许多炎症和营养标志物被用来预测肺癌的预后。C-反应蛋白（CRP）-淋巴细胞比值（CLR）是各种癌症的有用预测因素。然而，术前CLR在非小细胞肺癌（NSCLC）患者中的预后价值尚待确定。我们与已知标记进行比较，检查了CLR的意义。共招募了两个中心治疗的1380名经过手术切除的NSCLC患者，并将其分为派生和验证队列。计算CLR后，根据受试者工作特征曲线分析确定的截断值，将患者分为高和低CLR组。随后，我们确定了CLR与临床病理因素和预后的统计学关联，并通过倾向分数匹配进一步分析了其预后影响。在检查的所有炎症标志物中，CLR产生了最高的曲线下面积值。CLR的预后影响在倾向评分匹配后仍然显著。高CLR组的预后明显比低CLR组差（5年无病生存率[DFS]：58.1％ vs. 81.9％，P＜0.001；5年总生存率[OS]：72.1％ vs. 91.2％，P＜0.001）。结果在验证队列中得到确认。多变量分析还显示高CLR是DFS和OS的独立因素（DFS：风险比[HR] 1.42，P = 0.027；OS：HR 1.95，P = 0.0037）。术前CLR是预测接受手术的NSCLC患者的预后的有用标志物。 ©2023. 华人外科肿瘤学会。

Many inflammatory and nutritional markers have been used to predict prognosis in lung cancer. The C-reactive protein (CRP)-to-lymphocyte ratio (CLR) is a useful prognostic factor in various cancers. However, the prognostic value of preoperative CLR in patients with non-small cell lung cancer (NSCLC) remains to be established. We examined the significance of the CLR compared with known markers.A total of 1380 surgically resected NSCLC patients treated at two centers were recruited and divided into derivation and validation cohorts. After CLRs were calculated, patients were classified into high and low CLR groups based on the cutoff value determined by receiver operating characteristics curve analysis. Subsequently, we determined the statistical associations of the CLR with clinicopathological factors and prognosis and further analyzed its prognostic impact by propensity-score matching.Of all the inflammatory markers examined, CLR yielded the highest area-under-the-curve value. The prognostic impact of CLR remained significant after propensity-score matching. Prognosis was significantly worse in the high-CLR group than in the low-CLR group (5-year, disease-free survival [DFS]: 58.1% vs. 81.9%, P < 0.001; 5-year overall survival [OS]: 72.1% vs. 91.2%, P < 0.001). The results were confirmed in the validation cohorts. Multivariable analysis also showed high CLR as an independent factor for both DFS and OS (DFS: hazard ratio [HR] 1.42, P = 0.027; OS: HR 1.95, P = 0.0037).Preoperative CLR is a useful marker for predicting the prognosis of NSCLC patients who have undergone surgery.© 2023. Society of Surgical Oncology.