Prognostic and predictive value of tumor infiltration proportion within lymph nodes in N1 colorectal cancer
IntroductionLymph node metastasis is a crucial determinant of prognosis in colorectal cancer (CRC), significantly impacting survival outcomes and treatment decision-making. This study aims to evaluate the prognostic value of tumor infiltration proportion within lymph nodes (TIPLN) in N1 CRC patients...
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Frontiers Media S.A.
2025-03-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2025.1512960/full |
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| author | Rujie Chen Jun Zhu Jun Zhu Dong Xu Xiaoyan Fan Yihuan Qiao Xunliang Jiang Jun Hao Yongtao Du Xihao Chen Guo Yuan Jipeng Li Jipeng Li |
| author_facet | Rujie Chen Jun Zhu Jun Zhu Dong Xu Xiaoyan Fan Yihuan Qiao Xunliang Jiang Jun Hao Yongtao Du Xihao Chen Guo Yuan Jipeng Li Jipeng Li |
| author_sort | Rujie Chen |
| collection | DOAJ |
| description | IntroductionLymph node metastasis is a crucial determinant of prognosis in colorectal cancer (CRC), significantly impacting survival outcomes and treatment decision-making. This study aims to evaluate the prognostic value of tumor infiltration proportion within lymph nodes (TIPLN) in N1 CRC patients and to develop a TIPLN-based nomogram to predict prognosis.MethodsA total of 416 N1 CRC patients who underwent radical resection were enrolled and divided into training and validation cohorts. Whole-slide images of lymph nodes were annotated to assess the TIPLN. Univariable and multivariable Cox regression analyses were conducted to identify independent prognostic factors and to develop a nomogram for predicting patient outcomes. The precision and discrimination of the nomogram were evaluated using the area under the receiver operating characteristic curve (AUC), concordance index (C-index), and calibration curve. Decision curve analysis (DCA) was performed to compare the net benefit of the nomogram at different threshold probabilities. Additionally, net reclassification index (NRI) and integrated discrimination improvement (IDI) were used to evaluate the nomogram’s clinical utility.ResultsHigh TIPLN levels were significantly associated with poorer overall survival (OS). Five variables, including TIPLN, were selected to construct the nomogram. The C-index in OS prediction was 0.739 and 0.753 for the training and validation cohorts, respectively. Additionally, strong precision and discrimination were demonstrated through AUC and calibration curves. The NRI (training cohort: 0.191 for 3-year and 0.436 for 5-year OS prediction; validation cohort: 0.180 for 3-year and 0.439 for 5-year OS prediction) and IDI (training cohort: 0.079 for 3-year and 0.094 for 5-year OS prediction; validation cohort: 0.078 for 3-year and 0.098 for 5-year OS prediction) suggest that the TIPLN-based nomogram significantly outperformed the clinicopathological nomogram. Furthermore, DCA demonstrated the high clinical applicability of the TIPLN-based nomogram for predicting OS.ConclusionsTIPLN could serve as a prognostic predictor for N1 CRC patients. The TIPLN-based nomogram enhances survival prediction accuracy and facilitates more informed, individualized clinical decision-making. |
| format | Article |
| id | doaj-art-5903e0079a334f6989990cb1d9ca0eb7 |
| institution | Kabale University |
| issn | 2234-943X |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj-art-5903e0079a334f6989990cb1d9ca0eb72025-08-20T03:40:33ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2025-03-011510.3389/fonc.2025.15129601512960Prognostic and predictive value of tumor infiltration proportion within lymph nodes in N1 colorectal cancerRujie Chen0Jun Zhu1Jun Zhu2Dong Xu3Xiaoyan Fan4Yihuan Qiao5Xunliang Jiang6Jun Hao7Yongtao Du8Xihao Chen9Guo Yuan10Jipeng Li11Jipeng Li12Department of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, ChinaDepartment of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, ChinaDepartment of General Surgery, The Southern Theater Air Force Hospital, Guangzhou, ChinaDivision of Digestive Surgery, Xi’an International Medical Center Hospital of Digestive Diseases, Xi’an, ChinaDepartment of Experiment Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, ChinaDepartment of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, ChinaDepartment