Objective  To explore the relationship between immune scores and prognosis, and establish a clinical nomogram to predict the survival of patients with lung adenocarcinoma.

Methods  The clinicopathological features and immune scores of 337 patients with lung adenocarcinoma were obtained from The Cancer Genome Atlas (TCGA) database. Multivariate COX proportional hazards regression model was used to analyze the independent predictors of overall survival in patients with lung adenocarcinoma. Based on the results of the multivariate analysis, a nomogram was established. The consistency index (C-index) and calibration curve were used to measure the prediction accuracy and discrimination ability.

Results The patients were divided into three subgroups according to the immune scores. Compared with patients with low immune scores, patients with high immune scores had significantly better overall survival (HR=0.56, 95%CI: 0.34-0.91, P=0.018). Additionally, the TNM stage of the tumor was also an important factor affecting survival. The C-index for predicting overall survival was 0.71(95%CI: 0.665-0.755). Calibration curves for the probability of overall survival at 1, 3, and 5 years demonstrated significant concordance between nomogram-predicted and observed values.

Conclusion  High immune score was significantly associated with better overall survival in patients with lung adenocarcinoma, and the TNM stage of the tumor also significantly influenced the overall survival. In addition, the nomogram developed for predicting prognosis may be helpful in estimating the survival of patient with lung adenocarcinoma.

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