Peripheral blood inflammation marker-based adrenal cortex cancer prognosis evaluation method

Abstract

The invention relates to an adrenal cortical carcinoma prognosis evaluation method based on a peripheral blood inflammation marker, which comprises the following steps: acquiring a peripheral blood detection result and tumor pathological characteristics of a patient before treatment, and calculating a derived neutrophil-lymphocyte ratio and a platelet-leukocyte ratio based on the peripheral blood detection result; inputting the derived neutrophil-lymphocyte ratio, the platelet-leukocyte ratio, the age of the patient and the tumor pathological characteristics into a prognostic scoring model to obtain a risk score; wherein the prognosis scoring model is a regression model which is screened by adopting Cox regression analysis and is established with variables related to the postoperative disease-free lifetime. According to the invention, the accuracy of prognosis evaluation of the adrenal cortex cancer can be improved.

Description

Technical Field

[0001] This invention relates to the field of prognostic assessment technology for adrenocortical carcinoma, and in particular to a prognostic assessment method for adrenocortical carcinoma based on peripheral blood inflammatory markers. Background Technology

[0002] Adrenocortical carcinoma (ACC) is a rare malignant tumor with unique biological behavior. Its tumor microenvironment (TME) is characterized by strong inflammatory infiltration and immunosuppression, which is fundamentally different from common epithelial tumors such as colorectal cancer. ACC has a high recurrence rate after surgery, but the recurrence patterns and timing are highly heterogeneous, posing a core challenge to clinical management.

[0003] Currently, commonly used prognostic assessment tools in clinical practice include the European Adrenal Tumor Research Network (ENSAT) staging system, the Ki-67 proliferation index, and the S-GRAS (Survey-Gradual Regression Assay) scoring system. However, these tools mainly rely on tumor pathological features and fail to fully reflect the impact of the host's systemic inflammatory state and immune microenvironment on prognosis.

[0004] While some studies in the current field have used general inflammatory markers such as the neutrophil-lymphocyte ratio and platelet-lymphocyte ratio for the diagnosis or prognosis of common cancers such as colorectal cancer, lung cancer, and gastric cancer, these markers have not been screened and validated for the unique pathophysiological environment of ACC. The inflammatory spectrum of ACC is specific, for example, it is associated with immune dysregulation caused by excessive glucocorticoids and unique bone marrow hematopoietic responses, resulting in poor predictive efficacy or inconsistent conclusions for pan-cancer inflammatory markers. Summary of the Invention

[0005] The technical problem to be solved by the present invention is to provide a method for prognostic assessment of adrenocortical carcinoma based on peripheral blood inflammatory markers, which can improve the accuracy of prognostic assessment of adrenocortical carcinoma.

[0006] The technical solution adopted by this invention to solve its technical problem is: to provide a method for prognostic assessment of adrenocortical carcinoma based on peripheral blood inflammatory markers, comprising: Obtain the patient's peripheral blood test results and tumor pathological characteristics before treatment, and calculate the derived neutrophil-lymphocyte ratio and platelet-leukocyte ratio based on the peripheral blood test results; The derived neutrophil-lymphocyte ratio, platelet-to-leukocyte ratio, patient age, and tumor pathological characteristics are input into the prognostic scoring model to obtain a risk score; wherein, the prognostic scoring model is a regression model established by screening variables related to postoperative disease-free survival using Cox regression analysis.

[0007] The derived neutrophil-lymphocyte ratio was obtained through... The calculation yielded that, This is to derive the neutrophil-lymphocyte ratio. The neutrophil count in peripheral blood test results. This refers to the total number of white blood cells in the peripheral blood test results.

[0008] The platelet-to-leukocyte ratio is obtained through The calculation yielded that, The platelet-to-white blood cell ratio; This refers to the platelet count in peripheral blood test results. This refers to the total number of white blood cells in the peripheral blood test results.

[0009] The tumor pathological features include ENSAT staging, Ki-67 index, and surgical resection status.

