| 董海峰,李康宁,张恒,等.基于 SEER数据库胃印戒细胞癌病人预后列线图构建、验证与评价[J].安徽医药,2025,29(3):529-535. |
| 基于 SEER数据库胃印戒细胞癌病人预后列线图构建、验证与评价 |
| Development, validation and evaluation of prognostic nomogram to predict overall survival in patients with gastric signet ring cell carcinoma based on the SEER database |
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| DOI：10.3969/j.issn.1009-6469.2025.03.019 |
| 中文关键词: 癌，印戒细胞 病理状态，体征和症状 LASSO-Cox回归 列线图 监测、流行病学和最终结果数据库 预后 |
| 英文关键词: Carcinoma, signet ring cell Pathological conditions, signs and symptoms LASSO-Cox regression Nomogram SEER database Prognosis |
| 基金项目:河南省医学科技攻关联合共建项目基金( LHGJ20220456) |
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| 中文摘要: |
| 目的分析影响胃印戒细胞癌( GSRC)病人的预后因素，构建并验证列线图以预测 GSRC病人总生存率( OS)。方法收集监测、流行病学和最终结果( SEER)数据库中 2010—2015年诊断为 GSRC的病人 1 735例，根据 R软件 caret包按 7∶3随机分为训练集( 1 251例)和验证集( 484例)。采用 LASSO-Cox回归筛选变量并构建列线图，验证和评价列线图模型的预测效能，并与第 7版美国癌症联合委员会( AJCC)分期系统相比较。结果病人年龄、种族、 T分期、 N分期、 M分期、婚姻状态、手术治疗、化疗、区域淋巴结数和肿瘤长径是 GSRC病人预后的独立危险因素( P<0.05)。列线图一致性指数( C-index)在训练集和验证集中分别为 0.78［95%CI:(0.76，0.79)］和 0.76［95%CI:(0.74，0.79)］。 1、3、5年 OS受试者操作特征曲线( ROC曲线)下面积在训练集和验证集中分别是 0.83、0.88、0.89和 0.82、0.86、0.88。AJCC分期 C-index在训练集和验证集中分别为 0.70［95%CI:(0.68，0.71)］和 0.67［95%CI:(0.64，0.70)］。 1、3、5年 OS ROC曲线下面积在训练集和验证集中分别为 0.72、0.80、0.82和 0.69、0.76、0.79。结论列线图能够对 GSRC病人的总生存率做出个体化预测，为临床决策提供依据。 |
| 英文摘要: |
| Objective To assess the prognostic factors of gastric signet ring cell carcinoma (GSRC) patients, and to construct and vali-date a nomogram to predict the overall survival rate (OS) of GSRC patients.Methods Data of 1 735 patients diagnosed with GSRCfrom 2010 to 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) database and randomly divided into atraining set (n=1 251) and a validation set (n=484) according to the R software caret package in a 7:3 ratio. LASSO Cox regression wasused to screen variables and construct a column chart to validate and evaluate the predictive performance of the column chart model,and compared with the 7th edition of the American Joint Committee on Cancer (AJCC) staging system.Results Age, marital status,race, T stage, N stage, M stage, surgical treatment, chemotherapy, regional lymph nodes examined, and tumor size were identified as in-dependent risk factors for the prognosis of GSRC patients. The C-index of the nomogram was observed to be 0.78 [95% CI: (0.76, 0.79)] in the training set and 0.76 [95%CI: (0.74, 0.79)] in the validation set. Additionally, the areas under the curve (AUC) of the 1-,3-, and 5-year OS receiver operating characteristic curves (ROC) in the training set were found to be 0.83, 0.88, and 0.89, respectively, with thecorresponding figures in the validation set being 0.82, 0.86, and 0.88. The AJCC staging C-index was 0.70 [95% CI: (0.68, 0.71)] and 0.67 [95% CI: (0.64, 0.70)] in the training and validation sets, respectively. The areas under the ROC curve of the 1-,3-, and 5-year OS were 0.72, 0.80, 0.82 and 0.69, 0.76, 0.79 in the training and validation sets, respectively.Conclusion The nomogram can be utilized to evaluate the OS of GSRC patients on an individual basis, providing a useful tool for clinical decision-making. |
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