Prognostic value of the immunohistochemical score based on four markers in head and neck squamous cell carcinoma

Qing-Qing Xu; Qing-Jie Li; Zhen Xu; Li-Long Lan; Zan Hou; Juan Liu; LiXia Lu; Yuan-Yuan Chen; Run-Zhe Chen; Xin Wen

doi:10.3389/fimmu.2023.1076890

Prognostic value of the immunohistochemical score based on four markers in head and neck squamous cell carcinoma

Front Immunol. 2023 Feb 22:14:1076890. doi: 10.3389/fimmu.2023.1076890. eCollection 2023.

Authors

Qing-Qing Xu^{1

2}, Qing-Jie Li², Zhen Xu², Li-Long Lan², Zan Hou², Juan Liu², LiXia Lu², Yuan-Yuan Chen², Run-Zhe Chen², Xin Wen^{1

3}

Affiliations

¹ Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
² Department of Radiation Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and Therapy, Guangzhou, China.
³ Department of Radiation Oncology, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China.

Abstract

Purpose: Head and neck squamous cell carcinoma (HNSCC) ranks sixth among all cancers globally regarding morbidity, and it has a poor prognosis, high mortality, and highly aggressive properties. In this study, we established a model for predicting prognosis based on immunohistochemical (IHC) scores.

Methods: Data on 402 HNSCC cases were collected, the glmnet Cox proportional hazards model was used, risk factors were analyzed for predicting the prognosis of survival, and the IHC score was established. We used the IHC score to predict disease-free survival (DFS) using training and independent validation cohorts, including 264 cases in total. Additionally, the accuracy of the IHC score and the TNM system (8^th edition) was compared. A DFS prediction nomogram was established by combining the prognostic factors.

Results: The IHC scores included CK, Ki-67, p16, and p40 staining intensity. The concordance index and the Kaplan-Meier survival analysis showed that the IHC scores had high predictive power for HNSCC. Our results showed that the IHC score is an independent factor that can predict prognosis in a multivariate Cox regression analysis. When predicting DFS, the IHC score had a significantly higher value for the area under the ROC curve (AUC) than that of the TNM system. A nomogram was established and included the IHC score, age, tumor location, and the TNM stage. The calibration curves exhibited high consistency between the prognosis predicted by our nomogram and the actual prognosis.

Conclusions: The IHC score was more accurate than the eighth edition of the TNM system in predicting HNSCC prognosis. Therefore, combining the two methods can facilitate individualized patient consultation and care.

Keywords: TNM system; head and neck squamous cell carcinoma; immunohistochemistry; nomogram; prognosis.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Head and Neck Neoplasms*
Humans
Nomograms*
Prognosis
Proportional Hazards Models
Squamous Cell Carcinoma of Head and Neck

Grants and funding

This research was funded by the National Natural Science Foundation of China (82003214) and Guangdong Basic and Applied Basic Research Foundation (2019A1515110076).