Xie Honghui, Zhang Lin, Chen Lizhi, Zhou Wenchao, Zhang Lijuan, Su Yong, Li Bocheng, Ding Peng, Xiao Yun, Lu Tianzhu, Gong Xiaochang, Li Jingao
NHC Key Laboratory of Personalized Diagnosis and Treatment of Nasopharyngeal Carcinoma, Jiangxi Cancer Hospital, Nanchang, Jiangxi, 330029, People's Republic of China.
Department of Radiation Oncology, Jiangxi Cancer Hospital, Nanchang, Jiangxi, 330029, People's Republic of China.
Immunotargets Ther. 2025 Jun 17;14:577-587. doi: 10.2147/ITT.S516853. eCollection 2025.
This study aimed to assess the prognostic value of circulating immune cells in newly diagnosed, non-metastatic nasopharyngeal carcinoma (NPC) and to develop a nomogram combining immune cell counts with clinical characteristics.
In this retrospective study, patients with non-metastatic NPC treated between January 2015 and December 2018 were included. Circulating immune cell subtypes were measured using cellular immunochip technology. Survival outcomes were assessed using Kaplan-Meier analysis, and independent prognostic factors were identified through multivariate analysis (MVA). A prognostic nomogram was constructed and evaluated using Harrell's concordance index (C-index).
A total of 459 patients were included, with a median follow-up of 62 months. Optimal cutoff values for CD4+ T cells (420 cells/μL), CD8+ T cells (430 cells/μL), CD3+ T cells (1100 cells/μL), and CD4/CD8 ratio (1.00) were determined using X-tile. Higher levels of CD4+ T cells (78.6% vs 64.2%, p < 0.001), CD8+ T cells (77.5% vs 71.4%, p = 0.113), CD3+ T cells (83.1% vs 70.0%, p = 0.003), and CD4/CD8 ratio (77.6% vs 60.0%, p = 0.001) were associated with better 5-year progression-free survival. MVA confirmed high CD4/CD8 ratio and CD3+ T cell count as independent prognostic factors. The nomogram combining CD3+ T cells, CD4/CD8 ratio, and N classification showed superior prognostic accuracy compared with the clinical model alone (C-index: 0.686 vs 0.648, p < 0.001).
Circulating immune cells, particularly CD3+ T cells and CD4/CD8 ratio, are significant prognostic indicators in NPC. The proposed nomogram may help predict disease progression and support individualized treatment planning.
本研究旨在评估新诊断的非转移性鼻咽癌（NPC）中循环免疫细胞的预后价值，并开发一种将免疫细胞计数与临床特征相结合的列线图。
在这项回顾性研究中，纳入了2015年1月至2018年12月期间接受治疗的非转移性NPC患者。使用细胞免疫芯片技术测量循环免疫细胞亚型。采用Kaplan-Meier分析评估生存结局，并通过多变量分析（MVA）确定独立预后因素。构建了一个预后列线图，并使用Harrell一致性指数（C指数）进行评估。
共纳入459例患者，中位随访时间为62个月。使用X-tile确定了CD4 + T细胞（420个细胞/μL）、CD8 + T细胞（430个细胞/μL）、CD3 + T细胞（1100个细胞/μL）和CD4/CD8比值（1.00）的最佳截断值。较高水平的CD4 + T细胞（78.6%对64.2%，p < 0.001）、CD8 + T细胞（77.5%对71.4%，p = 0.113）、CD3 + T细胞（83.1%对70.0%，p = 0.003）和CD4/CD8比值（77.6%对60.0%，p = 0.001）与更好的5年无进展生存期相关。MVA证实高CD4/CD8比值和CD3 + T细胞计数为独立预后因素。与单独的临床模型相比，结合CD3 + T细胞、CD4/CD8比值和N分期的列线图显示出更高的预后准确性（C指数：0.686对0.648，p < 0.001）。
循环免疫细胞，特别是CD3 + T细胞和CD4/CD8比值，是NPC的重要预后指标。所提出的列线图可能有助于预测疾病进展并支持个体化治疗计划。
