| Citation: |
FU Shenbo, JIN Long, LIANG Jing, GUO Junjun, CHE Yu, LI Chenyang, CHEN Yong. Construction of A Nomogram Prognostic Model Based on Pretreatment Inflammatory Indicator for Esophageal Squamous Cell Carcinoma Patients Treated with Radical Radiotherapy[J]. Cancer Research on Prevention and Treatment, 2025, 52(2): 142-150. DOI: 10.3971/j.issn.1000-8578.2025.24.0718
|
To describe the significance of the pretreatment inflammatory indicators in predicting the prognosis of patients with esophageal squamous cell carcinoma (ESCC) after undergoing radical radiotherapy.
The data of 246 ESCC patients who underwent radical radiotherapy were retrospectively collected. Receiver operating characteristic (ROC) curves were drawn to determine the optimal cutoff values for platelet-lymphocyte ratio (PLR), neutrophil-lymphocyte ratio (NLR), and systemic immune-inflammation index (SII). The Kaplan-Meier method was used for survival analysis. We conducted univariate and multivariate analyses by using the Cox proportional risk regression model. Software R (version 4.2.0) was used to create the nomogram of prognostic factors.
The results of the ROC curve analysis showed that the optimal cutoff values of PLR, NLR, and SII were 146.06, 2.67, and 493.97, respectively. The overall response rates were 77.6% and 64.5% in the low and high NLR groups, respectively (P<0.05). The results of the Kaplan-Meier survival analysis revealed that the prognosis of patients in the low PLR, NLR, and SII group was better than that of patients in the high PLR, NLR, and SII group (all P<0.05). The results of the multivariate Cox regression analysis showed that gender, treatment modalities, T stage, and NLR were independent factors affecting the overall survival (OS). In addition, T stage and NLR were independent factors affecting the progression-free survival (PFS) (all P<0.05). The nomogram models of OS and PFS prediction were established based on multivariate analysis. The C-index values were 0.703 and 0.668. The calibration curves showed excellent consistency between the predicted and observed OS and PFS.
The pretreatment values of PLR, NLR, and SII are correlated with the prognosis of patients with ESCC who underwent radical radiotherapy. Moreover, NLR is an independent factor affecting the OS and PFS of ESCC patients. The NLR-based nomogram model has a good predictive ability.
Competing interests: The authors declare that they have no competing interests.
| [1] |
Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: Globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2024, 74(3): 229-263. doi: 10.3322/caac.21834
|
| [2] |
郑荣寿, 陈茹, 韩冰峰, 等. 2022年中国恶性肿瘤流行情况分析[J]. 中华肿瘤杂志, 2024, 46(3): 221-231. [Zheng RS, Chen R, Han BF, et al. Cancer incidence and mortality in China, 2022][J]. Zhonghua Zhong Liu Za Zhi, 2024, 46(3): 221-231.]
Zheng RS, Chen R, Han BF, et al. Cancer incidence and mortality in China, 2022][J]. Zhonghua Zhong Liu Za Zhi, 2024, 46(3): 221-231.
|
| [3] |
He F, Wang J, Liu L, et al. Esophageal cancer: Trends in incidence and mortality in china from 2005 to 2015[J]. Cancer Medicine, 2021, 10(5): 1839-1847. doi: 10.1002/cam4.3647
|
| [4] |
Cooper JS, Guo MD, Herskovic A, et al. Chemoradiotherapy of locally advanced esophageal cancerlong-term follow-up of a prospective randomized trial (rtog 85-01)[J]. JAMA, 1999, 281(17): 1623-1627.