[0010] The technical solution adopted by this invention to solve its technical problem is: to provide a prognostic assessment system for adrenocortical carcinoma based on peripheral blood inflammatory markers, comprising: The calculation module is used to acquire the peripheral blood test results and tumor pathological characteristics of the patient before treatment, and to calculate the derived neutrophil-lymphocyte ratio and platelet-white blood cell ratio based on the peripheral blood test results. The assessment module is used to input the derived neutrophil-lymphocyte ratio, platelet-white blood cell ratio, patient age, and tumor pathological characteristics into the prognostic scoring model to obtain a risk score; wherein, the prognostic scoring model is a regression model established by screening variables related to postoperative disease-free survival using Cox regression analysis.

[0011] The acquisition and calculation module through Calculate the derived neutrophil-lymphocyte ratio, where, This is to derive the neutrophil-lymphocyte ratio. The neutrophil count in peripheral blood test results. This refers to the total number of white blood cells in the peripheral blood test results.

[0012] The acquisition and calculation module through Calculate the platelet-to-white blood cell ratio, where, The platelet-to-white blood cell ratio; This refers to the platelet count in peripheral blood test results. This refers to the total number of white blood cells in the peripheral blood test results.

[0013] The tumor pathological features include ENSAT staging, Ki-67 index, and surgical resection status.

[0014] The technical solution adopted by the present invention to solve its technical problem is: to provide an electronic device, including a memory, a processor, and a computer program stored in the memory and executable on the processor, wherein the processor executes the computer program to implement the steps of the above-mentioned method for prognostic assessment of adrenocortical carcinoma based on peripheral blood inflammatory markers.

[0015] The technical solution adopted by the present invention to solve its technical problem is: to provide a computer-readable storage medium having a computer program stored thereon, wherein when the computer program is executed by a processor, it implements the steps of the above-mentioned method for prognostic assessment of adrenocortical carcinoma based on peripheral blood inflammatory markers.

[0016] Beneficial effects Due to the adoption of the above technical solution, the present invention has the following advantages and positive effects compared with the prior art: The present invention organically combines the inflammatory markers of dNLR and PWR in a specific combination with the mature S-GRAS, thereby achieving a more accurate assessment of the risk of recurrence after ACC surgery. Attached Figure Description

[0017] Figure 1 This is a flowchart of the first embodiment of the prognostic assessment method for adrenocortical carcinoma based on peripheral blood inflammatory markers of the present invention; Figure 2 This is a Kaplan-Meier curve of DFS and OS for patients with adrenocortical carcinoma; Figure 3 This is a univariate and multivariate analysis plot of clinical factors predicting disease-free survival and overall survival in patients with adrenocortical carcinoma. Figure 4 This is a univariate and multivariate analysis plot of clinical factors predicting disease-free survival and overall survival in patients with adrenocortical carcinoma after radical surgery; Figure 5 This is a comparison curve of DFS based on different inflammatory marker groups; Figure 6 This is an OS comparison curve based on different inflammatory marker groups. Detailed Implementation

[0018] The present invention will be further illustrated below with reference to specific embodiments. It should be understood that these embodiments are for illustrative purposes only and are not intended to limit the scope of the invention. Furthermore, it should be understood that after reading the teachings of this invention, those skilled in the art can make various alterations or modifications to the invention, and these equivalent forms also fall within the scope defined by the appended claims.

[0019] The first embodiment of the present invention relates to a prognostic assessment method for adrenocortical carcinoma based on peripheral blood inflammatory markers. This method improves the accuracy of prognostic assessment of adrenocortical carcinoma by constructing a prognostic scoring model based on a combination of peripheral blood inflammatory markers and tumor pathological features.

[0020] Because peripheral blood inflammatory markers include the neutrophil-lymphocyte ratio ( ), derived neutrophil-lymphocyte ratio ( ), platelet-lymphocyte ratio ( Lymphocyte-to-monocyte ratio ( ), systemic immune inflammatory index ( ), platelet-to-white blood cell ratio ( This implementation method requires identifying which indicators are specific in ACC prognostic assessment and constructing a prognostic scoring model, among other inflammatory markers.

