Combined detection of peripheral blood VEGF and inflammation biomarkers to evaluate the clinical response and prognostic prediction of non-operative ESCC

Yuanyuan Ma,Xiaohui Zhi,Chen Yan,Liqing Zhou,Xin Li,Kan Jiang,Xinyu Su,Jianhong Xia,Hongliang Li

doi:10.1038/s41598-021-94329-8

Abstract

An association between angiogenesis/inflammation status and tumor has been reported in various types of cancer. This study sought to assess the role of peripheral blood VEGF and some inflammation biomarkers in evaluating clinical response and prognosis in patients with non-operative esophageal squamous cell carcinoma (ESCC). Peripheral blood of 143 patients with non-operative ESCC at our institute was dynamically collected at 5 time points including 1 day before radiotherapy, during radiotherapy (15f), at the end of radiotherapy, 1 month after radiotherapy, and 3 months after radiotherapy. VEGF expression in the peripheral blood was detected and related inflammation biomarkers such as GPS, CAR and CLR were counted. Logistic regression and Cox regression were implemented respectively to analyze the correlation of each predictor with clinical response and prognosis. The performance of combined testing was estimated using AUCs. Based on independent predictors, a nomogram prediction model was established to predict the probabilities of 1- and 2-year PFS of patients. The effectiveness of the nomogram model was characterized by C-index, AUC, calibration curves and DCA. VEGF and CLR levels at the end of radiotherapy were independent predictors of clinical response, while VEGF and GPS levels at 3 months after radiotherapy were independent prognostic predictors. The efficacy of combined detection of VEGF and CLR is superior to the single detection in evaluating clinical response and prognosis. The nomogram showed excellent accuracy in predicting PFS. The combined detection of VEGF and CLR at the end of radiotherapy can be used to evaluate the clinical response of patients with non-operative ESCC, and the combined detection of VEGF and GPS 3 months after radiotherapy can be used to predict the prognosis. Implemented by nomogram model, it is expected to provide practical and reliable method to evaluate the clinical response and prognosis of patients with non-operative ESCC tool.

Highlights

Esophageal cancer is one of the most common malignant tumors in the digestive system, with the seventh and sixth morbidity rates in the world[1]
We conformed the important value of combined detection of peripheral blood VEGF end of radiotherapy and CLR end of radiotherapy with respect to clinical response evaluating, as well as combined detection of peripheral blood VEGF 3 months after radiotherapy and GPS 3 months after radiotherapy in progression-free survival prediction
VEGF, as the strongest factor inducing of a ngiogenesis[19], can directly act on vascular endothelial cells, release proteases and degrade the extracellular matrix, promoting the growth of new blood vessels[20]

Summary

Introduction

Esophageal cancer is one of the most common malignant tumors in the digestive system, with the seventh and sixth morbidity rates in the world[1]. Finding a specific and sensitive biomarkers and method to evaluate the clinical response and prognosis of non-operative ESCC patients becomes imperative. We combined detection peripheral blood VEGF and inflammation biomarkers to the clinical response assessment and prognosis prediction of patients with non-operative ESCC. The aim of our study was to evaluate the clinical response and prognosis of non-operative ESCC patients by monitoring simple biomarkers, and to establish a nomogram prediction model for prognostic prediction. It is useful for the classification and management of patients and illustrative for early treatment strategy

Objectives

Methods

Results

Conclusion