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Global Translational Medicine Blood parameters for SCLC and AC relapse prognosis

significant differences between patients with a high and relative amount (percentage) of the CXCR1 receptor in
low risk of relapse-free survival. lymphocytes; [CXCR2] – the relative amount (percentage)
The results of the Cox proportional hazards model of the CXCR2 receptor in monocytes; “Y” is the result of
analysis confirm the relationship of all 3 parameters with the regression equation.
relapse-free survival in both the univariate and multivariate According to the AUC expert scale, the prognostic
models (P < 0.05, Table 4). model is classified as “very good” quality with an AUC
14
In the high-risk group of AC recurrence, only the of 0.831. The optimal threshold value for distinguishing
absolute values of the concentration of monocytes, low- and high-risk groups for tumor recurrence is 0.417,
eosinophilic leukocytes, the ratio between them, the with a sensitivity of 84.9%, and specificity of 89.0% (Table 7).
proportion of lymphocytes with the CXCR1 receptor and Specifically, if the Y value is >0.417, the probability that
the CYFRA 21-1 level were significantly higher than in the patient has a high risk of tumor recurrence is 90.4%.
the low-risk group (Table 5). The remaining parameters Conversely, if the Y value is ≤0.417, the probability that the
(SII, IPI, SIRI indices, HIF-1α, CXCL5, CXCL8, TuM2 patient has a low risk of tumor recurrence is 84.9%.
PK, CXCR1, etc.) did not demonstrate any significant The performance of the proposed regression model is
differences between the high- and low-risk groups of demonstrated by the Kaplan-Meier graph, which shows
patients. Only these five parameters were included in the relapse-free survival in patients with Stage III SCLC
Cox proportional hazards models, where they were found (Figure 2).
to significantly affect patient survival (Table 6).
The 1-year follow-up shows the distribution of high
The results of ROC analysis show the prognostic and low relapse-free survival of patients with Stage III
characteristics of the selected indicators for the duration SCLC according to the results of the regression equation
of relapse-free survival in Stage III SCLC (Table 7). The Y (Figure 2), which corresponds to TNM stratification
proportion of blood lymphocytes expressing the CXCR1 (Figure 1B). By the end of the 1 year, the survival rate
st
receptor demonstrated the highest prognostic efficiency for the low-risk group was 74% according to TNM
(76.7%). The prognostic efficiency was 71.2% and 74.0% for stratification, and 76% according to the regression equation
CXCR2-positive monocytes and CYFRA 21-1, respectively. of blood parameters. For patients with a high risk, survival
To improve the accuracy of the results, the values of these after treatment was 47% and 45%, according to TNM
parameters were subjected to logistic regression analysis. stratification and regression equation of blood parameters,
The resulting Equation I includes a combination of these respectively. Besides, there is a clear difference between
indicators. The prognostic accuracy for the calculated high and low survival of patients based on the regression
threshold value (> 0.417) was 87.7% (Table 7). equation as early as the first month after the treatment, with
+
exp( 5.315 0.116 *[CYFRA + ] this difference increasing over time. In contrast, the curve
−
1.901*[CXCR + 2]) difference in high and low relapse-free survival based on
1] 0.279 *[CXCR
Y = (I) TNM stratification becomes visible only two months after
1 exp( 5.315 0.116 *[CYFRA ] the treatment.
+
−
+
+ 1.901*[CXCR + 1] 0.279 *[CXCR 2]) According to the results of ROC analysis for selected
parameters in Stage III AC, the highest specificity (84.4%)
Logistic regression equation for predicting relapse-free was found for the relative number of lymphocytes
survival in patients with Stage III SCLC. expressing the CXCR1, while its diagnostic sensitivity did
Note: [CYFRA] – the concentration (ng/ml) of the not exceed 66.2% (Table 8). The values of other selected
CYFRA 21-1 antigen in the blood serum; [CXCR1] – the indicators showed comparable figures, with sensitivity
Table 4. Cox proportional hazards models for SCLC patients
Indicator Univariate model Multivariate model
HR 95% CI P‑value HR 95% CI P‑value
CXCR1, lymphocytes, % 1.122 1.003 – 1.241 *0.007 1.091 1.001 – 1.181 *0.021
CXCR2, monocytes, % 1.023 1.002 – 1.044 *0.023 1.013 1.001 – 1.025 *0.043
CYFRA 21-1, ng/ml 1.102 1.009 – 1.195 *0.027 1.073 1.009 – 1.137 *0.022
Note: *: P<0.05 indicates the value is statistically significant.
Abbreviations: HR: Hazards ratio; 95% CI: 95% Confidence interval; CXCR1: C-X-C motif chemokine receptor 1; CXCR2: C-X-C motif chemokine
receptor 2; CYFRA 21-1: Cytokeratin 19 fragment antigen 21-1.

Volume 3 Issue 4 (2024) 7 doi: 10.36922/gtm.4865