[0021] This implementation method collected clinical data from 141 patients with pathologically confirmed ACC, including the patients' age, gender, peripheral blood test results before treatment, and tumor pathological characteristics.

[0022] First, calculations were made based on the peripheral blood test results of these patients before treatment. , , , , and The calculation method is as follows: neutrophil-lymphocyte ratio ( ): ; Derived neutrophil-lymphocyte ratio ( ): ; Platelet-to-white blood cell ratio (PBC) ): ; Platelet-lymphocyte ratio (PQR) ): ; Lymphocyte-to-monocyte ratio ( ): ; Systemic immune inflammatory index (SCI) ): .

[0023] in, The neutrophil count in peripheral blood test results. This refers to the lymphocyte count in peripheral blood test results. This refers to the monocyte count in peripheral blood test results. This refers to the platelet count in peripheral blood test results. This refers to the total number of white blood cells in the peripheral blood test results.

[0024] Survival analysis of a large sample ACC cohort (see...) Figure 2 It was discovered and confirmed that after adjusting for pathological factors such as ENSAT staging and Ki-67, only and It has independent and significant predictive value for postoperative disease-free survival (DFS), while other indicators commonly seen in colorectal cancer and other cancers (such as...) , In ACC, the predictive power is insignificant or weak. Figure 3 and Figure 4 It can be seen that, compared to , By eliminating the influence of neutrophils themselves on the denominator, the ACC background more stably reflects the immune balance between neutrophils and lymphocytes. In the ACC, a lower... The value was found to be strongly associated with a worse prognosis, which may reflect the imbalance between tumor-driven platelet production inhibition and persistent leukocytosis unique to ACC, a phenomenon that distinguishes it from other cancers.

[0025] The tumor pathological features collected in this embodiment include ENSAT staging, Ki-67 index, and surgical resection status (R status). To construct a prognostic scoring model, this embodiment divided the clinical data of 141 pathologically confirmed ACC patients into a training set and a validation set. Each data sample included the patient's... , Age, ENSAT stage, Ki-67 index, surgical resection status, and whether adrenocortical carcinoma has recurred, and will , Using age, ENSAT stage, Ki-67 index, and surgical resection status as input variables, a multivariate Cox proportional hazards model was established to integrate intrinsic tumor characteristics (from the S-GRAS framework) and host-specific inflammatory responses (from...). + The prognostic scoring model.

[0026] When assessing the prognostic outcome of adrenocortical carcinoma in patients, such as Figure 1 As shown, it includes the following steps: Step 1: Obtain the patient's peripheral blood test results and tumor pathological characteristics before treatment, and calculate based on the peripheral blood test results. and ; Step 2, , The patient's age and tumor pathological characteristics are input into the prognostic scoring model to obtain a risk score.

[0027] This implementation method can also classify patients into "low relapse risk group," "intermediate relapse risk group," or "high relapse risk group" based on the obtained risk score, recommend treatment strategies based on the classification results, and generate visualized survival curves. To verify the correctness of the selection of peripheral blood inflammatory marker combinations, this implementation method also constructs a prognostic model with other inflammatory indicators added as input variables. Figure 5 The DFS comparison curves based on different inflammatory marker groups are shown. From Figure 5 It can be seen that, The DFS curve of the high-performing group was significantly lower than that of the low-performing group (decreasing faster), indicating that... Patients with elevated levels of [something] have a higher risk of postoperative recurrence and shorter disease-free survival; and this degree of separation is greater than [something else]. The grouping is more obvious, thus proving its validity. Compare It more stably reflects immune balance (and has a stronger ability to distinguish prognosis). While the DFS curves for high / low groupings may separate, the difference is not as significant as... Clearly, indicating The ability to distinguish between postoperative recurrence and recurrence is not as good as . The DFS curve for the low-group was lower than that for the high-group (approaching significant separation), indicating that... Patients with reduced disease-free survival have shorter disease-free survival and a higher risk of relapse. Figure 6 OS comparison curves based on different inflammatory marker groups are shown. From Figure 6 It can be seen that, The OS curve of the high-performing group was significantly lower than that of the low-performing group, and the separation was better. This confirms Its predictive value for overall survival is better than . The OS curves of high / low groups are poorly separated and may even partially overlap, indicating that... The accuracy of predicting the patient's final survival time is not as good as . The OS curve of the low-performing group was significantly lower than that of the high-performing group, which intuitively reflects the low... Patients not only have a high risk of relapse, but also a higher risk of eventual death. The imbalances specific to ACC provide evidence at the level of survival curves.

