Development and validation of nomogram based on lncRNA ZFAS1 for predicting survival in lymph node-negative esophageal squamous cell carcinoma patients
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Hongtai Shi1,*, Zhenhua Liu2,*, Dong Pei1,*, Youqin Jiang1, Haiwen Zhu1 and Bin Chen1
1Department of Radiotherapy, The Third People’s Hospital of Yancheng, Yancheng 224005, China
2Department of Radiotherapy, Yancheng City No.1 People’s Hospital, Yancheng 224000, China
*These authors contributed equally to this work
Bin Chen, email: email@example.com
Keywords: lncRNA, ZFAS1, nomogram, ESCC
Received: July 05, 2017 Accepted: July 26, 2017 Published: August 04, 2017
Background: There is increasing evidence of a relationship between long non-coding RNA (lncRNA) and cancer. This study aimed to examine the prognostic value of the lncRNA ZFAS1 in esophageal squamous cell carcinoma (ESCC).
Results: The results showed that ZFAS1 expression was significantly higher in ESCC tissues compared with the corresponding adjacent normal tissues (P < 0.001). ESCC patients with high ZFAS1 expression had a poor overall survival (OS). Histological grade, T stage and ZFAS1 expression were integrated to develop the nomogram. The nomogram showed a significantly better prediction of OS for patients with lymph node-negative ESCC. The ROC curve also showed higher specificity and sensitivity for predicting 3- and 5-year ESCC patient survival compared with the AJCC staging system. The decision curve analysis also indicated a greater potential for the nomogram in clinical application compared with the AJCC staging system. Importantly, our findings were supported by a validation cohort.
Materials and Methods: We retrospectively investigated 398 lymph node-negative ESCC patients. Data from the primary cohort (n = 246) were used to develop a multivariate nomogram. The nomogram was internally validated for discrimination and calibration with bootstrap samples and was externally validated with an independent patient cohort (n = 152).
Conclusions: Our proposed nomogram, which integrates clinicopathological factors and ZFAS1 expression, can accurately predict the prognosis of lymph node-negative ESCC patients without preoperative chemoradiotherapy.
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