| Objective As one of the most common head and neck cancer,the early screening and timely intervention are important to improve its prognosis in laryngeal squamous cell carcinoma（LSCC）.However,currently,there are no reliable biomarkers for the screening and prognosis of LSCC.Recent studies have shown that inflammation plays an essential role in tumor development and several inflammation-based peripheral blood biomarkers have been shown to have prognostic value.This study lies in identifying the independent risk factors of peripheral blood biomarkers and general clinical features of laryngeal cancer,then developing and validating a nomogram that can auxiliary predict the occurrence of laryngeal cancer.Methods We retrospectively reviewed the clinical data of 251 patients who were recently diagnosed with LSCC and 359 who were recently diagnosed with benign laryngeal lesions（BLL）in the Department of Otolaryngology Head and neck surgery of the First Affiliated Hospital of Anhui Medical University.Using the receiver operating characteristic（ROC）curve analysis,the cut-off and diagnostic efficiency of each variable were determined.The statistically significant potential independent risk factors were screened through univariate analysis and multivariate LASSO-Logistic regression analysis,then,the nomogram model was constructed.The discrimination of the model was evaluated by area under curve（AUC）,the consistency of the model was evaluated by calibration chart,the net benefit of clinical application was evaluated by decision curve analysis（DCA）,and the data were internally verified by 10-fold cross validation.Results Nine independent risk factors were screened from peripheral blood markers and general clinical characteristics by multivariate analysis,the age（OR = 7.481,95% CI =4.519-12.626,P < 0.001）,gender（OR = 9.760,95% CI = 4.574-22.513,P < 0.001）,smoking history（OR = 2.054,95% CI = 1.173-3.629,P = 0.012）,red blood cell distribution width（RDW,OR = 2.507,95% CI = 1.523-4.150,P < 0.001）,platelet-to-lymphocyte ratio（PLR,OR = 1.952,95% CI = 1.175-3.256,P = 0.010）,albumin（ALB,OR = 0.593,95% CI = 0.357-0.985,P = 0.043）,albumin-globulin ratio（AGR,OR = 0.405,95% CI = 0.190-0.838,P = 0.016）,fibrinogen degradation products（FDP,OR = 2.096,95% CI = 1.147-3.845,P = 0.016）and fibrinogen（FIB,OR = 2.168,95% CI = 1.310-3.598,P = 0.003）were included the LSCC diagnostic nomogram model.The nomogram predicted LSCC with an AUC of 0.907 and in the internal validation with an AUC of 0.900.The calibration curve also proved that the nomogram predicted outcomes were close to the ideal curve,it could be considered that the predicted outcomes were consistent with the real outcomes,and the DCA result indicated that the nomogram had good net benefits and could assist doctors in clinical decision-making.Conclusions 1.Age,gender,smoking history,RDW,PLR,ALB,AGR,FDP and FIB are independent risk factors for LSCC.Among them,ALB and AGR were negatively correlated to LSCC,while age,male,smoking history,RDW,PLR,FDP and FIB were positively relevant to LSCC.2.A nomogram for LSCC was constructed with good predictive performance,which may provide a practical approach for personalized early screening and auxiliary diagnosis of potential risk factors,and assist physicians to make a personalized diagnosis and treatment for patients. |
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