Nomogram Incorporating the WNT/β-Catenin Signaling Pathway for Predicting the Survival of Cutaneous Melanoma

Yu-Xin Zhou; Xin Wang; De-Quan Pang; Ying-Man Wang; Jing Bai; Fei Tian; Duo Han; Shuwei Shi; Lei Hu

doi:10.2147/IJGM.S309616

Nomogram Incorporating the WNT/β-Catenin Signaling Pathway for Predicting the Survival of Cutaneous Melanoma

Int J Gen Med. 2021 Jun 23:14:2751-2761. doi: 10.2147/IJGM.S309616. eCollection 2021.

Authors

Yu-Xin Zhou¹, Xin Wang², De-Quan Pang¹, Ying-Man Wang³, Jing Bai⁴, Fei Tian¹, Duo Han¹, Shuwei Shi¹, Lei Hu¹

Affiliations

¹ Department of Radiation Oncology, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, People's Republic of China.
² Department of Radiation Oncology, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention & Therapy, Tianjin, Tianjin's Clinical Research Center for Cancer, Tianjin, People's Republic of China.
³ Department of Radiation and Chemotherapy Oncology, North China University of Science and Technology Affiliated Hospital, Tangshan, Hebei, People's Republic of China.
⁴ Department of Pharmacology, North China University of Science and Technology, Tangshan, Hebei, People's Republic of China.

Abstract

Background: Accurate prediction of the survival of cutaneous melanoma (CM) permits the selection of the optimal treatment. Currently, the TNM stage has limitations in predicting the survival of CM. There is evidence that the WNT/β-catenin signaling pathway has the potential to predict the CM prognosis. However, it still needs further investigation.

Objective: This study aims to establish a nomogram incorporating the WNT/β-catenin signaling pathway to improve the predicted accuracy of the overall survival (OS) of CM.

Methods: Two hundred and eighty CM patients were recruited and followed up. The clinicopathological characteristics and the key genes of the WNT/β-catenin signaling pathway (VEGF, β-catenin, and DKK1) were chosen as potential variables associated with the OS. In the training cohort (n = 190), a nomogram was built to estimate the 1-, 3-, and 5-year OS, and its discriminations and calibrations were valid by the verification cohort (n = 90). The predicted accuracies of the nomogram with or without the Wnt/β-catenin pathway and TNM stage were compared.

Results: A nomogram integrating independent risk factors (ulceration, lymph node metastasis, distant metastasis, Breslow thickness, dermal mitoses, β-catenin, VEGF, and DKK1), which were evaluated by a multivariate analysis, was constructed to predict the 1-, 3-, and 5-year OS of CM patients. Good discrimination and calibration were obtained regardless of the training or validation datasets. The nomogram incorporating the Wnt/β-catenin signaling pathway showed the highest accuracy [area under the curve (AUC)=0.914, 0.852, 0.785] compared with the nomogram without the Wnt/β-catenin signaling pathway (AUC=0.693, 0.640, 0.615) and the TNM stage (AUC=0.726, 0.693, 0.673).

Conclusion: The prognostic value of the established nomogram incorporating the WNT/β-catenin signaling pathway was better than it without WNT/β-catenin signaling pathway and TNM stage, which might be beneficial in the development of optimal treatment options.

Keywords: TNM; WNT/β-catenin signaling pathway; cutaneous melanoma; nomogram; overall survial.

Grants and funding

Science and Technology Planning Project of Hebei Province (NO. 112761175)Science and Technology Planning Project of Tangshan city (NO. 12140209A-30).