|
| [5] |
Minsky BD, Pajak TF, Ginsberg RJ, et al. Int 0123 (radiation therapy oncology group 94-05) phase iii trial of combined-modality therapy for esophageal cancer: High-dose versus standard-dose radiation therapy[J]. J Clin Oncol, 2002, 20(5): 1167-1174. doi: 10.1200/JCO.2002.20.5.1167
|
| [6] |
Hulshof M, Geijsen ED, Rozema T, et al. Randomized study on dose escalation in definitive chemoradiation for patients with locally advanced esophageal cancer (artdeco study)[J]. J Clin Oncol, 2021, 39(25): 2816-2824. doi: 10.1200/JCO.20.03697
|
| [7] |
Kim E, Koroukian S, Thomas CR Jr. Conditional survival of esophageal cancer: An analysis from the seer registry (1988-2011)[J]. J Thorac Oncol, 2015, 10(10): 1490-1497. doi: 10.1097/JTO.0000000000000649
|
| [8] |
Wei WQ, Chen ZF, He YT, et al. Long-term follow-up of a community assignment, one-time endoscopic screening study of esophageal cancer in China[J]. J Clin Oncol, 2015, 33(17): 1951-1957. doi: 10.1200/JCO.2014.58.0423
|
| [9] |
Greten FR, Grivennikov SI. Inflammation and cancer: Triggers, mechanisms, and consequences[J]. Immunity, 2019, 51(1): 27-41. doi: 10.1016/j.immuni.2019.06.025
|
| [10] |
Hanahan D, Weinberg RA. Hallmarks of cancer: The next generation[J]. Cell, 2011, 144(5): 646-674. doi: 10.1016/j.cell.2011.02.013
|
| [11] |
He K, Si L, Pan X, et al. Preoperative systemic immune-inflammation index (sii) as a superior predictor of long-term survival outcome in patients with stage i-ii gastric cancer after radical surgery[J]. Front Oncol, 2022, 12: 829689. doi: 10.3389/fonc.2022.829689
|
| [12] |
Cupp MA, Cariolou M, Tzoulaki I, et al. Neutrophil to lymphocyte ratio and cancer prognosis: An umbrella review of systematic reviews and meta-analyses of observational studies[J]. BMC Medicine, 2020, 18(1): 360. doi: 10.1186/s12916-020-01817-1
|
| [13] |
Yuan Q, Xu C, Wang W, et al. Predictive value of nlr and plr in driver-gene-negative advanced non-small cell lung cancer treated with pd-1/pd-l1 inhibitors: A single institutional cohort study [J]. Technol Cancer Res Treat, 2024, 23: 15330338241246651.
|
| [14] |
Asaka S, Shimakawa T, Nishiguchi R, et al. Preoperative and postoperative c-reactive protein to albumin ratio (car) as a prognostic marker for survival of esophageal squamous cell carcinoma patients after surgery[J]. Anticancer Res, 2023, 43(11): 5139-5147. doi: 10.21873/anticanres.16714
|
| [15] |
Nost TH, Alcala K, Urbarova I, et al. Systemic inflammation markers and cancer incidence in the uk biobank[J]. Eur J Epidemiol, 2021, 36(8): 841-848. doi: 10.1007/s10654-021-00752-6
|
| [16] |
Faria SS, Giannarelli D, Cordeiro De Lima VC, et al. Development of a prognostic model for early breast cancer integrating neutrophil to lymphocyte ratio and clinical-pathological characteristics[J]. Oncologist, 2024, 29(4): e447-e454. doi: 10.1093/oncolo/oyad303
|
| [17] |
Dong Q, Zhao F, Li Y, et al. The correlation between systemic inflammatory markers and efficiency for advanced gastric cancer patients treated with icis combined with chemotherapy[J]. Immunology, 2024, 172(1): 77-90. doi: 10.1111/imm.13759
|
| [18] |
Li C, Wu J, Jiang L, et al. The predictive value of inflammatory biomarkers for major pathological response in non-small cell lung cancer patients receiving neoadjuvant chemoimmunotherapy and its association with the immune-related tumor microenvironment: A multi-center study[J]. Cancer Immunol Immunother, 2023, 72(3): 783-794. doi: 10.1007/s00262-022-03262-w
|
| [19] |
Aoyama T, Kazama K, Maezawa Y, et al. Usefulness of nutrition and inflammation assessment tools in esophageal cancer treatment[J]. In Vivo, 2023, 37(1): 22-35. doi: 10.21873/invivo.13051
|
| [20] |
Shaul ME, Fridlender ZG. Tumour-associated neutrophils in patients with cancer[J]. Nat Rev Clin Oncol, 2019, 16(10): 601-620. doi: 10.1038/s41571-019-0222-4
