Open AccessPrognostic value of an immunohistochemical signature in patients with esophageal squamous cell carcinoma undergoing radical esophagectomy
Author(s) -
Meng Jin,
Zhang Junhua,
Xiu Yingjie,
Jin Yan,
Xiang Jiaqing,
Nie Yongzhan,
Fu Shen,
Zhao Kuaile
Publication year - 2018
Publication title -
molecular oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.332
H-Index - 88
eISSN - 1878-0261
pISSN - 1574-7891
DOI - 10.1002/1878-0261.12158
Subject(s) - nomogram , medicine , esophagectomy , cohort , oncology , immunohistochemistry , esophageal squamous cell carcinoma , receiver operating characteristic , esophageal cancer , carcinoma , cancer
Here, we aimed to identify an immunohistochemical ( IHC )‐based classifier as a prognostic factor in patients with esophageal squamous cell carcinoma ( ESCC ). A cohort of 235 patients with ESCC undergoing radical esophagectomy (with complete clinical and pathological information) were enrolled in the study. Using the least absolute shrinkage and selection operator ( LASSO ) regression model, we extracted six IHC features associated with progression‐free survival ( PFS ) and then built a classifier in the discovery cohort ( n = 141). The prognostic value of this classifier was further confirmed in the validation cohort ( n = 94). Additionally, we developed a nomogram integrating the IHC ‐based classifier to predict the PFS . We used the IHC ‐based classifier to stratify patients into high‐ and low‐risk groups. In the discovery cohort, 5‐year PFS was 22.4% (95% CI: 0.14–0.36) for the high‐risk group and 43.3% (95% CI: 0.32–0.58) for the low‐risk group ( P = 0.00064), and in the validation cohort, 5‐year PFS was 20.58% (95% CI: 0.12–0.36) for the high‐risk group and 36.43% (95% CI: 0.22–0.60) for the low‐risk group ( P = 0.0082). Multivariable analysis demonstrated that the IHC ‐based classifier was an independent prognostic factor for predicting PFS of patients with ESCC . We further developed a nomogram integrating the IHC ‐based classifier and clinicopathological risk factors (gender, American Joint Committee on Cancer staging, and vascular invasion status) to predict the 3‐ and 5‐year PFS . The performance of the nomogram was evaluated and proved to be clinically useful. Our 6‐ IHC marker‐based classifier is a reliable prognostic tool to facilitate the individual management of patients with ESCC after radical esophagectomy.