[0028] It is not difficult to see that the present invention will and This specific combination of inflammatory markers, organically integrated with the mature S-GRAS, enables a more precise assessment of the risk of recurrence after ACC surgery.

[0029] A second embodiment of the present invention relates to a prognostic assessment system for adrenocortical carcinoma based on peripheral blood inflammatory markers, comprising: The calculation module is used to acquire the peripheral blood test results and tumor pathological characteristics of the patient before treatment, and to calculate the derived neutrophil-lymphocyte ratio and platelet-white blood cell ratio based on the peripheral blood test results. The assessment module is used to input the derived neutrophil-lymphocyte ratio, platelet-white blood cell ratio, patient age, and tumor pathological characteristics into the prognostic scoring model to obtain a risk score; wherein, the prognostic scoring model is a regression model established by screening variables related to postoperative disease-free survival using Cox regression analysis.

[0030] The acquisition and calculation module through Calculate the derived neutrophil-lymphocyte ratio, where, This is to derive the neutrophil-lymphocyte ratio. The neutrophil count in peripheral blood test results. This refers to the total number of white blood cells in the peripheral blood test results.

[0031] The acquisition and calculation module through Calculate the platelet-to-white blood cell ratio, where, The platelet-to-white blood cell ratio; This refers to the platelet count in peripheral blood test results. This refers to the total number of white blood cells in the peripheral blood test results.

[0032] The tumor pathological features include ENSAT staging, Ki-67 index, and surgical resection status.

[0033] A third embodiment of the present invention relates to an electronic device, including a memory, a processor, and a computer program stored in the memory and executable on the processor, wherein the processor executes the computer program to implement the steps of the adrenocortical carcinoma prognostic assessment method based on peripheral blood inflammatory markers of the first embodiment.

[0034] The fourth embodiment of the present invention relates to a computer-readable storage medium having a computer program stored thereon, which, when executed by a processor, implements the steps of the adrenocortical carcinoma prognostic assessment method based on peripheral blood inflammatory markers of the first embodiment.

[0035] Those skilled in the art will understand that embodiments of this application can be provided as methods, systems, or computer program products. Therefore, this application can take the form of a completely hardware embodiment, a completely software embodiment, or an embodiment combining software and hardware aspects. Furthermore, this application can take the form of a computer program product implemented on one or more computer-usable storage media (including, but not limited to, disk storage and optical storage) containing computer-usable program code.

[0036] This application is described with reference to flowchart illustrations and / or block diagrams of methods, apparatus (systems), and computer program products according to embodiments of this application. It will be understood that each block of the flowchart illustrations and / or block diagrams, and combinations of blocks in the flowchart illustrations and / or block diagrams, can be implemented by computer program instructions. These computer program instructions can be provided to a processor of a general-purpose computer, special-purpose computer, embedded processor, or other programmable data processing apparatus to produce a machine, such that the instructions, which execute via the processor of the computer or other programmable data processing apparatus, generate instructions for implementing the flowchart... Figure 1 One or more processes and / or boxes Figure 1 A device that provides the functions specified in one or more boxes.

[0037] These computer program instructions may also be stored in a computer-readable storage medium that can direct a computer or other programmable data processing device to operate in a particular manner, such that the instructions stored in the computer-readable storage medium produce an article of manufacture including instruction methods implemented in a process. Figure 1 One or more processes and / or boxes Figure 1 The function specified in one or more boxes.

[0038] These computer program instructions may also be loaded onto a computer or other programmable data processing equipment to cause a series of operational steps to be performed on the computer or other programmable equipment to produce a computer-implemented process, thereby providing instructions that execute on the computer or other programmable equipment for implementing the process. Figure 1 One or more processes and / or boxes Figure 1 The steps of the function specified in one or more boxes.

