血清肌酐胱抑素C比值评估鼻咽癌患者临床预后的价值
Clinical prognostic value of creatinine-cystatin C ratio in patients with nasopharyngeal carcinoma
常敏强 1闻朱音 1王琴 1章栽良 1王晓丹1
作者信息
- 1. 陆军第七十二集团军医院耳鼻咽喉科,浙江 湖州 313000
- 折叠
摘要
目的 探讨血清肌酐胱抑素C比值(creatinine-cystatin C ratio,CCR)对鼻咽癌(nasopharyngeal carcinoma,NPC)的预后价值.方法 回顾性分析2007年1月～2015年12月于陆军第七十二集团军医院进行诊治的NPC患者,根据CCR是否＜0.81(中位数)分为高表达组和低表达组,对高表达组和低表达组的预测变量进行比较.采用Kaplan-Meier生存分析法及Cox回归分析CCR对总生存期(overall survival,OS)的影响,基于相关预测因素构建临床预测模型及列线图并对其进行评价.结果 共纳入516例NPC患者,高表达组中高龄患者占比(22.5%)明显低于低表达组(32.6%),高分化患者占比(22.5%)明显更高(14.7%),TNM分期为Ⅰ期和Ⅱ期的患者占比(40.7%)明显高于低表达组(29.8%),上述指标差异均有统计学意义(P均＜0.05).Kaplan-Meier生存分析提示低表达的CCR与较差的OS显著相关,多因素Cox回归分析结果表明,年龄、CCR、病理学分级、从确诊到治疗时间、TNM分期与OS显著相关(P＜0.05).基于上述预测因素构建的临床预测模型的AUC值高于传统TNM分期模型,且其列线图预测OS时与实际有较好的一致性.结论 CCR可被视为NPC患者的一个潜在的预后评估因素.
Abstract
OBJECTIVE To investigate the prognostic value of serum creatinine-cystatin C ratio(CCR)for nasopharyngeal carcinoma(NPC).METHODS NPC patients who underwent consultation at the Army 72nd Group Military Hospital from January 2007 to December 2015 were retrospectively analyzed and divided into high-expression and low-expression groups according to whether the CCR was＜0.81(median),and the predictive variables of the high-expression and low-expression groups were compared.Kaplan-Meier survival analysis and Cox regression were used to analyze the effect of CCR on overall survival(OS),and clinical prediction models and column line diagrams were constructed and evaluated based on relevant predictive factors.RESULTS A total of 516 NPC patients were included.The percentage of elderly patients in the high-expression group(22.5%)was significantly lower than that in the low-expression group(32.6%),and the percentage of highly-differentiated patients(22.5%)was significantly higher(14.7%),and the percentage of patients with TNM stage Ⅰ and Ⅱ(40.7%)was significantly higher than that in the low-expression group(29.8%),and the differences of the above indexes were all statistically significant(P Kaplan-Meier survival analysis suggested that low-expression CCR was significantly associated with poorer OS,and multifactorial Cox regression analysis showed that age,CCR,pathologic grade,time from diagnosis to treatment,and TNM stage were significantly associated with OS(P＜0.05).The clinical prediction model constructed on the basis of the above predictive factors had higher AUC values than the traditional TNM staging model,and its column line graph predicted OS with good agreement with the actual.CONCLUSION CCR can be considered as a potentially useful prognostic factor for NPC patients.
关键词
鼻咽癌/预后/胱抑素C/血清肌酐/临床预测模型Key words
Nasopharyngeal Carcinoma/Prognosis/cystatin C/creatinine/clinical prediction model引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
维普
万方数据