of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, ChinaDepartment of Experiment Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, ChinaDepartment of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, ChinaDepartment of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, ChinaDepartment of Breast, Shaanxi Provincial Cancer Hospital, Xi’an, ChinaDepartment of Digestive Surgery, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, ChinaDepartment of Experiment Surgery, Xijing Hospital, Fourth Military Medical University, Xi’an, ChinaIntroductionLymph node metastasis is a crucial determinant of prognosis in colorectal cancer (CRC), significantly impacting survival outcomes and treatment decision-making. This study aims to evaluate the prognostic value of tumor infiltration proportion within lymph nodes (TIPLN) in N1 CRC patients and to develop a TIPLN-based nomogram to predict prognosis.MethodsA total of 416 N1 CRC patients who underwent radical resection were enrolled and divided into training and validation cohorts. Whole-slide images of lymph nodes were annotated to assess the TIPLN. Univariable and multivariable Cox regression analyses were conducted to identify independent prognostic factors and to develop a nomogram for predicting patient outcomes. The precision and discrimination of the nomogram were evaluated using the area under the receiver operating characteristic curve (AUC), concordance index (C-index), and calibration curve. Decision curve analysis (DCA) was performed to compare the net benefit of the nomogram at different threshold probabilities. Additionally, net reclassification index (NRI) and integrated discrimination improvement (IDI) were used to evaluate the nomogram’s clinical utility.ResultsHigh TIPLN levels were significantly associated with poorer overall survival (OS). Five variables, including TIPLN, were selected to construct the nomogram. The C-index in OS prediction was 0.739 and 0.753 for the training and validation cohorts, respectively. Additionally, strong precision and discrimination were demonstrated through AUC and calibration curves. The NRI (training cohort: 0.191 for 3-year and 0.436 for 5-year OS prediction; validation cohort: 0.180 for 3-year and 0.439 for 5-year OS prediction) and IDI (training cohort: 0.079 for 3-year and 0.094 for 5-year OS prediction; validation cohort: 0.078 for 3-year and 0.098 for 5-year OS prediction) suggest that the TIPLN-based nomogram significantly outperformed the clinicopathological nomogram. Furthermore, DCA demonstrated the high clinical applicability of the TIPLN-based nomogram for predicting OS.ConclusionsTIPLN could serve as a prognostic predictor for N1 CRC patients. The TIPLN-based nomogram enhances survival prediction accuracy and facilitates more informed, individualized clinical decision-making.https://www.frontiersin.org/articles/10.3389/fonc.2025.1512960/fullcolorectal cancerN1 stagetumor infiltration proportionlymph nodesprognostic model |
| spellingShingle | Rujie Chen Jun Zhu Jun Zhu Dong Xu Xiaoyan Fan Yihuan Qiao Xunliang Jiang Jun Hao Yongtao Du Xihao Chen Guo Yuan Jipeng Li Jipeng Li Prognostic and predictive value of tumor infiltration proportion within lymph nodes in N1 colorectal cancer Frontiers in Oncology colorectal cancer N1 stage tumor infiltration proportion lymph nodes prognostic model |
| title | Prognostic and predictive value of tumor infiltration proportion within lymph nodes in N1 colorectal cancer |
| title_full | Prognostic and predictive value of tumor infiltration proportion within lymph nodes in N1 colorectal cancer |
| title_fullStr | Prognostic and predictive value of tumor infiltration proportion within lymph nodes in N1 colorectal cancer |
| title_full_unstemmed | Prognostic and predictive value of tumor infiltration proportion within lymph nodes in N1 colorectal cancer |
| title_short | Prognostic and predictive value of tumor infiltration proportion within lymph nodes in N1 colorectal cancer |
| title_sort | prognostic and predictive value of tumor infiltration proportion within lymph nodes in n1 colorectal cancer |
| topic | colorectal cancer N1 stage tumor infiltration proportion lymph nodes prognostic model |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2025.1512960/full |
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