| 方金梅,赵于飞,龙腾飞,等.基于美国国家癌症研究所监测、流行病学、结果数据库食管癌病人预后影响因素分析[J].安徽医药,2022,26(3):475-480. |
| 基于美国国家癌症研究所监测、流行病学、结果数据库食管癌病人预后影响因素分析 |
| Factors affecting prognosis of esophageal cancer patients based on SEER database |
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| DOI：10.3969/j.issn.1009-6469.2022.03.012 |
| 中文关键词: 食管肿瘤 数据库 危险因素 列线图 预后 |
| 英文关键词: Esophageal neoplasms Database Risk factors Nomogram Prognosis |
| 基金项目:国家自然科学基金资助项目( 11805198) |
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| 中文摘要: |
| 目的剖析影响食管癌病人生存的临床参数，构建列线图以预测食管癌病人的 1年、 3年及 5年生存率。方法利用美国国家癌症研究所监测、流行病学、结果数据库( National Cancer Institute，The Surveillance Epidemiology and End Results program，SEER)，共获 2010年 1月至 2015年 12月 8 863例食管癌病人的年龄、病理等临床资料和相关随访数据。按随机数字表法分为验证组( 2 656例)和列线图建模组( 6 207例)(分配比例是 3∶7)。建模组用 Kaplan-Meier进行单因素生存分析，用 log-rank检验法评估生存率的差异；将在单因素分析中差异有统计学意义的变量纳入多因素 Cox比例风险模型，寻找建模组病人预后独立影响因素，将确定因素纳入并构建列线图，预测食管癌病人 1年、 3年及 5年生存率。通过一致性指数( C-index)和校正曲线评估其预测的准确性和判别能力。结果食管癌病人的年龄、性别、种族、组织分级、美国癌症联合协会( AJCC)第 7版 T分期、 N分期、 M分期、手术、化疗均是其预后独立影响因素( P<0.05)将以上因素纳入并构建列线图。 C-index:建模组内部验证为 0.726(95%CI:0.718~0.734)，验证组外部验证为 0.723(95%CI:0.71，1~0.735)；同时两组的校正曲线一致性良好。结论分析 |
| 英文摘要: |
| Objective To predict the 1-year, 3-year and 5-year survival rates of patients with esophageal cancer and construct a Nomogram by analyzing the clinical parameters that affect the survival.Methods The age, clinicopathological and follow-up data of 8863 patients with esophageal cancer between January 2010 and December 2015 were collected from the National Cancer Institute′sSurveillance Epidemiology and End Results (SEER) database. They were assigned into two groups according to the method of randomnumber table: verification group (2 656 patients) and Nomogram modeling group (6 207 patients) (the allocation ratio was 3∶7). In Nomogram modeling group, the Kaplan-Meier method was used to perform the single factor survival analysis, and log-rank test method was employed to assess the differences in survival rate. Then variables with statistically significant difference were included in the multivariate Cox proportional hazards model to find out the independent prognostic influencing factors, which were used to construct Nomogramto predict the 1-year, 3-year and 5-year survival rates of patients with esophageal cancer. Then the Harrell′s C-index and calibration curve were used to estimate the accuracy and discrimination ability of the Nomogram system.Results The independent prognostic factors were age, gender, race, tissue grade, The American Joint Committee on Cancer (AJCC) 7th T stage, N stage, M stage, operation andchemotherapy (P<0.05), which were all included and construct Nomogram. Concordance index (C-index): the internal validation of the modeling group was 0.726 (95%CI:0.718-0.734), and the external validation of the verification group was 0.723 (95%CI:0.711-0.735); meanwhile, the calibration curves of the two groups were in good agreement.Conclusion The Nomogram showed good accuracy in predicting survival rate of patients with esophageal cancer, which can help clinicians make more accurate prognostic evaluation. |
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