ArticleScientific reports2026
Integrating CD45 + CD3+ and CD3 + CD8+ T-cell markers into nomograms for predicting survival in gastroesophageal junction carcinoma.
Article in Scientific reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
To develop and validate prognostic nomograms for overall (OS) and progression-free survival (PFS) in gastroesophageal junction (GEJ) carcinoma to enable risk-stratified clinical decision-making. In this retrospective study of 618 patients, prognostic factors were selected using LASSO regression. Nomograms were constructed and validated by assessing discrimination (C-index, time-dependent ROC curves), calibration, and clinical utility (decision curve analysis). Patients were stratified into high- and low-risk groups based on nomogram-derived scores. The OS nomogram incorporated serum CD3 + CD8+ cells, mismatch repair status, metastatic lymph node count, and maximum tumor diameter. It demonstrated superior discriminative performance compared with the AJCC 9th edition staging system (C-index 0.716, 95% CI 0.679-0.752 vs. 0.683, 95% CI 0.646-0.721). The PFS nomogram included CD45 + CD3+CD19 + cells, CD3 + CD8+ cells, carcinoembryonic antigen, metastatic lymph nodes, and tumor diameter, also outperforming AJCC staging (C-index 0.709, 95% CI 0.676-0.743 vs. 0.647, 95% CI 0.610-0.684). Both models showed excellent calibration. Decision curve analysis confirmed their clinical utility across risk thresholds, with significant survival differences between risk groups (log-rank test, p < 0.001). Restricted cubic spline analysis revealed nonlinear associations between key immune cell levels (CD45 + CD3+ and CD3 + CD8+) and survival outcomes (all p < 0.05). This study establishes the first clinically validated risk-stratification model for GEJ carcinoma. The nomograms precisely identify low-risk patients who may avoid unnecessary adjuvant therapy and high-risk patients likely to benefit from treatment intensification, thereby enhancing personalized management.
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