A predictive model for prognostic risk stratification of early-stage NSCLC based on clinicopathological and miRNA panel

IF 4.5 2区 医学 Q1 ONCOLOGY
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Abstract

Objective

The 5-year survival rate of early-stage non-small cell lung cancer (NSCLC) is still not optimistic. We aimed to construct prognostic tools using clinicopathological (CP) and serum 8-miRNA panel to predict the risk of overall survival (OS) in early-stage NSCLC.

Materials and methods

A total of 799 patients with early-stage NSCLC, treated between April 2008 and September 2019, were included in this study. A sub-group of patients with serum samples, 280, were analyzed for miRNA profiling. The primary endpoint of the study was OS. The CP panel for prognosis was developed using multivariate and forward stepwise selection analyses. The serum 8-miRNA panel was developed using the miRNAs that were significant for prognosis, screened using real-time quantitative PCR (qPCR) followed by differential, univariate and Cox regression analyses. The combined model was developed using CP panel and serum 8-miRNA panel. The predictive performance of the panels and the combined model was evaluated using the area under curve (AUC) values of receiver operating characteristics (ROC) curves and Kaplan-Meier survival analysis.

Result

The prognostic panels and the combined model (comprising CP panel and serum 8-miRNA panel) was used to classify the patients into high-risk and low-risk groups. The OS rates of these two groups were significantly different (P<0.05). The two panels had higher AUC than the two guidelines, and the combined model had the highest AUC. The AUC of the combined model (AUC=0.788; 95 %CI 0.706–0.871) was better than that of the National Comprehensive Cancer Network (NCCN) guideline (AUC=0.601; 95 %CI 0.505–0.697) and Chinese Society of Clinical Oncology (CSCO) guideline (AUC=0.614; 95 %CI 0.520–0.708).

Conclusion

The combined model based on CP panel and serum 8-miRNA panel allows better prognostic risk stratification of patients with early-stage NSCLC to predict risk of OS.

基于临床病理和 miRNA 面板的早期 NSCLC 预后风险分层预测模型。
目的:早期非小细胞肺癌(NSCLC)的 5 年生存率仍然不容乐观:早期非小细胞肺癌(NSCLC)的5年生存率仍不容乐观。我们旨在利用临床病理(CP)和血清8-miRNA面板构建预后工具,以预测早期NSCLC的总生存(OS)风险:本研究共纳入2008年4月至2019年9月期间接受治疗的799例早期NSCLC患者。对其中280例患者的血清样本进行了miRNA图谱分析。研究的主要终点是OS。通过多变量分析和前向逐步选择分析,建立了用于预后的 CP 面板。利用实时定量 PCR(qPCR)筛选出对预后有显著影响的 miRNA,然后进行差异分析、单变量分析和 Cox 回归分析,从而建立了血清 8-miRNA 面板。使用 CP 面板和血清 8-miRNA 面板建立了组合模型。使用接收者操作特征曲线(ROC)的曲线下面积(AUC)值和 Kaplan-Meier 生存分析评估了预后面板和组合模型的预测性能:结果:预后面板和组合模型(包括 CP 面板和血清 8-miRNA 面板)可用于将患者分为高危和低危两组。两组患者的 OS 率有显著差异(PConclusion:基于CP面板和血清8-miRNA面板的联合模型能更好地对早期NSCLC患者进行预后风险分层,预测OS风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Lung Cancer
Lung Cancer 医学-呼吸系统
CiteScore
9.40
自引率
3.80%
发文量
407
审稿时长
25 days
期刊介绍: Lung Cancer is an international publication covering the clinical, translational and basic science of malignancies of the lung and chest region.Original research articles, early reports, review articles, editorials and correspondence covering the prevention, epidemiology and etiology, basic biology, pathology, clinical assessment, surgery, chemotherapy, radiotherapy, combined treatment modalities, other treatment modalities and outcomes of lung cancer are welcome.
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