Abstract
OBJECTIVE: To investigate the relationship between the C-reactive protein-albumin-lymphocyte index (CALLY) and clinicopathological characteristics, as well as its prognostic value in stage III breast cancer patients. METHODS: A retrospective analysis was conducted on the clinicopathological data of 187 stage III breast cancer patients who were treated in our hospital from 2010 to 2015. The optimal cut-off value for CALLY index was determined by ROC curve. Chi-square tests and Fisher's exact tests were used for intergroup analysis. Survival curves were plotted using Kaplan-Meier method, and comparisons between groups were made using Log Rank test. Univariate and multivariate analyses were performed using the COX regression model. A nomogram prediction model was constructed based on the results of multivariate analysis and validated using the concordance index (C-index), calibration curves, and decision curve analysis (DCA). RESULTS: According to ROC curve, the optimal cut-off value for CALLY was determined to be 0.10, dividing the patients into a low CALLY group (54 patients) and a high CALLY group (133 patients). CALLY was identified as a potential independent prognostic factor for stage III breast cancer patients. Patients with high CALLY values had longer survival time than those with low CALLY values (DFS: χ(2) = 9.109, P = 0.0025; OS: χ(2) = 5.637, P = 0.0176). The C-indices for the nomograms predicting DFS and OS were 0.692 (95% CI: 0.541-0.811) and 0.730 (95% CI: 0.586-0.838), respectively. The calibration curves showed excellent calibration performance for predicting 1-year and 3-year DFS and OS. Decision curve analysis revealed that the nomogram model had better clinical performance than the CALLY model in predicting 3-year, 5-year, and 10-year DFS and OS. CONCLUSION: CALLY index is a potential independent prognostic factor for stage III breast cancer patients. It provides new insights and methods for clinical diagnosis and treatment of breast cancer.