Effect of CD+4 T cells and CD+4/CD+8 in peripheral blood on survival of patients with stage Ⅳ non-small cell lung cancer—Establishment of a Nomogram prediction model
Wang Lixue1,2, Wang Haojie1,2, Ouyang Weiwei2, Yang Wengang2, Ma Zhu2, Li Qingsong2, Li Huiqin2, Chen Xiaxia2, Li Xiaoyang2, Geng Yichao2, Su Shengfa2, Lu Bing2
1Teaching and Research Section of Oncology, Guizhou Medical University, Guiyang 550004, China; 2Department of Thoracic Oncology, Affiliated Hospital of Guizhou Medical University, Guizhou Cancer Hospital, Guiyang 550004, China
Abstract：Objective To explore the possibility of CD+4 T cells and CD+4/CD+8 ratio in peripheral blood to predict the survival of patients with stage Ⅳ non-small cell lung cancer (NSCLC), and to establish a Nomogram prediction model. Methods The influence of CD+4 T cells and CD+4/CD+8 ratio on the clinical factors and survival of 682 patients pathologically diagnosed with stage Ⅳ NSCLC with no history of cancer treatment was retrospectively analyzed and the Nomogram prediction model was established. Combined with the changes of immune cells levels in 110 patients after treatment, the prognostic and predictive values of CD+4 T cells and CD+4/CD+8 ratio were verified. Countable data were analyzed by t-test. The survival rate was calculated by Kaplan-Meier method, log-rank test or univariate analysis. The multivariate analysis was performed by Cox regression model. Results Univariate analysis demonstrated that CD+4> 43.15% before treatment significantly prolonged the survival. By multivariate analysis of Cox regression model, CD+4>43.15% was an independent prognostic factor to prolong survival for stage Ⅳ NSCLC. The Nomogram model was established and verified that the predicted and actual overall survivals were highly consistent. Further analysis showed that 43.15% as the critical value of CD+4T cell level significantly prolonged survival when CD+4 expressed at a high-level before treatment, after treatment, before and after treatment, or combined with CD+4/CD+8>1.65. Conclusions The baseline level of CD+4 T cells before treatment in peripheral blood is an independent prognostic factor for stage Ⅳ NSCLC. The CD+4/CD+8 ratio before treatment has limited value in predicting the prognosis.
Wang Lixue,Wang Haojie,Ouyang Weiwei et al. Effect of CD+4 T cells and CD+4/CD+8 in peripheral blood on survival of patients with stage Ⅳ non-small cell lung cancer—Establishment of a Nomogram prediction model[J]. Chinese Journal of Radiation Oncology, 2020, 29(9): 751-756.
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2020, Vol. 29 
