Predictive potential of Nomogram based on GMWG for patients with hepatocellular carcinoma after radical resection

Abstract

Background Since it’s a challenging task to precisely predict the prognosis of patients with hepatocellular carcinoma (HCC). We developed a nomogram based on a novel indicator GMWG [(Geometric Mean of gamma-glutamyltranspeptidase (GGT) and white blood cell (WBC)] and explored its potential in the prognosis for HCC patients. Methods The patients enrolled in this study were randomly assigned to training and validation cohorts. And we performed the Least Absolute Shrinkage and Selection Operator proportional hazards model (LASSO Cox) model with clinical characteristics, serum indexes, and novel GMWG. Multivariate analysis was performed to build a nomogram. The performance of the nomogram was evaluated by C-index, the area under the receiver operating characteristic curve (AUC), and the calibration curve. Kaplan-Meier curves showed discrimination of the nomogram. Clinical utility was assessed by decision curve analysis (DCA). The discrimination ability of the nomogram was determined by the net reclassification index (NRI). Results The geometric mean of GGT and white WBC count (GMWG), neutrophil to lymphocyte ratio (NLR), and tumor size were significantly associated with the overall survival (OS). The variables above were used to develop the nomogram. The indexes of nomogram were 0.70 and 071 in the training or validation cohort, respectively. AUC of 1-, 3- and 5-year OS showed satisfactory accuracy as well. The calibration curve showed agreement between the ideal and predicted values. Kaplan-Meier curves based on the overall survival (OS) and disease-free survival (DFS) showed significant differences between nomogram predictive low and high groups. DCA showed clinical utilities while NRI showed discrimination ability in both training or validation cohort. Conclusions GMWG might be a potential prognostic indicator for patients with HCC. The nomogram containing GMWG also showed satisfaction prediction capacity.

Beta2-Microglobulin as Predictive Biomarkers in the Prognosis of Hepatocellular Carcinoma and Development of a New Nomogram

“… 44 Moreover, we compared our nomogram with other similar models for HCC patients published in the previous literature. These models include a nomogram based on NLR (neutrophil to lymphocyte ratio), GMWG (the geometric mean of GGT and white WBC count), and tumor size with a C-index value of 0.70, 45 a prognostic model developed by parameters of Aspartate Transaminase/Alanine Transaminase Ratio and clinical features with a C-index value of 0.680, 46 and a prognostic model constructed by platelet count and clinical features with a C-index value of 0.660. 47 Our model achieved a C-index of 0.712 (95% CI, 0.698–0.726), indicating higher predictive accuracy compared to these previously published models.…”

The Ratio of Preoperative Serum Biomarkers Predicts Prognosis in Patients With Oral Squamous Cell Carcinoma

“…In a retrospective study of 309 patients with OSCC, a high platelet count, high neutrophil count and low lymphocyte count were found to be associated with reduced overall survival (OS) and disease-free survival (DFS) (13). Some studies have also indicated that an increased pretreatment neutrophil-to-lymphocyte ratio (NLR) is associated with poor outcomes in hepatocellular carcinoma, colorectal cancer, endometrial cancer, and gastric cancer (14)(15)(16)(17). However, few studies have reported the prognostic values of the ratios of immune-inflammatory cells, such as the NLR, lymphocyte-to-monocyte ratio (LMR), neutrophil-to-white blood cell ratio (NWR), and lymphocyte-to-white blood cell ratio (LWR), especially in patients with OSCC.…”