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Evaluating and validating the predictive ability of preoperative systemic inflammatory/immune cells in gastric cancer following R0 resection

  • Authors:
    • Wenbo Xue
    • Xuezhong Xu
    • Yulin Tan
    • Yan Qian
    • Hao Wang
    • Yibo Wang
    • Yixin Xu
    • Xiaojun Zhu
    • Peng Jiang
    • Wei Ding

  • View Affiliations

  • Published online on: September 13, 2019     https://doi.org/10.3892/ol.2019.10867
  • Pages: 5205-5214

  • Copyright: © Xue et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The present study aimed to compare the predictive abilities of preoperative systemic inflammatory/immune cell ratios in gastric cancer (GC) following curative R0 resection, and to screen the optimal parameter incorporated into nomograms to predict the postoperative overall survival (OS) and recurrence‑free survival (RFS). A total of 679 patients with GC were included in the study, divided into a primary cohort (300 cases), an internal validation cohort (278 cases), and an external validation cohort (101 cases). In the primary cohort, the prognostic abilities of all systemic inflammatory/immune cell accounts or ratios were compared by receiver operating characteristic (ROC) curve analysis. The area under the ROC curve (AUC) of the neutrophil‑monocyte‑lymphocyte ratio (NMLR) was largest for the prediction of OS (AUC=0.728) and RFS (AUC=0.695). The independent predictive factors for OS or RFS, including NMLR, degree of differentiation (DD), T‑stage and N‑stage were used to establish the 2 nomograms. The comprehensive predictive power of nomograms was compared with that of the tumor‑nodes‑metastasis (TNM) staging system and validated by bootstrap resampling. The concordance indexes (C‑indexes) of the nomograms for OS [C‑index, 0.851; 95% confidence interval (CI), 0.817‑0.883] and RFS (C‑index, 0.860; 95% CI, 0.831‑0.889), were increased compared with those for the DD, the NMLR and the TNM stage. The AUCs of the 2 nomograms (0.933 for OS and 0.944 for RFS) were largest among all predictive scoring systems. In the internal validation cohort, the C‑indexes of the nomograms for OS and RFS were 0.840 and 0.916, respectively. In the external validation cohort, the C‑indexes of the nomograms for OS and RFS nomograms were 0.827 and 0.891, respectively. The present study demonstrated that the NMLR was an independent prognostic factor for patients with GC. The proposed nomograms were demonstrated to have a good predictive ability with improved sensitivity and accuracy in survival and recurrence in patients with GC undergoing R0 resection.
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November-2019
Volume 18 Issue 5

Print ISSN: 1792-1074
Online ISSN:1792-1082

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Spandidos Publications style
Xue W, Xu X, Tan Y, Qian Y, Wang H, Wang Y, Xu Y, Zhu X, Jiang P, Ding W, Ding W, et al: Evaluating and validating the predictive ability of preoperative systemic inflammatory/immune cells in gastric cancer following R0 resection. Oncol Lett 18: 5205-5214, 2019
APA
Xue, W., Xu, X., Tan, Y., Qian, Y., Wang, H., Wang, Y. ... Ding, W. (2019). Evaluating and validating the predictive ability of preoperative systemic inflammatory/immune cells in gastric cancer following R0 resection. Oncology Letters, 18, 5205-5214. https://doi.org/10.3892/ol.2019.10867
MLA
Xue, W., Xu, X., Tan, Y., Qian, Y., Wang, H., Wang, Y., Xu, Y., Zhu, X., Jiang, P., Ding, W."Evaluating and validating the predictive ability of preoperative systemic inflammatory/immune cells in gastric cancer following R0 resection". Oncology Letters 18.5 (2019): 5205-5214.
Chicago
Xue, W., Xu, X., Tan, Y., Qian, Y., Wang, H., Wang, Y., Xu, Y., Zhu, X., Jiang, P., Ding, W."Evaluating and validating the predictive ability of preoperative systemic inflammatory/immune cells in gastric cancer following R0 resection". Oncology Letters 18, no. 5 (2019): 5205-5214. https://doi.org/10.3892/ol.2019.10867