Kunlun Li,1 Yuqing Jiang,1 Delun Li,2 Jianguang Sun1 

1Department of Orthopaedics, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China; 2Data Center, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China

Correspondence: Delun Li, Data Center, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China, Email lidelun1997@163.com

Objective: The purpose of this study is to evaluate the relationship between some comprehensive indices (platelet-to-neutrophil ratio (PNR), fibrinogen-to-lymphocyte ratio (FLR), albumin-to-monocyte ratio (AMR)) and bone metastasis of lung cancer.
Methods: A total of 1535 patients with lung cancer treated in Meizhou People’s Hospital from November 2017 to May 2025 were retrospectively analyzed. Clinical characteristics (age, body mass index (BMI), bone metastasis, and PNR, FLR, and AMR levels) were collected. The optimal cutoff values of PNR, FLR, and AMR were calculated through the receiver operating characteristic (ROC) curve. The relationships between PNR, FLR, AMR and bone metastasis were analyzed.
Results: There were 665 (665/1535, 43.3%) patients had bone metastasis and 870 (870/1535, 56.7%) without. The levels of PNR (54.11 (38.11, 79.59) vs 50.06 (33.55, 72.10), p=0.004), and FLR (3.88 (2.67, 6.03) vs 3.36 (2.26, 5.27), p< 0.001) in patients with bone metastasis were higher, and AMR (67.22 (47.55, 97.00) vs 70.45 (50.66, 104.91), p=0.027) was lower than those in patients without bone metastasis. The levels of PNR and FLR in bone metastasis group were higher than those in non-bone metastasis group among non-smoking patients, while AMR in bone metastasis group was lower than those in non-bone metastasis group among smoking patients. ROC analyses revealed that the critical value was 75.40 and area under the ROC curve (AUC) was 0.673 for PNR as an indicator for bone metastasis, while the critical value was 4.515 and AUC was 0.659 for FLR in non-smoking patients.
Conclusion: In conclusion, lung cancer mainly occurs in elderly men, among whom approximately 43% of patients have bone metastases. PNR and FLR have good predictive value in bone metastasis of non-smoking lung cancer patients.

Keywords: lung cancer, bone metastasis, platelet, to, neutrophil count ratio, fibrinogen, to, lymphocyte count ratio