Gut microbiota-associated nutritional-immune status predicts prognosis in postoperative NSCLC patients.
A PNI value of ≥46.2 is associated with improved 5-year survival in postoperative NSCLC patients, indicating a potential link between nutritional status and cancer outcomes.
Where it sits
this study against the rest of the pnc-27 corpusSummary and findings
This study analyzed the prognostic nutritional index (PNI) and its association with gut microbiota in postoperative non-small cell lung cancer (NSCLC) patients. A PNI value of ≥46.2 was linked to improved 5-year survival rates. The study involved a cohort of 511 NSCLC patients and utilized various microbiota analysis methods.
Abstract
<h4>Background</h4>Surgical resection is the primary treatment for non-small cell lung cancer (NSCLC) patients with stages I and II; however, the postoperative prognosis varies among individuals. The prognostic nutritional index (PNI) reflects the nutritional-immune status of patients, but its microbial determinants remain unclear.<h4>Methods</h4>PNI was analyzed in a cohort of 372 retrospective and 139 prospective NSCLC patients. This analysis integrated gut microbiota signatures using 16S rRNA sequencing, fecal metabolomics, and murine fecal microbiota transplantation (FMT) models.<h4>Results</h4>A PNI value of ≥46.2 stratified postoperative NSCLC patients with improved 5-y survival (HR = 0.3889, 95% CI 0.2840-0.5356, <i>p</i> < 0.001). Patients with a high PNI showed enrichment of short-chain fatty acid (SCFA)-producing taxa, such as <i>Akkermansia</i> and <i>Eubacterium hallii</i>, and elevated butyrate/isovalerate levels, correlating with increased infiltration of CD8<sup>+</sup> T cells (Pearson <i>r</i> = 0.51, <i>p</i> = 0.02). FMT from high-PNI patients reduced lung tumor growth in mice compared with FMT from low-PNI patients (7.2 vs 18 nodules, <i>p</i> = 0.01). Oral administration of <i>A. muciniphila</i> or/and <i>E. hallii</i> or butyrate suppressed tumor growth and enhanced CD8<sup>+</sup> tumor-infiltrating lymphocytes (TILs) (<i>p</i> < 0.001).<h4>Conclusion</h4>PNI and its linked gut microbiota‒SCFA axis are clinically prognostic biomarkers and potential immunomodulatory targets for early-stage NSCLC. Targeting this axis may serve as a promising coadjuvant strategy for NSCLC patients undergoing surgical resection.
Background
The paper addresses the clinical question of how gut microbiota and nutritional-immune status may influence prognosis in postoperative NSCLC patients. Prior research has suggested that gut microbiota can impact immune function and overall health, but the specific implications for cancer prognosis remain unclear. This study aims to clarify these relationships to potentially guide postoperative care.
Methods
Not reported in abstract.
Results
Not reported in abstract.
Interpretation
Not reported in abstract.
Key findings
- Not reported in abstract.
Limitations
- Not reported in abstract.