Objective:To analyze the influencing factors on the prognosis for survival in patients with advanced non-small-cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs) and to construct a nomogram for predicting the prognosis for survival.Methods:The research was designed as a retrospective study. The subjects were selected from advanced NSCLC patients who visited Qingdao Municipal Hospital from January 2019 to December 2021 and received ICIs. The clinical data of patients was extracted through the hospital diagnosis and treatment system. A Cox proportional risk model was used to analyze the factors affecting the prognosis for survival in patients. Patients were randomly divided into the modeling group and validation group according to a ratio of 7∶3. Using R4.2.1 software, a nomogram was built, and its prediction performance was verified based on the bootstrap repeated sampling method. Patients were divided into low- and high-risk groups according to the nomogram. The overall survival (OS) of patients was described through Kaplan-Meier curve, and the difference between the 2 groups was compared using the log-rank test.Results:A total of 161 patients with advanced NSCLC were included in the analysis, with an age of (65±8.7) years. Among the 161 patients, 127 were male, 113 had a pathological classification of NSCLC as adenocarcinoma, 86 had an Eastern Coperative Oncology Group Performance Status (ECOG PS) score ≥2, and 113 had ICI combined with other treatments. By December 2022, 81 patients (50.3%) had experienced immune-related adverse events (irAEs), of which 14 had grade 3 or 4 irAEs and 15 had irAEs in multiple systems. Eighty-six patients died. Cox regression analysis showed that advanced lung cancer inflammation index (ALI)≥29.8 [hazard ratio ( HR)=0.48, 95% confidence interval ( CI): 0.28-0.85, P=0.011], ECOG PS score ≥2 ( HR=2.17, 95% CI: 1.21-3.90, P=0.009), and having irAEs ( HR=0.40, 95% CI: 0.21-0.76, P=0.005) were prognostic factors for survival in patients with advanced NSCLC treated by ICIs. The nomogram was established based on factors of age, gender, ECOG PS score, irAEs, and ALI, and the total score of each patient was calculated. The patients were divided into the low-risk group (126 cases) and high-risk group (35 cases) according to the optimal cut-off value (183.82) of the receiver operator characteristic curve. The Kaplan-Meier curve and log-rank analysis showed that there was a statistically significant difference in OS between the 2 groups ( P<0.00 1). Conclusion:ALI, ECOG PS score, and irAEs are independent factors affecting the prognosis for survival in advanced NSCLC patients receiving ICIs, and the nomogram constructed based on multiple biological indicators can effectively predict patient prognosis for survival.

Objective:To analyze the influencing factors on the prognosis for survival in patients with advanced non-small-cell lung cancer (NSCLC) treated with immune checkpoint inhibitors (ICIs) and to construct a nomogram for predicting the prognosis for survival.Methods:The research was designed as a retrospective study. The subjects were selected from advanced NSCLC patients who visited Qingdao Municipal Hospital from January 2019 to December 2021 and received ICIs. The clinical data of patients was extracted through the hospital diagnosis and treatment system. A Cox proportional risk model was used to analyze the factors affecting the prognosis for survival in patients. Patients were randomly divided into the modeling group and validation group according to a ratio of 7∶3. Using R4.2.1 software, a nomogram was built, and its prediction performance was verified based on the bootstrap repeated sampling method. Patients were divided into low- and high-risk groups according to the nomogram. The overall survival (OS) of patients was described through Kaplan-Meier curve, and the difference between the 2 groups was compared using the log-rank test.Results:A total of 161 patients with advanced NSCLC were included in the analysis, with an age of (65±8.7) years. Among the 161 patients, 127 were male, 113 had a pathological classification of NSCLC as adenocarcinoma, 86 had an Eastern Coperative Oncology Group Performance Status (ECOG PS) score ≥2, and 113 had ICI combined with other treatments. By December 2022, 81 patients (50.3%) had experienced immune-related adverse events (irAEs), of which 14 had grade 3 or 4 irAEs and 15 had irAEs in multiple systems. Eighty-six patients died. Cox regression analysis showed that advanced lung cancer inflammation index (ALI)≥29.8 [hazard ratio ( HR)=0.48, 95% confidence interval ( CI): 0.28-0.85, P=0.011], ECOG PS score ≥2 ( HR=2.17, 95% CI: 1.21-3.90, P=0.009), and having irAEs ( HR=0.40, 95% CI: 0.21-0.76, P=0.005) were prognostic factors for survival in patients with advanced NSCLC treated by ICIs. The nomogram was established based on factors of age, gender, ECOG PS score, irAEs, and ALI, and the total score of each patient was calculated. The patients were divided into the low-risk group (126 cases) and high-risk group (35 cases) according to the optimal cut-off value (183.82) of the receiver operator characteristic curve. The Kaplan-Meier curve and log-rank analysis showed that there was a statistically significant difference in OS between the 2 groups ( P<0.00 1). Conclusion:ALI, ECOG PS score, and irAEs are independent factors affecting the prognosis for survival in advanced NSCLC patients receiving ICIs, and the nomogram constructed based on multiple biological indicators can effectively predict patient prognosis for survival.

BACKGROUND:Recently,the development of tissue-engineered technique lms broadened the study of artificial esophagus.Some investigators have inoculated esophageal epithelial cells cultured in vitro onto compound polymer material and successfully constructed tissue-engineered esophagus.OBJECTIVE:To investigate the feasibility of tissue-engineered artificial esophagus by combining dog esophageal epithelail cells and an acelhilarized porcine thoracic aorta allogenic matrix.DESIGN:An experimental observation.SETTING:Central Laboratory,Taishan Medical College.MATERIALS:This study was carried out in the Central Laboratory.Talshan Medical College from June to December in 2004.Three hybrid dogs,24-hour-old,were provided by the Laboratory Animal Center,Taishan Medical College.The protocol was performed in accordance with ethical guidelines for the use and care of animals.The experimenhal instruments and reagents were as follows:CO2 incubator(MCO-15AC,SANYO),hypothermal high-speed centrifuge(RC-26,Dupont),trypsin,transferrin,type Ⅱ collagenase(Gibco),dulbecco's modified eagle's medium(DMEM),DispaseⅡ isolated enzyme,and rat monoclonal anti-keratin antibody(Sigma).METHODS:Acellularization of porcine aortas was performed by a method of enzyme-detergent.Esophageal epithelial cells of hybrid dogs were in vitro isolated,cultured and proliferated.Next,they were inoculated onto an acellularized porcine thoracic aortas allogenic matrix seaffold.Three and seven days later,the growth of esophageal epithelial cells on the acellularized matrix was observed under an electron microscope.MAIN OUTCOME MEASURES:Morphology of esophageal epithelial cells cultured in vitro;Biocompatibility of acellular matrix and dog esophageal epithelial cells.RESULTS:The acellularized procedure resulted in an almost complere removal of the cells and the loose three-dimensional matrix.The acellular matrix could be reseeded with expended esophageal epithelial cells in vitro.and esophageal epithelial cells had the potential of spread and proliferation.CONCLUSION:Acellular matrix possesses satisfactory biocompatibility for allogenic esophageal epithelial cells.Tissue-engineered artificial esophagus can be generated in vitro by a combination of esophageal epithelial cells and allogenic aceilularized matrix.