The prognostic predictive value of indirect bilirubin-inflammation score in patients with nasopharyngeal carcinoma

Objective To construct an effective prognostic model based on indirect bilirubin (IBIL) and inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR), to predict overall survival (OS) in patients with nasopharynge...

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Main Authors: JI Huojin, LI Jun, LUO Yonglin, QIN Weiling, YE Yinxin, CAI Yonglin
Format: Article
Language:zho
Published: Editorial Office of Journal of Guangxi Medical University 2024-09-01
Series:Guangxi Yike Daxue xuebao
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Online Access:https://journal.gxmu.edu.cn/article/doi/10.16190/j.cnki.45-1211/r.2024.09.006
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author JI Huojin
LI Jun
LUO Yonglin
QIN Weiling
YE Yinxin
CAI Yonglin
author_facet JI Huojin
LI Jun
LUO Yonglin
QIN Weiling
YE Yinxin
CAI Yonglin
author_sort JI Huojin
collection DOAJ
description Objective To construct an effective prognostic model based on indirect bilirubin (IBIL) and inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR), to predict overall survival (OS) in patients with nasopharyngeal carcinoma (NPC). Methods Hematological parameters, including IBIL and parameters of peripheral blood cells, were retrospectively analyzed in 688 NPC patients before treatment. These patients were randomly divided into a training set (n=481) and a test set (n=207). The IBIL-inflammation (IBI) score was developed using the machine learning. A nomogram was established, and the performance of the prediction model was measured by the concordance index (C-index), time-dependent receiver operating characteristic (ROC) curve, and decision curve analysis (DCA). The interaction and mediation between the biomarkers were further analyzed. Results By comparing 14 types of machine learning algorithms, the optimal model, oblique random survival forest, was selected to construct IBI score. The C-index of the IBI score was 0.722 in the training set, 0.564 in the test set, and 0.672 in the entire set. The area under the curve of time-dependent ROC at 1, 3, and 5 years was 0.762, 0.712, and 0.705 in the entire set respectively. IBI score was significantly positively correlated with clinical TNM stage (P < 0.05). The nomogram, which integrated age, sex, clinical stage, and IBI score, demonstrated good clinical utility and predictive ability, as evaluated by the DCA. Significant interaction was found between IBIL and PLR, and inflammatory markers did not exhibit any medicating effects on the influence of IBIL on NPC survival. Conclusion The IBI score, as a potential prognostic factor for NPC patients, offers advantages in convenience and cost-effectiveness for detection. It can provide a basis for personalized prognostic predictions and the formulation of clinical treatment strategies for NPC.
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spelling doaj-art-0f2af6e33a5e4281a19c7f0cc6d032592025-08-20T02:15:20ZzhoEditorial Office of Journal of Guangxi Medical UniversityGuangxi Yike Daxue xuebao1005-930X2024-09-014191273128110.16190/j.cnki.45-1211/r.2024.09.006gxykdxxb-41-9-1273The prognostic predictive value of indirect bilirubin-inflammation score in patients with nasopharyngeal carcinomaJI Huojin0LI Jun1LUO Yonglin2QIN Weiling3YE Yinxin4CAI Yonglin5Department of Clinical Laboratory, Wuzhou Red Cross Hospital, Wuzhou 543002, ChinaDepartment of Clinical Laboratory, Wuzhou Red Cross Hospital, Wuzhou 543002, ChinaDepartment of Clinical Laboratory, Wuzhou Red Cross Hospital, Wuzhou 543002, ChinaDepartment of Clinical Laboratory, Wuzhou Red Cross Hospital, Wuzhou 543002, ChinaDepartment of Clinical Laboratory, Wuzhou Red Cross Hospital, Wuzhou 543002, ChinaGuangxi Health Commission Key Laboratory of Molecular Epidemiology of Nasopharyngeal Carcinoma[Wuzhou Red Cross Hospital], Wuzhou 543002, ChinaObjective To construct an effective prognostic model based on indirect bilirubin (IBIL) and inflammatory markers, including neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR), to predict overall survival (OS) in patients with nasopharyngeal carcinoma (NPC). Methods Hematological parameters, including IBIL and parameters of peripheral blood cells, were retrospectively analyzed in 688 NPC patients before treatment. These patients were randomly divided into a training set (n=481) and a test set (n=207). The IBIL-inflammation (IBI) score was developed using the machine learning. A nomogram was established, and the performance of the prediction model was measured by the concordance index (C-index), time-dependent receiver operating characteristic (ROC) curve, and decision curve analysis (DCA). The interaction and mediation between the biomarkers were further analyzed. Results By comparing 14 types of machine learning algorithms, the optimal model, oblique random survival forest, was selected to construct IBI score. The C-index of the IBI score was 0.722 in the training set, 0.564 in the test set, and 0.672 in the entire set. The area under the curve of time-dependent ROC at 1, 3, and 5 years was 0.762, 0.712, and 0.705 in the entire set respectively. IBI score was significantly positively correlated with clinical TNM stage (P < 0.05). The nomogram, which integrated age, sex, clinical stage, and IBI score, demonstrated good clinical utility and predictive ability, as evaluated by the DCA. Significant interaction was found between IBIL and PLR, and inflammatory markers did not exhibit any medicating effects on the influence of IBIL on NPC survival. Conclusion The IBI score, as a potential prognostic factor for NPC patients, offers advantages in convenience and cost-effectiveness for detection. It can provide a basis for personalized prognostic predictions and the formulation of clinical treatment strategies for NPC.https://journal.gxmu.edu.cn/article/doi/10.16190/j.cnki.45-1211/r.2024.09.006nasopharyngeal carcinomabilirubininflammationprognosis
spellingShingle JI Huojin
LI Jun
LUO Yonglin
QIN Weiling
YE Yinxin
CAI Yonglin
The prognostic predictive value of indirect bilirubin-inflammation score in patients with nasopharyngeal carcinoma
Guangxi Yike Daxue xuebao
nasopharyngeal carcinoma
bilirubin
inflammation
prognosis
title The prognostic predictive value of indirect bilirubin-inflammation score in patients with nasopharyngeal carcinoma
title_full The prognostic predictive value of indirect bilirubin-inflammation score in patients with nasopharyngeal carcinoma
title_fullStr The prognostic predictive value of indirect bilirubin-inflammation score in patients with nasopharyngeal carcinoma
title_full_unstemmed The prognostic predictive value of indirect bilirubin-inflammation score in patients with nasopharyngeal carcinoma
title_short The prognostic predictive value of indirect bilirubin-inflammation score in patients with nasopharyngeal carcinoma
title_sort prognostic predictive value of indirect bilirubin inflammation score in patients with nasopharyngeal carcinoma
topic nasopharyngeal carcinoma
bilirubin
inflammation
prognosis
url https://journal.gxmu.edu.cn/article/doi/10.16190/j.cnki.45-1211/r.2024.09.006
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