|
| [21] |
Hedrick CC, Malanchi I. Neutrophils in cancer: Heterogeneous and multifaceted[J]. Nat Rev Immunol, 2022, 22(3): 173-187. doi: 10.1038/s41577-021-00571-6
|
| [22] |
Wculek SK, Bridgeman VL, Peakman F, et al. Early neutrophil responses to chemical carcinogenesis shape long-term lung cancer susceptibility[J]. iScience, 2020, 23(7): 101277. doi: 10.1016/j.isci.2020.101277
|
| [23] |
Li P, Lu M, Shi J, et al. Dual roles of neutrophils in metastatic colonization are governed by the host nk cell status[J]. Nat Commun, 2020, 11(1): 4387. doi: 10.1038/s41467-020-18125-0
|
| [24] |
Strobech JE, Giuriatti P, Erler JT. Neutrophil granulocytes influence on extracellular matrix in cancer progression[J]. Am J Physiol Cell Physiol, 2022, 323(2): C486-C493. doi: 10.1152/ajpcell.00122.2022
|
| [25] |
Giannakeas V, Narod SA. Incidence of cancer among adults with thrombocytosis in Ontario, Canada[J]. JAMA Netw Open, 2021, 4(8): e2120633. doi: 10.1001/jamanetworkopen.2021.20633
|
| [26] |
Li M, Zhao S, Lopez G, et al. Mean platelet volume, thrombocytosis, and survival in non-small cell lung cancer patients treated with first-line pembrolizumab alone or with chemotherapy[J]. Cancer Immunol Immunother, 2023, 72(7): 2067-2074. doi: 10.1007/s00262-023-03392-9
|
| [27] |
Rothwell PM, Wilson M, Price JF, et al. Effect of daily aspirin on risk of cancer metastasis: A study of incident cancers during randomised controlled trials[J]. Lancet, 2012, 379(9826): 1591-1601. doi: 10.1016/S0140-6736(12)60209-8
|
| [28] |
Tao DL, Tassi Yunga S, Williams CD, et al. Aspirin and antiplatelet treatments in cancer[J]. Blood, 2021, 137(23): 3201-3211. doi: 10.1182/blood.2019003977
|
| [29] |
Wu Y, Yuan M, Wang C, et al. T lymphocyte cell: A pivotal player in lung cancer[J]. Front Immunol, 2023, 14: 1102778. doi: 10.3389/fimmu.2023.1102778
|
| [30] |
Zhang X, Jing J. Effect of peripheral blood lymphocytes on prognosis of multiple cancers[J]. Cancer Control, 2023, 30: 10732748231202921.
|
| [31] |
Pirozzolo G, Gisbertz SS, Castoro C, et al. Neutrophil-to-lymphocyte ratio as prognostic marker in esophageal cancer: A systematic review and meta-analysis[J]. J Thorac Dis, 2019, 11(7): 3136-3145. doi: 10.21037/jtd.2019.07.30
|
| [32] |
Cai G, Yu J, Meng X. Predicting prognosis and adverse events by hematologic markers in patients with locally advanced esophageal squamous cell carcinoma treated with neoadjuvant chemoradiotherapy[J]. Cancer Manag Res, 2020, 12: 8497-8507. doi: 10.2147/CMAR.S257058
|
| [33] |
Wu YF, Chu SC, Chang BS, et al. Hematologic markers as prognostic factors in nonmetastatic esophageal cancer patients under concurrent chemoradiotherapy[J]. Biomed Res Int, 2019, 2019: 1263050.
|
| [34] |
Yang J, Zheng J, Qiu J, et al. Systemic immune-inflammatory index, tumor-infiltrating lymphocytes, and clinical outcomes in esophageal squamous cell carcinoma receiving concurrent chemoradiotherapy[J]. J Immunol Res, 2023, 2023: 4275998.
|
| [35] |
Schalper KA, Carleton M, Zhou M, et al. Elevated serum interleukin-8 is associated with enhanced intratumor neutrophils and reduced clinical benefit of immune-checkpoint inhibitors[J]. Nat Med, 2020, 26(5): 688-692. doi: 10.1038/s41591-020-0856-x
|
| [36] |
Hwang M, Canzoniero JV, Rosner S, et al. Peripheral blood immune cell dynamics reflect antitumor immune responses and predict clinical response to immunotherapy[J]. J Immunother Cancer, 2022, 10(6): e004688. doi: 10.1136/jitc-2022-004688
|
Figures(7) / Tables(4)
This work is licensed under a Creative Commons Attribution 3.0 License.
Copyright © Editorial Department of Cancer Prevention Research 鄂公网安备 42011102005013号 鄂ICP备2022015867号
Supported by: Beijing Renhe Information Technology Co., Ltd. 
DownLoad: