Zhang Zhi, Gu Weiguo, Hu Mingbin, Zhang Guohua, Yu Feng, Xu Jinbiao, Deng Jianxiong, Xu Linlin, Mei Jinhong, Wang Chunliang, Qiu Feng
Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, China.
Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
Front Oncol. 2022 Aug 25;12:696037. doi: 10.3389/fonc.2022.696037. eCollection 2022.
Compelling evidence indicates that elevated peripheral serum lymphocytes are associated with a favorable prognosis in various cancers. However, the association between serum lymphocytes and glioma is contradictory. In this study, a nomogram was established to predict the diagnosis of glioma-grading through Ki-67 expression and serum lymphocytes.
We performed a retrospective analysis of 239 patients diagnosed with LGG and 178 patients with HGG. Immunohistochemistry was used to determine the Ki-67 expression. Following multivariate logistic regression analysis, a nomogram was established and used to identify the most related factors associated with HGG. The consistency index (C-index), decision curve analysis (DCA), and a calibration curve were used to validate the model.
The number of LGG patients with more IDH1/2 mutations and 1p19q co-deletion was greater than that of HGG patients. The multivariate logistic analysis identified Ki-67 expression, serum lymphocyte count, and serum albumin (ALU) as independent risk factors associated with HGG, and these factors were included in a nomogram in the training cohort. In the validation cohort, the nomogram demonstrated good calibration and high consistency (C-index = 0.794). The Spearman correlation analysis revealed a significant association between HGG and serum lymphocyte count (r = -0.238, 0.001), ALU (r = -0.232, 0.001), and Ki-67 expression (r = 0.457, 0.001). Furthermore, the Ki-67 expression was negatively correlated with the serum lymphocyte count (r = -0.244, 0.05). LGG patients had lower Ki-67 expression and higher serum lymphocytes compared with HGG patients, and a combination of these two variables was significantly higher in HGG patients.
The constructed nomogram is capable of predicting the diagnosis of glioma-grade. A decrease in the level of serum lymphocyte count and increased Ki-67 expression in HGG patients indicate that their immunological function is diminished and the tumor is more aggressive.
有力证据表明，外周血淋巴细胞升高与多种癌症的良好预后相关。然而，血清淋巴细胞与胶质瘤之间的关联存在矛盾。在本研究中，通过Ki-67表达和血清淋巴细胞建立了一个列线图来预测胶质瘤分级诊断。
我们对239例诊断为低级别胶质瘤（LGG）的患者和178例高级别胶质瘤（HGG）患者进行了回顾性分析。采用免疫组织化学法测定Ki-67表达。经过多因素逻辑回归分析，建立列线图并用于识别与HGG相关的最主要因素。一致性指数（C指数）、决策曲线分析（DCA）和校准曲线用于验证模型。
具有更多异柠檬酸脱氢酶1/2（IDH1/2）突变和1p19q共缺失的LGG患者数量多于HGG患者。多因素逻辑分析确定Ki-67表达、血清淋巴细胞计数和血清白蛋白（ALU）为与HGG相关的独立危险因素，这些因素被纳入训练队列的列线图中。在验证队列中，列线图显示出良好的校准和高一致性（C指数 = 0.794）。Spearman相关性分析显示HGG与血清淋巴细胞计数（r = -0.238，P = 0.001）、ALU（r = -0.232，P = 0.001）和Ki-67表达（r = 0.457，P = 0.001）之间存在显著关联。此外，Ki-67表达与血清淋巴细胞计数呈负相关（r = -0.244，P = 0.05）。与HGG患者相比，LGG患者的Ki-67表达较低，血清淋巴细胞较高，并且这两个变量的组合在HGG患者中显著更高。
构建的列线图能够预测胶质瘤分级诊断。HGG患者血清淋巴细胞计数水平降低和Ki-67表达增加表明其免疫功能下降，肿瘤更具侵袭性。
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