目的:本研究的目的是开发一种功能性临床列线图,用于基于外周血淋巴细胞预测原发性前列腺癌(PCa)患者的8年总生存期(OS)。
方法:使用来自中国94名PCa患者的单机构注册数据,这项研究确定并整合了生存的重要预后因素以构建列线图.通过一致性指数(C指数)和ROC曲线(受试者工作特征曲线)测量辨别能力。并通过校准曲线测量预测准确性。使用决策曲线分析(DCA)来测量临床有用性。
结果:共纳入94例患者进行分析。通过LASSO-Cox回归确定了五个独立的预后因素,并将其纳入列线图:年龄,T阶段,外周血CD3(+)CD4(+)T淋巴细胞的绝对计数,CD3(-)CD16(+)CD56(+)NK细胞与CD4(+)/CD8(+)比值。预测模型的曲线下面积(AUC)值5-,8-,10年总生存率分别为0.81,0.76和0.73.5-概率的校准曲线,8年和10年的操作系统显示了列线图预测与实际观测之间的最佳一致性。分层为不同的风险组允许显著的区别。DCA模型具有良好的临床应用价值。
结论:我们开发了一种新的列线图,可以对诊断为PCa的患者进行个性化的OS预测。这一发现揭示了PCa的年龄和存活率的相对关系,和更良好的预后患者表现出更高水平的CD4+T,CD4+/CD8+比值与CD3(-)CD16(+)CD56(+)NK细胞特异性。这种临床适用的预后模型表现出很有希望的预测能力,在知情决策过程中为临床医生提供有价值的支持。
OBJECTIVE: The purpose of this
study was to develop a functional clinical nomogram for predicting 8-year overall survival (OS) of patients with prostate cancer (PCa) primary based on
peripheral lymphocyte.
METHODS: Using data from a single-institutional registry of 94 patients with PCa in China, this
study identified and integrated significant prognostic factors for survival to build a nomogram. The discriminative ability was measured by concordance index (C-index) and ROC curves (Receiver Operating Characteristic Curves). And the predictive accuracy was measured by the calibration curves. Decision curve analyses (DCA) was used to measure the clinical usefulness.
RESULTS: A total of 94 patients were included for analysis. Five independent prognostic factors were identified by LASSO-Cox regression and incorporated into the nomogram: age, the T stage, the absolute counts of
peripheral CD3(+)CD4(+) T lymphocytes, CD3(-)CD16(+)CD56(+) NK cells and CD4(+)/CD8(+) ratio. The area under the curve (AUC) values of the predictive model for 5-, 8-, and 10-year overall survival were 0.81, 0.76, and 0.73, respectively. The calibration curves for probability of 5-,8- and 10-year OS showed optimal agreement between nomogram prediction and actual observation. The stratification into different risk groups allowed significant distinction. DCA indicated the good clinical application value of the model.
CONCLUSIONS: We developed a novel nomogram that enables personalized prediction of OS for patients diagnosed with PCa. This finding revealed a relative in age and survival rate in PCa, and a more favorable prognosis in patients exhibiting higher levels of CD4 + T, CD4+/CD8 + ratio and CD3(-)CD16(+)CD56(+) NK cells specifically. This clinically applicable prognostic model exhibits promising predictive capabilities, offering valuable support to clinicians in informed decision-making process.