A multi-parametric prognostic model based on clinical features and serological markers predicts overall survival in non-small cell lung cancer patients with chronic hepatitis B viral infection

• Published in: Cancer cell international Vol. 20; no. 1; pp. 1 - 555
• Main Authors: Chen, Shulin, Huang, Hanqing, Liu, Yijun, Lai, Changchun, Peng, Songguo, Zhou, Lei, Chen, Hao, Xu, Yiwei, He, Xia
• Format: Journal Article
• Language: English
• Published: London BioMed Central 19-11-2020; BMC
• Subjects: Antibodies; Antigens; Apolipoproteins; Body mass index; Cell survival; Chronic infection; Hepatitis B; Hepatitis B virus; Infections; Lasso regression; Lung cancer; Lymphocytes; Medical prognosis; Metastasis; Neutrophils; Nomograms; Non-small cell lung cancer; Non-small cell lung carcinoma; Patients; Primary Research; Prognostic; Regression analysis; Risk groups; Serology; Small cell lung carcinoma; Variables; Viral infections; China
• ISSN: 1475-2867; 1475-2867
• DOI: 10.1186/s12935-020-01635-8

Abstract
Background
To establish and validate a multi-parametric prognostic model based on clinical features and serological markers to estimate the overall survival (OS) in non-small cell lung cancer (NSCLC) patients with chronic hepatitis B viral (HBV) infection.
Methods
The prognostic model was established by using Lasso regression analysis in the training cohort. The incremental predictive value of the model compared to traditional TNM staging and clinical treatment for individualized survival was evaluated by the concordance index (C-index), time-dependent ROC (tdROC) curve, and decision curve analysis (DCA). A prognostic model risk score based nomogram for OS was built by combining TNM staging and clinical treatment. Patients were divided into high-risk and low-risk subgroups according to the model risk score. The difference in survival between subgroups was analyzed using Kaplan–Meier survival analysis, and correlations between the prognostic model, TNM staging, and clinical treatment were analysed.
Results
The C-index of the model for OS is 0.769 in the training cohorts and 0.676 in the validation cohorts, respectively, which is higher than that of TNM staging and clinical treatment. The tdROC curve and DCA show the model have good predictive accuracy and discriminatory power compare to the TNM staging and clinical treatment. The prognostic model risk score based nomogram show some net clinical benefit. According to the model risk score, patients are divided into low-risk and high-risk subgroups. The difference in OS rates is significant in the subgroups. Furthermore, the model show a positive correlation with TNM staging and clinical treatment.
Conclusions
The prognostic model showed good performance compared to traditional TNM staging and clinical treatment for estimating the OS in NSCLC (HBV+) patients.