An Energy-Efficient Test and Predictive Model for Recurrence After Radiotherapy in Localized Intermediate and Advanced Cervical Cancer Were Created Using Thymidine Kinase 1 in Conjunction with Inflammatory Markers and Tumor Markers

Abstract

Purpose

Construction of a nomogram model based on Thymidine kinase 1 (TK1) in combination with inflammatory indicators and tumor markers to predict the probability of recurrence in mid- to late-stage cervical cancer.

Methods

One hundred fourteen instances of intermediate and advanced cervical cancer admitted to our hospital’s radiotherapy department between June 2017 and January 2023 were retrospectively studied. Logistic regression analysis includes variables relevant for univariate analysis. Meaningful indications from multifactor analysis were included in the nomogram model, the model’s correctness was evaluated using the C-index, and the model’s effectiveness was assessed using calibration curves, clinical decision curves, and clinical impact curves.

Results

A nomogram model was created due to the logit regression analysis that revealed the squamous cell carcinoma antigen (SCC) and TK1 as independent recurrence predictors following cervical cancer radiation (P<0.05). The C index and Area Under the Curve (AUC) were 0.79 (95% CI 0.67–0.91). The AUC and C-index were both more extraordinary than those of TNM staging alone (C-index 0.57, 95% CI 0.43–0.71) and SCC alone (C-index 0.67, 95% CI 0.51–0.82). Calibration curves, Decision Curve Analysis (DCA), and clinical impact curves (CIC) indicate that the model predicts probabilities more accurately.

Conclusion

The nomogram model based on TK1 combined with inflammatory markers and tumor markers is more reliable than the TNM staging and SCC systems alone for forecasting recurrence after radiotherapy in intermediate- and advanced-stage cervical cancer. It is also a cheap, practical, and simple-to-obtain model that can supplement the TNM staging system for forecasting prognosis and significantly enhances clinicians’ decision-making.

Keywords:

• cervical cancer
• thymidine kinase 1
• inflammatory factors
• prognosis
• nomogram

Ethics Approval and Informed Consent

This study was approved by the Medical Ethics Committee of the Affiliated Hospital of North Sichuan Medical College blessed the study (2023ER85-1) and written informed consent was obtained from all patients and the study complied with the Declaration of Helsinki.

Acknowledgments

The authors wish to thank Xiaojie Ma for help of data analysis.

Author Contributions

The work reported is significantly enhanced by the contributions of all authors, who took part in the conception, study design, execution, data acquisition, analysis, and interpretation, or in all of these areas; who drafted, revised, or critically reviewed the article; who approved the final version to be published; who decided which journal to submit the article to; and who agreed to take responsibility for all aspects of the work. Yuanyuan Luo, Xiaojie Ma, contributed to this work equally and shared the first authorship.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

The Clinical Research of Sichuan Anti-Cancer Association (Qilu) provided funding for this project. [XH2022-XXX].