基于SEER数据库构建男性鼻咽鳞状细胞癌患者预后模型
Construction of a prognostic model for male nasopharyngeal squamous cell carcinoma patients based on SEER database
何蔼 1吴清明2
作者信息
- 1. 武汉科技大学医学院,湖北 武汉 430065;天门市第一人民医院耳鼻咽喉头颈外科,湖北 天门 431700
- 2. 武汉科技大学医学院,湖北 武汉 430065
- 折叠
摘要
目的:建立一个列线图来预测男性鼻咽鳞状细胞癌患者的生存率.方法:从SEER数据库下载和提取2010-2015年男性鼻咽鳞状细胞癌患者的临床资料,随机分为建模组(811例)和验证组(363例),最小绝对值选择与收缩算子(Least absolute shrinkage and selection operator,LASSO)回归对自变量进行筛选,采用Cox竞争风险模型进行多因素分析,构建列线图预测男性鼻咽鳞状细胞癌患者1年、3年、5年的生存率,采用一致性指数(C-index)、校准曲线、受试者工作特征曲线下面积(Area under a receiver operating characteristic curve,AUC)评估模型的区分度及准确度,临床决策曲线评估模型的临床实用价值,根据构建的模型,计算出模型的风险评分,以中位数水平将样本分为高风险组及低风险组,比较高风险组及低风险组生存率.结果:共纳入1 174例患者,建模组(n=811)和验证组(n=363).经LASSO回归和Cox回归分析表明,T分期、M分期、年龄、脑转移、肝转移、肺转移是男性鼻咽鳞状细胞癌独立危险因素.建模组和验证组的C-index分别为0.676(95%CI:0.642～0.701)和0.668(95%CI:0.619～0.717).建模组和验证组的AUC结果表明,这个列线图具有很高的准确性.校准曲线显示观察值与预测值高度一致,证明成功构建了预后模型.在建模组和验证组中,高风险组与低风险组的生存率差异均有统计学意义(P＜0.000 1).结论:T分期、M分期、年龄、脑转移、肝转移、肺转移是男性鼻咽鳞状细胞癌患者生存独立的预后因素.该模型有助于指导临床医师做出治疗方案的选择,延长患者生存率.
Abstract
Objective:To establish a column chart to predict the survival rate of male nasopharyngeal squamous cell carcinoma patients.Methods:Clinical data of male nasopharyngeal squamous cell carcinoma patients from 2010 to 2015 were downloaded and extracted from the SEER database.They were randomly divided into a modeling group(811 cases)and a validation group(363 cases).Least absolute shrinkage and selection operator(LASSO)regression was used to screen independent variables,and Cox competitive risk model was used for multivariate analysis.A column chart was constructed to predict the 1-year,3-year and the 5-year survival probability.The consistency index(C-index),calibration curve,and Area under a receiver operating characteristic curve(AUC)were used to assess the model's differentiation and accuracy.The clinical applicability value of the model was evaluated using the clinical decision curve analysis(DCA),and the risk score of the model was calculated based on the constructed model.The models were divided into high-risk and low-risk groups at the median level,and the survival curves between the high-risk group and low-risk group was compared.Results:A total of 1 174 patients were included,including the modeling group(n=811)and the validation group(n=363).Lasso regression and cox regression analysis showed that T stage,M stage,age,brain metastasis,liver metastasis,and lung metastasis were independent risk factors for male nasopharyngeal squamous cell carcinoma.The C-index of the modeling group and the validation group were 0.676(95%CI:0.642-0.701)and 0.668(95%CI:0.619-0.717),respectively.The AUC results of the modeling and validation groups indicate that the ROC curve exhibits high accuracy.The calibration curve demonstrates a high level of consistency between observed and predicted values,confirming the successful construction of the prognostic model.there were statistical differences in the survival curves between the modeling group and the validation group(P＜0.000 1).Conclusion:This study identified risk factors for survival in male nasopharyngeal squamous cell carcinoma patients.T stage,M stage,age,brain metastasis,liver metastasis,and lung metastasis are independent risk factors for male nasopharyngeal squamous cell carcinoma.This model helps guide clinical physicians in making treatment choices and prolonging survival rates of patients.
关键词
SEER数据库/男性/鼻咽癌/预后/鳞状细胞癌Key words
SEER database/Male/Nasopharyngeal carcinoma/Prognosis/squamous cell carcinoma引用本文复制引用
出版年
2024
国家科技期刊平台
NSTL
万方数据