{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T10:16:07Z","timestamp":1788430567957,"version":"build-2803163510"},"reference-count":20,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Neuroendocrine prostate cancer (NEPC) is a rare and aggressive malignancy with limited prognostic tools. The Lung Immune Prognostic Index (LIPI), derived from dNLR and lactate dehydrogenase, has demonstrated prognostic value in small-cell lung cancer but has not been evaluated in NEPC. This study assessed the prognostic role of LIPI in NEPC. Methods: This multicenter retrospective study included 34 patients with NEPC (21 secondary, 13 de novo) from four centers in Turkey. Laboratory data were collected at NEPC diagnosis (T3), initial prostate cancer diagnosis (T1), and castration-resistant prostate cancer diagnosis (T2). LIPI was scored using original fixed cut-offs. Survival analyses included Kaplan\u2013Meier, Cox regression, and ROC methods. Results: At NEPC diagnosis, 18 patients (52.9%) had Good LIPI and 16 (47.1%) Intermediate + Poor LIPI. Intermediate + Poor LIPI was associated with significantly shorter overall survival (median 4 vs. 15 months; log-rank p = 0.001; HR 3.83, 95% CI 1.65\u20138.90). In multivariable analysis, albumin was an independent predictor (HR 0.37, p = 0.015), while LIPI showed a trend (HR 2.35, p = 0.091). LIPI demonstrated the highest discriminatory ability for 6-month overall survival (AUC 0.763, p = 0.009). LIPI at earlier disease stages did not predict time to transformation or castration resistance. Among secondary NEPC patients, worsening LIPI trajectory was associated with shorter survival (median 4 vs. 10 months; log-rank p = 0.031). Conclusions: LIPI at NEPC diagnosis was associated with overall survival and demonstrated the highest discriminatory ability among the inflammatory indices assessed. As a routine blood-based score, LIPI may support risk stratification at NEPC diagnosis. Prospective validation is warranted.<\/jats:p>","DOI":"10.3390\/diagnostics16172839","type":"journal-article","created":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T09:20:43Z","timestamp":1788427243000},"page":"2839","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Prognostic Role of the Lung Immune Prognostic Index in Neuroendocrine Prostate Cancer: A Multicenter Retrospective Study"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4021-6095","authenticated-orcid":false,"given":"Merve","family":"Turan","sequence":"first","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Aydin Adnan Menderes University, Zafer Neighborhood, 09100 Aydin, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"software","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"visualization","vocabulary":"credit"},{"role":"validation","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1809-5581","authenticated-orcid":false,"given":"Mehmet Nuri","family":"Baser","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Aydin Adnan Menderes University, Zafer Neighborhood, 09100 Aydin, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8284-6565","authenticated-orcid":false,"given":"Fatima","family":"Ozkaya Kutluay","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Pamukkale University, 20070 Denizli, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6654-3815","authenticated-orcid":false,"given":"Ahmet","family":"Unlu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Antalya Education and Research Hospital, University of Health Sciences, 07100 Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5050-3333","authenticated-orcid":false,"given":"Ozlem","family":"Kutlu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Izmir City Hospital, University of Health Sciences, 35540 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3274-2565","authenticated-orcid":false,"given":"Umut","family":"Cak\u0131roglu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Izmir City Hospital, University of Health Sciences, 35540 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8749-9825","authenticated-orcid":false,"given":"Asim Armagan","family":"Aydin","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Antalya Education and Research Hospital, University of Health Sciences, 07100 Antalya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7698-3574","authenticated-orcid":false,"given":"Olcun Umit","family":"Unal","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Izmir City Hospital, University of Health Sciences, 35540 Izmir, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8142-0362","authenticated-orcid":false,"given":"Gamze","family":"Gokoz Dogu","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Pamukkale University, 20070 Denizli, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5974-6339","authenticated-orcid":false,"given":"Esin","family":"Oktay","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Faculty of Medicine, Aydin Adnan Menderes University, Zafer Neighborhood, 09100 Aydin, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"validation","vocabulary":"credit"},{"role":"resources","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1016\/j.euo.2024.12.014","article-title":"Emergence of Neuroendocrine Tumors in Patients Treated with Androgen Receptor Pathway Inhibitors for Metastatic Prostate Cancer: A Systematic Review and 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