J Cancer 2017; 8(5):744-753. doi:10.7150/jca.17423

Research Paper

A Nomogram based on Inflammatory Factors C-Reactive Protein and Fibrinogen to Predict the Prognostic Value in Patients with Resected Non-Small Cell Lung Cancer

Qiuyao Zeng1,2*, Ning Xue1,3*, Danian Dai1,4*, Shan Xing1,2, Xia He1,2, Shibing Li1,3, Yi Du5, Chumei Huang6, Linfang Li1,2✉, Wanli Liu1,2✉

1. State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China;
2. Department of Clinical Laboratory, Sun Yat-sen University Cancer Center, Guangzhou, China;
3. Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, China;
4. Department of Breast Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, China;
5. School of Medical Laboratory Science, Guangdong Medical University, Dongguan, China;
6. Department of Laboratory Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
* Equal contributors.

Abstract

Purpose: This study aimed to develop an effective nomogram for predicting survival in surgically treated non-small cell lung cancer patients.

Methods: We retrospectively evaluated 856 NSCLC in this study. Cox regression analyses were performed to identify significant prognostic factors for developing a nomogram to predict overall survival (OS). The discriminative ability was assessed with the concordance index (C-index).

Results: On multivariate analysis of the 856 cohort, independent factors for survival were CRP, fibrinogen, tumor status, nodal status, distant metastasis and clinical stage, which were entered into the nomogram. The C-index of the established nomogram 0.720 (95% CI: 0.671-0.769) was higher than that of the seventh edition TNM staging system 0.689 (95% CI: 0.668-0.709) for predicting OS (P < 0.05). Compared with patients with low CRP levels (< 8.6 g/L) and low fibrinogen levels (< 3.7 g/L), patients with high CRP and fibrinogen levels had shorter OS. Subgroup analyses revealed that the nomogram was a favorable prognostic parameter in stage I-IV NSCLC (P < 0.05).

Conclusion: A nomogram integrating CRP and fibrinogen, which could be convenient and feasible to obtain from the serum preoperatively, may assist in risk stratification for individual patient with resected NSCLC.

Keywords: nomogram, NSCLC, prognosis.

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How to cite this article:
Zeng Q, Xue N, Dai D, Xing S, He X, Li S, Du Y, Huang C, Li L, Liu W. A Nomogram based on Inflammatory Factors C-Reactive Protein and Fibrinogen to Predict the Prognostic Value in Patients with Resected Non-Small Cell Lung Cancer. J Cancer 2017; 8(5):744-753. doi:10.7150/jca.17423. Available from http://www.jcancer.org/v08p0744.htm