A Nomogram Prognostic Model for Advanced Hepatocellular Carcinoma Based on the Interaction Between CD8(+)T Cell Counts and Age

OBJECTIVE: CD8(+)T cells are essential components of the adaptive immune system and are crucial in the body’s immune system. This study aimed to investigate how the prognosis of patients with advanced hepatocellular carcinoma (HCC) was affected by their CD8(+) T cell counts and age and established an effective nomogram model to predict the overall survival (OS). METHODS: A total of 427 patients with advanced HCC from Beijing Ditan Hospital, Capital Medical University, were enrolled in this study and randomly divided into training and validation groups, with 300 and 127 individuals in each group, respectively. Cox regression analysis was used to screen for independent risk factors for advanced HCC, and the interactive relationship between CD8(+)T cells and patient age was examined to establish a nomogram prediction model. RESULTS: Cox multivariate regression and interaction analyses indicated that tumor number, tumor size, aspartate aminotransferase (AST), C-reactive protein (CRP), relationship of CD8(+)T cell counts and age were independent predictors of 6-month OS in patients with advanced HCC, and the nomogram model was established based on these factors. The area under the receiver operating characteristic curve (AUC) of the nomogram model for predicting the 3-month, 6-month, and 12-month OS rates were 0.821, 0.802, and 0.756, respectively. Moreover, in clinical practice, patients with true-positive survival benefit more than true-positive death, therefore, we selected 25% as the clinical decision threshold probability based on probability density functions (PDFs) and clinical utility curves (CUCs), which can distinguish approximately 92% of patients who died and 37% of patients who survived. CONCLUSION: The nomogram model based on CD8(+)T cell counts and age accurately assessed the prognosis of patients with advanced HCC and suggested that high CD8(+)T cell levels are beneficial to the survival of patients with advanced HCC.