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A nomogram concerning immune infiltration and radiosensitivity to predict biochemical recurrence after radical
Chunyan Qiu1, Xingni Zhou, Zhijian Chen
1National Cancer Center/National Clinical Research Center for Cancer, Cancer Hospital Chinese Academy of Medical Sciences, Shenzhen Center, Shenzhen 518116, China.
Purpose:
To construct a nomogram concerning immune infiltration and radiosensitivity to predict biochemical recurrence (BCR) after radical radiation therapy in prostate cancer (PCa).
Methods:
The Affymetrix microarray GSE116918 was acquired from the Gene Expression Omnibus (GEO) database. This cohort was grouped into biochemical recurrence ("BCR" group), among whom some patients developed metastatic recurrence ("MET" group), while the other patients were free from biochemical recurrence ("NO" group). Gene set enrichment analysis (GSEA) was performed. Immune infiltration was quantified by CIBERSORT, and infiltration score (IFS) and radiosensitivity score (RSS) were constructed. Cox multivariate regression coefficients were used to generate a nomogram.
Results:
Compared to patients in the NO group, patients in the BCR group tended to be in a higher T stage (56.85% IN T1-2 VS. 43.15% IN T3-T4; <0.05). IFS was calculated based on the infiltration level of neutrophils, macrophages, plasmacytoid dendritic cells (pDC), activated dendritic cells (aDC), and CD56 bright NK cells. Patients in the IFS-low group had a significantly longer BCR-free survival than those in the IFS-high group (p<0.0001). RSS was calculated based on the expression levels of BRCA2, IGF1, BCL2L1, MAPK1, MAPK6, and MAPK13. Patients in the RSS-low group had a significantly longer BCR-free survival than those in the RSS-high group (p<0.0001). A nomogram predicting BCR after radical radiation therapy in PCa showed a 95% CI of [0.6584, 0.7928] for C-index, an AUC of 0.741 at 5 years, and fine calibration.
Conclusions:
In this study, we constructed a visual nomogram to predict BCR after radical radiation therapy in PCa with fine discriminatory and calibration capacity, which took elements, such as immune infiltration and radiosensitivity, into consideration for the first time.
