lateral sclerosis. J Cachexia Sarcopenia Muscle. 2024;15(6):2743\u201355.","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"5951_CR29","doi-asserted-by":"publisher","first-page":"1378762","DOI":"10.3389\/fonc.2024.1378762","volume":"14","author":"K Kasahara","year":"2024","unstructured":"Kasahara K, et al. Sarcopenia accompanied by systemic inflammation can predict clinical outcomes in patients with head and neck cancer undergoing curative therapy. Front Oncol. 2024;14:1378762.","journal-title":"Front Oncol"},{"key":"5951_CR30","doi-asserted-by":"publisher","first-page":"107327482413022","DOI":"10.1177\/10732748241302248","volume":"31","author":"E Ucgul","year":"2024","unstructured":"Ucgul E, et al. Factors influencing immunotherapy outcomes in cancer: sarcopenia and systemic inflammation. Cancer Control. 2024;31:10732748241302248.","journal-title":"Cancer Control"},{"key":"5951_CR31","doi-asserted-by":"crossref","unstructured":"Luo X et al. Molecular mechanisms and potential interventions during Aging-associated sarcopenia. Mech Ageing Dev, 2024: p. 112020.","DOI":"10.1016\/j.mad.2024.112020"},{"key":"5951_CR32","doi-asserted-by":"crossref","unstructured":"Sahin TK et al. Prognostic significance of the Royal marsden hospital (RMH) score in patients with cancer: A systematic review and Meta-Analysis. Cancers (Basel), 2024. 16(10).","DOI":"10.3390\/cancers16101835"}],"container-title":["BMC Geriatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-025-05951-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12877-025-05951-4\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12877-025-05951-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T04:49:03Z","timestamp":1747975743000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcgeriatr.biomedcentral.com\/articles\/10.1186\/s12877-025-05951-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,23]]},"references-count":32,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["5951"],"URL":"https:\/\/doi.org\/10.1186\/s12877-025-05951-4","relation":{},"ISSN":["1471-2318"],"issn-type":[{"value":"1471-2318","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,23]]},"assertion":[{"value":"29 January 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study was conducted in accordance with the Declaration of Helsinki and the ethical approval was obtained from the Research Ethics Committee of West China Hospital, Sichuan University (No. 2018\u201394). Given the anonymized and retrospective nature of this study, the requirement for patient consent was waived. All methods comply with relevant guidelines and regulations.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"367"}}