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
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 comparableimmunoscore 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 ofimmune 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,CD8center of tumor (CT), CD8invasive margin (IM), FoxP3CT, and CD45ROCT. The calibration curve showed prominent agreement between theobserved 2- and 5-year OS and that predicted by the nomogram. To simplify the nomogram, we developed a new immune-serumscoring system (I-SSS) based on the points awarded for each factor in the nomogram. Our I-SSS was able to stratify same-stagepatients into different risk subgroups. The combination of I-SSS and TNM stage had better prognostic value than the TNM stagealone. Conclusions: Our new I-SSS can accurately and individually predict LUAD prognosis and may be used to supplement prognosticationbased on the TNM stage.