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. 2023 Jun 15;23(1):548.
doi: 10.1186/s12885-023-10908-0.

Establishment and validation of a nomogram based on coagulation parameters to predict the prognosis of pancreatic cancer

Peng Yunpeng #  1   2 , Yin Lingdi #  1   2 , Zhu Xiaole #  1   2 , Huang Dongya  1   2 , Hu Le  1   2 , Lu Zipeng  1   2 , Zhang Kai  1   2 , Hou Chaoqun  1   2 , Miao Yi  1   2 , Guo Feng  3   4 , Li Qiang  5   6
Affiliations

Establishment and validation of a nomogram based on coagulation parameters to predict the prognosis of pancreatic cancer

Peng Yunpeng et al. BMC Cancer. .

Abstract

Background: In recent years, multiple coagulation and fibrinolysis (CF) indexes have been reported to be significantly related to the progression and prognosis of some cancers.

Objective: The purpose of this study was to comprehensively analyze the value of CF parameters in prognosis prediction of pancreatic cancer (PC).

Methods: The preoperative coagulation related data, clinicopathological information, and survival data of patients with pancreatic tumor were collected retrospectively. Mann Whitney U test, Kaplan-Meier analysis, and Cox proportional hazards regression model were applied to analyze the differences of coagulation indexes between benign and malignant tumors, as well as the roles of these indexes in PC prognosis prediction.

Results: Compared with benign tumors, the preoperative levels of some traditional coagulation and fibrinolysis (TCF) indexes (such as TT, Fibrinogen, APTT, and D-dimer) were abnormally increased or decreased in patients with pancreatic cancer, as well as Thromboelastography (TEG) parameters (such as R, K, α Angle, MA, and CI). Kaplan Meier survival analysis based on resectable PC patients showed that the overall survival (OS) of patients with elevated α angle, MA, CI, PT, D-dimer, or decreased PDW was markedly shorter than other patients; moreover, patients with lower CI or PT have longer disease-free survival. Further univariate and multivariate analysis revealed that PT, D-dimer, PDW, vascular invasion (VI), and tumor size (TS) were independent risk factors for poor prognosis of PC. According to the results of modeling group and validation group, the nomogram model based on independent risk factors could effectively predict the postoperative survival of PC patients.

Conclusion: Many abnormal CF parameters were remarkably correlated with PC prognosis, including α Angle, MA, CI, PT, D-dimer, and PDW. Furthermore, only PT, D-dimer, and PDW were independent prognostic indicators for poor prognosis of PC, and the prognosis prediction model based on these indicators was an effective tool to predict the postoperative survival of PC.

Keywords: Coagulation and fibrinolysis parameters; Pancreatic cancer; Predictive nomogram; Prognosis.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
The association between CF parameters and pancreatic cancer prognosis. (A-F) The association between CF parameters (including α angle, Ma, CI, PT, D-dimer, and PDW) and overall survival of PC. (G, H) The association between CF parameters (including CI, and PT) and disease-free survival of PC.
Fig. 2
Fig. 2
The Construction of prognostic nomogram for PC. (A) The prognostic nomogram for PC based on PT, D-dimer, PDW, VI, and TS. (B-D) The time-dependent ROC for 1-, 2-, and 3-year overall survival predictions. (E) The time dependent AUC of the nomogram in predicting PC overall survival. (F, G) The survival analysis of the nomogram. All patients were divided into two or three group according to optimal cutoffs provided by Survminer
Fig. 3
Fig. 3
The Validation of prognostic nomogram for PC. (A) The time dependent AUC of validation cohort in predicting PC overall survival. (B-D) The time-dependent ROC for 1-, 2-, and 3-year overall survival predictions of validation cohort. (E, F) The survival analysis based on data from validation cohort. All patients were divided into two or three group according to optimal cutoffs provided by Survminer
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