Honghui Xie, Lin Zhang, Lizhi Chen, Wenchao Zhou, Lijuan Zhang, Yong Su, Bocheng Li, Peng Ding, Yun Xiao, Tianzhu Lu, Xiaochang Gong, Jingao Li
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引用次数: 0
Abstract
Purpose: This study aimed to assess the prognostic value of circulating immune cells in newly diagnosed, non-metastatic nasopharyngeal carcinoma (NPC) and to develop a nomogram combining immune cell counts with clinical characteristics.
Methods: In this retrospective study, patients with non-metastatic NPC treated between January 2015 and December 2018 were included. Circulating immune cell subtypes were measured using cellular immunochip technology. Survival outcomes were assessed using Kaplan-Meier analysis, and independent prognostic factors were identified through multivariate analysis (MVA). A prognostic nomogram was constructed and evaluated using Harrell's concordance index (C-index).
Results: A total of 459 patients were included, with a median follow-up of 62 months. Optimal cutoff values for CD4+ T cells (420 cells/μL), CD8+ T cells (430 cells/μL), CD3+ T cells (1100 cells/μL), and CD4/CD8 ratio (1.00) were determined using X-tile. Higher levels of CD4+ T cells (78.6% vs 64.2%, p < 0.001), CD8+ T cells (77.5% vs 71.4%, p = 0.113), CD3+ T cells (83.1% vs 70.0%, p = 0.003), and CD4/CD8 ratio (77.6% vs 60.0%, p = 0.001) were associated with better 5-year progression-free survival. MVA confirmed high CD4/CD8 ratio and CD3+ T cell count as independent prognostic factors. The nomogram combining CD3+ T cells, CD4/CD8 ratio, and N classification showed superior prognostic accuracy compared with the clinical model alone (C-index: 0.686 vs 0.648, p < 0.001).
Conclusion: Circulating immune cells, particularly CD3+ T cells and CD4/CD8 ratio, are significant prognostic indicators in NPC. The proposed nomogram may help predict disease progression and support individualized treatment planning.
目的：本研究旨在评估循环免疫细胞对新诊断的非转移性鼻咽癌（NPC）的预后价值，并建立免疫细胞计数与临床特征相结合的nomogram。方法：在这项回顾性研究中，纳入了2015年1月至2018年12月期间接受治疗的非转移性鼻咽癌患者。采用细胞免疫芯片技术检测循环免疫细胞亚型。使用Kaplan-Meier分析评估生存结果，并通过多变量分析（multivariate analysis， MVA）确定独立预后因素。构建预后nomogram并使用Harrell’s concordance index （C-index）进行评价。结果：共纳入459例患者，中位随访时间为62个月。采用X-tile法测定CD4+ T细胞（420个细胞/μL）、CD8+ T细胞（430个细胞/μL）、CD3+ T细胞（1100个细胞/μL）和CD4/CD8比值（1.00）的最佳临界值。较高水平的CD4+ T细胞（78.6% vs 64.2%, p < 0.001）、CD8+ T细胞（77.5% vs 71.4%, p = 0.113）、CD3+ T细胞（83.1% vs 70.0%, p = 0.003）和CD4/CD8比值（77.6% vs 60.0%, p = 0.001）与较好的5年无进展生存率相关。MVA证实高CD4/CD8比值和CD3+ T细胞计数是独立的预后因素。结合CD3+ T细胞、CD4/CD8比值、N分型的nomogram预后准确性优于单纯临床模型（C-index: 0.686 vs 0.648, p < 0.001）。结论：循环免疫细胞特别是CD3+ T细胞和CD4/CD8比值是鼻咽癌重要的预后指标。所提出的nomogram图可能有助于预测疾病进展并支持个体化治疗计划。
期刊介绍：
Immuno Targets and Therapy is an international, peer-reviewed open access journal focusing on the immunological basis of diseases, potential targets for immune based therapy and treatment protocols employed to improve patient management. Basic immunology and physiology of the immune system in health, and disease will be also covered.In addition, the journal will focus on the impact of management programs and new therapeutic agents and protocols on patient perspectives such as quality of life, adherence and satisfaction.
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