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A Novel Prognostic Model and Practical Nomogram for Predicting the Outcomes of Colorectal Cancer: Based on Tumor Biomarkers and Log Odds of Positive Lymph Node Scheme.

作者信息

Zhu Jun, Hao Jun, Ma Qian, Shi Tingyu, Wang Shuai, Yan Jingchuan, Chen Rujie, Xu Dong, Jiang Yu, Zhang Jian, Li Jipeng

机构信息

State Key Laboratory of Cancer Biology, Institute of Digestive Diseases, Xijing Hospital, The Fourth Military Medical University, Xi'an, China.

Department of Experiment Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China.

出版信息

Front Oncol. 2021 Apr 16;11:661040. doi: 10.3389/fonc.2021.661040. eCollection 2021.


DOI:10.3389/fonc.2021.661040
PMID:33937076
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8085421/
Abstract

BACKGROUND: Emerging evidence shows that serum tumor biomarkers (TBs) and log odds of positive lymph node scheme (LODDS) are closely associated with the prognosis of colorectal cancer (CRC) patients. The aim of our study is to validate the predictive value of TBs and LODDS clinically and to develop a robust prognostic model to predict the overall survival (OS) of patients with CRC. METHODS: CRC patients who underwent radical resection and with no preoperative chemotherapy were enrolled in the study. The eligible population were randomized into training (70%) and test (30%) cohorts for the comprehensive evaluation of the prognostic model. Clinical implications of serum biomarkers and LODDS were identified by univariate and multivariate Cox proportion regression analysis. The predictive ability and discriminative performance were evaluated by Kaplan-Meier (K-M) curves and receiver operating characteristic (ROC) curves. Clinical applicability of the prognostic model was assessed by decision curve analysis (DCA), and the corresponding nomogram was constructed based on the above factors. RESULTS: A total of 1,202 eligible CRC patients were incorporated into our study. Multivariable COX analysis demonstrated that CA199 (HR = 1.304), CA125 (HR = 1.429), CEA (HR = 1.307), and LODDS (HR = 1.488) were independent risk factors for OS (all P < 0.0001). K-M curves showed that the high-risk group possessed a shorter OS than the low-risk counterparts. The area under curves (AUCs) of the model for 1-, 3- and 5-year OS were 86.04, 78.70, and 76.66% respectively for the train cohort (80.35, 77.59, and 74.26% for test cohort). Logistic DCA and survival DCA confirmed that the prognostic model displayed more clinical benefits than the conventional AJCC 8 TNM stage and CEA model. The nomograms were built accordingly, and the calibration plot for the probability of survival at 3- or 5-years after surgery showed an optimal agreement between prediction and actual observation. CONCLUSIONS: Preoperative serum TBs and LODDS have significant clinical implications for CRC patients. A novel prognostic model incorporating common TBs (CA199, CA125, and CEA) and LODDS displayed better predictive performance than both single factor and the TNM classification. A novel nomogram incorporating TBs and LODDS could individually predict OS in patients with CRC.

摘要
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7d0/8085421/9a42eb91028e/fonc-11-661040-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7d0/8085421/6a1f05a0c9b7/fonc-11-661040-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7d0/8085421/018c70cefa3e/fonc-11-661040-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7d0/8085421/70370d0b38c9/fonc-11-661040-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7d0/8085421/9a42eb91028e/fonc-11-661040-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7d0/8085421/6a1f05a0c9b7/fonc-11-661040-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7d0/8085421/018c70cefa3e/fonc-11-661040-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7d0/8085421/70370d0b38c9/fonc-11-661040-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7d0/8085421/9a42eb91028e/fonc-11-661040-g004.jpg

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引用本文的文献

[1]
Postoperative adjuvant chemotherapy in patients with stage II early onset colorectal cancer: exploration and discovery using real-world data and the SEER database.

Front Oncol. 2025-5-30

[2]
Development and validation of a logistic regression model for the diagnosis of colorectal cancer.

Sci Rep. 2025-4-28

[3]
Development and validation of nomograms for predicting the prognosis of colorectal cancer patients.

Transl Cancer Res. 2025-3-30

[4]
Development and validation of a preoperative systemic inflammation-based nomogram for predicting surgical site infection in patients with colorectal cancer.

Int J Colorectal Dis. 2024-12-21

[5]
A log odds of positive lymph nodes-based predictive model effectively forecasts prognosis and guides postoperative adjuvant chemotherapy duration in stage III colon cancer: a multi-center retrospective cohort study.

BMC Cancer. 2024-9-2

[6]
Log odds of positive lymph nodes show better predictive performance on the prognosis of early-onset colorectal cancer.

Int J Colorectal Dis. 2023-7-11

[7]
Prediction models of colorectal cancer prognosis incorporating perioperative longitudinal serum tumor markers: a retrospective longitudinal cohort study.

BMC Med. 2023-2-21

[8]
N7-methylguanosine-related lncRNAs: Distinction between hot and cold tumors and construction of predictive models in colon adenocarcinoma.

Front Oncol. 2022-9-15

[9]
Real-world survival of colon cancer after radical surgery: A single-institutional retrospective analysis.

Front Oncol. 2022-9-16

[10]
Log odds of positive lymph nodes as a novel prognostic predictor for colorectal cancer: a systematic review and meta-analysis.

BMC Cancer. 2022-3-18

本文引用的文献

[1]
N-myc downstream-regulated gene 2 promotes the protein stability of estrogen receptor beta via inhibition of ubiquitin-protein ligase E3A to suppress colorectal cancer.

J Gastrointest Oncol. 2020-12

[2]
Prognostic Values of Preoperative Inflammatory and Nutritional Markers for Colorectal Cancer.

Front Oncol. 2020-11-3

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Establishment and validation of a novel nomogram incorporating clinicopathological parameters into the TNM staging system to predict prognosis for stage II colorectal cancer.

Cancer Cell Int. 2020-7-6

[4]
Clinical Significances of Positive Postoperative Serum CEA and Post-preoperative CEA Increment in Stage II and III Colorectal Cancer: A Multicenter Retrospective Study.

Front Oncol. 2020-5-20

[5]
Harvest of at least 18 lymph nodes is associated with improved survival in patients with pN0 colon cancer: a retrospective cohort study.

J Cancer Res Clin Oncol. 2020-4-13

[6]
Prognosis of colorectal cancer patients is associated with the novel log odds of positive lymph nodes scheme: derivation and external validation.

J Cancer. 2020-1-16

[7]
Assessment of Factors Influencing Lymph Node Count in Colorectal Cancer.

J Coll Physicians Surg Pak. 2019-12

[8]
Circular RNA-Associated Competing Endogenous RNA Network and Prognostic Nomogram for Patients With Colorectal Cancer.

Front Oncol. 2019-11-8

[9]
Serum Chemokine CXCL7 as a Diagnostic Biomarker for Colorectal Cancer.

Front Oncol. 2019-10-9

[10]
Personalizing the Prediction of Colorectal Cancer Prognosis by Incorporating Comorbidities and Functional Status into Prognostic Nomograms.

Cancers (Basel). 2019-9-26

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