Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Jan 26, 2021; 9(3): 540-551
Published online Jan 26, 2021. doi: 10.12998/wjcc.v9.i3.540
Circulating immune parameters-based nomogram for predicting malignancy in laryngeal neoplasm
Min Chen, Yi Fang, Yue Yang, Pei-Jie He, Lei Cheng, Hai-Tao Wu
Min Chen, Yi Fang, Yue Yang, Pei-Jie He, Lei Cheng, Hai-Tao Wu, Department of Otolaryngology-Head and Neck Surgery, Eye, Ear, Nose, and Throat Hospital of Fudan University, Shanghai 200031, China
Author contributions: Chen M performed the study, analyzed data and wrote the original manuscript; Fang Y collected data and corrected the manuscript; Yang Y participated in data analysis and study design; He PJ and Cheng L reviewed and edited the manuscript; Wu HT designed the study and corrected the manuscript.
Supported by Health and Family Planning Commission of Shanghai Municipality of China, No. 2019SY059.
Institutional review board statement: The study was reviewed and approved by the Eye, Ear, Nose, and Throat Hospital of Fudan University Institutional Review Board (Approval No. 2017042-1).
Informed consent statement: All patients gave informed consent.
Conflict-of-interest statement: No potential conflict of interest was reported by the authors.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Hai-Tao Wu, PhD, Chief Physician, Doctor, Surgeon, Department of Otolaryngology-Head and Neck Surgery, Eye, Ear, Nose, and Throat Hospital of Fudan University, No. 83 Fenyang Road, Shanghai 200031, China. eentwuhaitao@163.com
Received: August 6, 2020
Peer-review started: August 6, 2020
First decision: November 14, 2020
Revised: November 28, 2020
Accepted: December 10, 2020
Article in press: December 10, 2020
Published online: January 26, 2021
Abstract
BACKGROUND

Malignancy prediction remains important to preoperative diagnosis and postoperative follow-up in laryngeal neoplasm.

AIM

To evaluate the circulating immune population and develop a nomogram for prediction of malignancy in patients with laryngeal neoplasm.

METHODS

A primary cohort of 156 patients was divided into laryngeal benign lesion, premalignant lesion and malignant lesion groups. Peripheral blood from patients was measured by blood routine test and flow cytometry. A nomogram was developed and applied to a validation cohort containing 55 consecutive patients.

RESULTS

Age, gender and seven circulating immune parameters exhibited significant differences between laryngeal benign lesion and premalignant lesion. The nomogram incorporated predictors, including gender, age, smoke index, proportions of monocytes, CD8+ T cells, CD4+ T cells, B cells and CD4/CD8+ T cell ratio. It showed good discrimination between laryngeal premalignant lesion and malignant lesion, with a C-index of 0.844 for the primary cohort. Application of this nomogram in the validation cohort (C-index, 0.804) still had good discrimination and good calibration. Decision curve analysis revealed that the nomogram was clinically useful.

CONCLUSION

This novel nomogram, incorporating both clinical risk factors and circulating immune parameters, could be appropriately applied in preoperative individualized prediction of malignancy in patients with laryngeal neoplasm.

Keywords: Laryngeal premalignant lesion, Laryngeal malignant lesion, Circulating immune cell, Nomogram, Laryngeal neoplasm, Malignancy prediction

Core Tip: Malignancy prediction remains important to preoperative diagnosis and postoperative follow-up in laryngeal neoplasm. There are continuing problems in differentiating premalignant lesions from malignant lesions of the larynx before surgery. Our finding suggested that laryngeal malignant lesions and premalignant lesions exhibit changes in the circulating immune phenotype. This circulating immune parameters-based novel nomogram could be appropriately applied in preoperative individualized prediction of malignancy in patients with laryngeal neoplasm.