ArticleTranslational lung cancer research2026
Dynamic changes in liver-to-spleen ratio: can it be a prognostic biomarker for chemo-immunotherapy in small cell lung cancer?
Article in Translational lung cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The liver-to-spleen ratio (LSR) is a non-invasive imaging biomarker used to assess non-alcoholic fatty liver disease (NAFLD). Given the potential link between the NAFLD-associated immune microenvironment and systemic anti-tumor immunity, we hypothesized that NAFLD-as defined by LSR-might predict clinical outcomes in small cell lung cancer (SCLC) patients treated with chemo-immunotherapy. This study aimed to evaluate the association between LSR-defined NAFLD, dynamic LSR changes, and treatment efficacy in SCLC patients receiving chemotherapy or chemo-immunotherapy. Methods: The study comprised 314 SCLC patients treated at Wuhan Union Hospital between March 2015 and March 2024; 160 received chemo-immunotherapy and 154 received chemotherapy alone. NAFLD was defined as LSR ≤1.1 on baseline computed tomography (CT) scans. Dynamic LSR changes were assessed using two follow-up measurements taken 1-3 months apart. Primary and secondary endpoints were overall survival (OS) and progression-free survival (PFS), objective response rate (ORR), and disease control rate (DCR), respectively. Survival analyses were performed using Kaplan-Meier curves and Cox regression models. Results: The prevalence of LSR-defined NAFLD at baseline was comparable between the chemo-immunotherapy group (36 cases, 22.5%) and the chemotherapy group (41 cases, 26.6%). No significant differences in OS or PFS were observed between NAFLD and non-NAFLD subgroups in either treatment cohort (all P>0.05). Although the second LSR measurement in the chemotherapy group indicated worse OS in the non-decreased group (9.7 Conclusions: Neither baseline LSR-defined NAFLD status nor short-term dynamic LSR changes predicted treatment outcomes in SCLC patients undergoing chemotherapy or chemo-immunotherapy. These results suggest that NAFLD may not contribute meaningfully to immunotherapy resistance mechanisms in SCLC.
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