A nomogram-based immune-serum scoring system predicts overall survival in patients with lung adenocarcinoma

Qiujuan Huang; Tongyuan Qu; Lisha Qi; Changxu Liu; Yuhong Guo; Qianru Guo; Guangning Li; Yalei Wang; Wenshuai Zhang; Wei Zhao; Danyang Ren; Leina Sun; Shengguang Wang; Bin Meng; Baocun Sun; Bin Zhang; Wenjuan Ma; Wenfeng Cao

doi:10.20892/j.issn.2095-3941.2020.0648

A nomogram-based immune-serum scoring system predicts overall survival in patients with lung adenocarcinoma

Cancer Biol Med. 2021 Mar 12;18(2):517-529. doi: 10.20892/j.issn.2095-3941.2020.0648. Online ahead of print.

Authors

Qiujuan Huang¹, Tongyuan Qu¹, Lisha Qi¹, Changxu Liu², Yuhong Guo¹, Qianru Guo¹, Guangning Li¹, Yalei Wang¹, Wenshuai Zhang¹, Wei Zhao¹, Danyang Ren¹, Leina Sun¹, Shengguang Wang³, Bin Meng¹, Baocun Sun¹, Bin Zhang⁴, Wenjuan Ma⁵, Wenfeng Cao¹

Affiliations

¹ Department of Pathology, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.
² Department of Pathology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin 300120, China.
³ Department of Lung Cancer, Tianjin Lung Cancer Center, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.
⁴ Department of Breast Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.
⁵ Department of Breast Imaging, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin 300060, China.

PMID: 33710816
PMCID: PMC8185867
DOI: 10.20892/j.issn.2095-3941.2020.0648

Abstract

Objective: The immunoscore, which is used to quantify immune infiltrates, has greater relative prognostic value than tumor, node, and metastasis (TNM) stage and might serve as a new system for classification of colorectal cancer. However, a comparable immunoscore for predicting lung adenocarcinoma (LUAD) prognosis is currently lacking.

Methods: We analyzed the expression of 18 immune features by immunohistochemistry in 171 specimens. The relationship of immune marker expression and clinicopathologic factors to the overall survival (OS) was analyzed with the Kaplan-Meier method. A nomogram was developed by using the optimal features selected by least absolute shrinkage and selection operator (LASSO) regression in the training cohort (n = 111) and evaluated in the validation cohort (n = 60).

Results: The indicators integrated in the nomogram were TNM stage, neuron-specific enolase, carcino-embryonic antigen, CD8_{center of tumor (CT)}, CD8_{invasive margin (IM)}, FoxP3_CT, and CD45RO_CT. The calibration curve showed prominent agreement between the observed 2- and 5-year OS and that predicted by the nomogram. To simplify the nomogram, we developed a new immune-serum scoring system (I-SSS) based on the points awarded for each factor in the nomogram. Our I-SSS was able to stratify same-stage patients into different risk subgroups. The combination of I-SSS and TNM stage had better prognostic value than the TNM stage alone.

Conclusions: Our new I-SSS can accurately and individually predict LUAD prognosis and may be used to supplement prognostication based on the TNM stage.

Keywords: Lung adenocarcinoma; immune microenvironment; immunoscore; nomogram; prognosis.

Abstract

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