An immunohistochemical analysis-based decision tree model for estimating the risk of lymphatic metastasis in pN0 squamous cell carcinomas of the lung

Yu Liu, Dongmei Lin, Ting Xiao, Ying Ma, Zhi Hu, Hongwei Zheng, Shan Zheng, Yan Liu, Min Li, Lin Li, Yan Cao, Suping Guo, Naijun Han, Xuebing Di, Kaitai Zhang, Shujun Cheng, Yanning Gao

Research output: Contribution to journalArticle

5 Scopus citations

Abstract

Aims: Lung cancer patients within the pN0 category have a significantly different outcome. The aim of this study was to develop a mathematical model to assist in predicting the prognosis of pN0 lung squamous cell carcinoma (SCC). Methods and results: Twenty-three proteins were examined by immunohistochemical (IHC) analysis on primary tumour tissues from 319 lung SCC patients. In a training group, using IHC data, a recursive partitioning decision tree (RP-DT) was used to build a model for estimating the risk for lymphatic metastasis. This model was then validated in a test cohort. Of 23 proteins, 8 (matrix metallopeptidase 1, metalloproteinase inhibitor 1, Ras GTPase-activating-like protein IQGAP1, targeting protein for Xklp2, urokinase-type plasminogen activator, cathepsin D, fascin, polymeric immunoglobulin receptor/secretory component) were selected, and generated a tree model in a training group of 255 patients to classify them as at high or low risk of lymphatic invasion, with accuracy of 78.0% (compared to histopathological diagnosis), sensitivity of 83.0% and specificity of 70.3%. When the tree model was applied to the test group, the accuracy, sensitivity and specificity were 76.6%, 76.0% and 76.9%, respectively. The performance of this mathematical model was substantiated further in 34 'problematic' stage I/pN0 patients by survival analysis. Conclusions: The RP-DT model, constructed with eight protein markers for estimating lymphatic metastasis risk in pN0 lung SCC, is clinically feasible and practical, using IHC data from the primary tumour.

Original languageEnglish (US)
Pages (from-to)882-891
Number of pages10
JournalHistopathology
Volume59
Issue number5
DOIs
StatePublished - Nov 1 2011

Keywords

  • Decision tree
  • Immunohistochemical analysis
  • Lymphatic metastasis
  • Prognosis
  • Squamous cell carcinomas of the lung

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology

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  • Cite this

    Liu, Y., Lin, D., Xiao, T., Ma, Y., Hu, Z., Zheng, H., Zheng, S., Liu, Y., Li, M., Li, L., Cao, Y., Guo, S., Han, N., Di, X., Zhang, K., Cheng, S., & Gao, Y. (2011). An immunohistochemical analysis-based decision tree model for estimating the risk of lymphatic metastasis in pN0 squamous cell carcinomas of the lung. Histopathology, 59(5), 882-891. https://doi.org/10.1111/j.1365-2559.2011.04013.x