[0039] The above description is merely a specific embodiment of the present invention, but the scope of protection of the present invention is not limited thereto. Any variations or substitutions that can be easily conceived by those skilled in the art within the technical scope disclosed in the present invention should be included within the scope of protection of the present invention. Therefore, the scope of protection of the present invention should be determined by the scope of the claims.

Claims

1. A method for prognostic assessment of adrenocortical carcinoma based on peripheral blood inflammatory markers, characterized in that, include: Obtain the patient's peripheral blood test results and tumor pathological characteristics before treatment, and calculate the derived neutrophil-lymphocyte ratio and platelet-leukocyte ratio based on the peripheral blood test results; The derived neutrophil-lymphocyte ratio, platelet-to-leukocyte ratio, patient age, and tumor pathological characteristics are input into the prognostic scoring model to obtain a risk score; wherein, the prognostic scoring model is a regression model established by screening variables related to postoperative disease-free survival using Cox regression analysis.

2. The method for prognostic assessment of adrenocortical carcinoma based on peripheral blood inflammatory markers according to claim 1, characterized in that, The derived neutrophil-lymphocyte ratio was obtained through... The calculation yielded that, This is to derive the neutrophil-lymphocyte ratio. The neutrophil count in peripheral blood test results. This refers to the total number of white blood cells in the peripheral blood test results.

3. The method for prognostic assessment of adrenocortical carcinoma based on peripheral blood inflammatory markers according to claim 1, characterized in that, The platelet-to-leukocyte ratio is obtained through The calculation yielded that, The platelet-to-white blood cell ratio; This refers to the platelet count in peripheral blood test results. This refers to the total number of white blood cells in the peripheral blood test results.

4. The method for prognostic assessment of adrenocortical carcinoma based on peripheral blood inflammatory markers according to claim 1, characterized in that, The tumor pathological features include ENSAT staging, Ki-67 index, and surgical resection status.

5. A prognostic assessment system for adrenocortical carcinoma based on peripheral blood inflammatory markers, characterized in that, include: The calculation module is used to acquire the peripheral blood test results and tumor pathological characteristics of the patient before treatment, and to calculate the derived neutrophil-lymphocyte ratio and platelet-white blood cell ratio based on the peripheral blood test results. The assessment module is used to input the derived neutrophil-lymphocyte ratio, platelet-white blood cell ratio, patient age, and tumor pathological characteristics into the prognostic scoring model to obtain a risk score; wherein, the prognostic scoring model is a regression model established by screening variables related to postoperative disease-free survival using Cox regression analysis.

6. The adrenocortical carcinoma prognostic assessment system based on peripheral blood inflammatory markers according to claim 5, characterized in that, The acquisition and calculation module through Calculate the derived neutrophil-lymphocyte ratio, where, This is to derive the neutrophil-lymphocyte ratio. The neutrophil count in peripheral blood test results. This refers to the total number of white blood cells in the peripheral blood test results.

7. The adrenocortical carcinoma prognostic assessment system based on peripheral blood inflammatory markers according to claim 5, characterized in that, The acquisition and calculation module through Calculate the platelet-to-white blood cell ratio, where, The platelet-to-white blood cell ratio; This refers to the platelet count in peripheral blood test results. This refers to the total number of white blood cells in the peripheral blood test results.

8. The adrenocortical carcinoma prognostic assessment system based on peripheral blood inflammatory markers according to claim 1, characterized in that, The tumor pathological features include ENSAT staging, Ki-67 index, and surgical resection status.

9. An electronic device comprising a memory, a processor, and a computer program stored in the memory and executable on the processor, characterized in that, When the processor executes the computer program, it implements the steps of the adrenocortical carcinoma prognostic assessment method based on peripheral blood inflammatory markers as described in any one of claims 1-4.

10. A computer-readable storage medium having a computer program stored thereon, characterized in that, When the computer program is executed by a processor, it implements the steps of the adrenocortical carcinoma prognostic assessment method based on peripheral blood inflammatory markers as described in any one of claims 1-4.

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