Department of Radiation Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China.
Department of Gastrointestinal Oncology, Guangxi Medical University Cancer Hospital, Nanning, Guangxi, 530021, People's Republic of China.
Radiat Oncol. 2024 Aug 13;19(1):108. doi: 10.1186/s13014-024-02500-y.
To explore the influence of circulating lymphocyte subsets, serum markers, clinical factors, and their impact on overall survival (OS) in locally advanced nasopharyngeal carcinoma (LA-NPC). Additionally, to construct a nomogram predicting OS for LA-NPC patients using independent prognostic factors.
A total of 530 patients with LA-NPC were included in this study. In the training cohort, Cox regression analysis was utilized to identify independent prognostic factors, which were then integrated into the nomogram. The concordance index (C-index) was calculated for both training and validation cohorts. Schoenfeld residual analysis, calibration curves, and decision curve analysis (DCA) were employed to evaluate the nomogram. Kaplan-Meier methods was performed based on risk stratification using the nomogram.
A total of 530 LA-NPC patients were included. Multivariate Cox regression analysis revealed that the circulating CD8T cell, platelet-to-lymphocyte ratio (PLR), lactate dehydrogenase (LDH), albumin (ALB), gender, and clinical stage were independent prognostic factors for LA-NPC (p < 0.05). Schoenfeld residual analysis indicated overall satisfaction of the proportional hazards assumption for the Cox regression model. The C-index of the nomogram was 0.724 (95% CI: 0.669-0.779) for the training cohort and 0.718 (95% CI: 0.636-0.800) for the validation cohort. Calibration curves demonstrated good correlation between the model and actual survival outcomes. DCA confirmed the clinical utility enhancement of the nomogram over the TNM staging system. Significant differences were observed in OS among different risk stratifications.
Circulating CD8 T cell, PLR, LDH, ALB, gender and clinical stage are independent prognostic factors for LA-NPC. The nomogram and risk stratification constructed in this study effectively predict OS in LA-NPC.
探讨循环淋巴细胞亚群、血清标志物、临床因素及其对局部晚期鼻咽癌（LA-NPC）总生存（OS）的影响，并构建基于独立预后因素预测 LA-NPC 患者 OS 的列线图。
本研究共纳入 530 例 LA-NPC 患者。在训练队列中，采用 Cox 回归分析识别独立预后因素，并将其整合到列线图中。计算训练和验证队列的一致性指数（C-index）。采用 Schoenfeld 残差分析、校准曲线和决策曲线分析（DCA）评估列线图。根据列线图进行风险分层，采用 Kaplan-Meier 方法进行生存分析。
共纳入 530 例 LA-NPC 患者。多因素 Cox 回归分析显示，循环 CD8+T 细胞、血小板与淋巴细胞比值（PLR）、乳酸脱氢酶（LDH）、白蛋白（ALB）、性别和临床分期是 LA-NPC 的独立预后因素（p<0.05）。Schoenfeld 残差分析表明 Cox 回归模型的比例风险假设总体上得到满足。列线图在训练队列中的 C-index 为 0.724（95%CI：0.669-0.779），在验证队列中的 C-index 为 0.718（95%CI：0.636-0.800）。校准曲线表明模型与实际生存结果具有良好的相关性。DCA 证实了列线图在 TNM 分期系统上的临床实用性增强。不同风险分层之间的 OS 存在显著差异。
循环 CD8+T 细胞、PLR、LDH、ALB、性别和临床分期是 LA-NPC 的独立预后因素。本研究构建的列线图和风险分层能够有效预测 LA-NPC 的 OS。
