# Gut microbiota-associated nutritional-immune status predicts prognosis in postoperative NSCLC patients

Article · Yu Q, Chen A, Yi J, Iqbal M, Tang Z, Ge H, Hu Y, Liu W, Zheng L, Tang J, Xiang J

- Archive id: doi:10.1080/19490976.2026.2652460
- Published: 2026-04-03
- Venue: Gut microbes
- DOI: https://doi.org/10.1080/19490976.2026.2652460
- PMID: 41933285
- PMCID: PMC13051591
- Citations: 1
- Source URL: https://doi.org/10.1080/19490976.2026.2652460
- PDF: https://europepmc.org/articles/PMC13051591/pdf
- Provenance: europepmc

## Abstract

Background 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. Methods 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. Results A PNI value of ≥46.2 stratified postoperative NSCLC patients with improved 5-y survival (HR = 0.3889, 95% CI 0.2840-0.5356, p \< 0.001). Patients with a high PNI showed enrichment of short-chain fatty acid (SCFA)-producing taxa, such as Akkermansia and Eubacterium hallii , and elevated butyrate/isovalerate levels, correlating with increased infiltration of CD8 + T cells (Pearson r = 0.51, p = 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, p = 0.01). Oral administration of A. muciniphila or/and E. hallii or butyrate suppressed tumor growth and enhanced CD8 + tumor-infiltrating lymphocytes (TILs) ( p \< 0.001). Conclusion 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.

_Abstract reproduced under CC-BY (article license as recorded by Europe PMC; abstract reproduced unmodified apart from markup removal)._

Topics: [Cancer Immunotherapy](https://space-kitty.com/topics/cancer-immunotherapy)

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