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Prognostic Significance of CSN2, CD8, and MMR Status-Associated Nomograms in Patients with Colorectal Cancer
Authors:Bing Zhu  Pei Zhang  Mulin Liu  Congqiao Jiang  Hao Liu  Jun Fu
Institution:2. Faculty of Pharmacy, Bengbu Medical College, Bengbu, 233000, China
Abstract:BACKGROUND: COP9 signalosome subunit 2 (CSN2) is believed to be involved in human cancer, but its prognostic significance in colorectal cancer (CRC) has not been elucidated. PATIENTS AND METHODS: We retrospectively analyzed the expression of CSN2 andCD8+ tumor-infiltrating lymphocytes (TILs), and mismatch repair (MMR) status in 267 paraffin-embedded specimens using immunohistochemistry in a training cohort. A number of risk factors were used to form nomograms to evaluate survival, and Harrell's concordance index (C-index) was used to evaluate the predictive accuracy. Further validation was performed in an independent cohort of 238cases. RESULTS: Low CSN2 expression and a low number of CD8 + TILs were significantly associated with diminished disease-free survival (DFS) and overall survival (OS) in CRC patients, and patients with MMR-deficient CRC had enhanced DFS and OS. Moreover, the multivariate Cox analysis identified CSN2, CD8 + TILs, and MMR status as independent prognostic factors for DFS and OS. Using these three markers and four clinicopathological risk variables, two nomograms were constructed and validated for predicting DFS and OS (C-index: training cohort, 0.836 (95% CI:0.804–0.868) and 0.841 (0.808–0.874), respectively; validation cohort, 0.801 (0.760–843) and 0.843 (0.806–0.881), respectively). CONCLUSIONS: CSN2, CD8+ TILs, and MMR status were independent prognostic factors. The nomograms could be used to generate individualized predictions for DFS and OS.
Keywords:Address all correspondence to: Bing Zhu or Jun Fu  Department of Gastrointestinal Surgery  The first Affiliated Hospital of Bengbu Medical College  Bengbu  233000  China  
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