首页|基于SEER数据库构建直肠癌术后患者的生存预测列线图及其验证

基于SEER数据库构建直肠癌术后患者的生存预测列线图及其验证

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目的 分析直肠癌术后患者总生存期(OS)的影响因素并构建其风险预测列线图模型。方法 从SEER数据库中筛选2010-2015年经病理诊断为直肠癌并行手术治疗的患者14 201例,按照7∶3的比例随机分为训练集9 941例和验证集4 260例;另收集兰州大学第二医院2017年1月1日—2021年12月31日与SEER数据库提取标准一致的直肠癌术后患者376例作为外部验证集。通过单因素及多因素COX回归分析并确定影响直肠癌术后患者OS的独立危险因素,据此构建列线图预测模型。通过C指数、受试者操作特征曲线下面积(AUC)评价该模型的区分能力,校准曲线评价该模型的预测值与实际值之间的接近程度。结果 多因素COX回归分析显示,直肠癌术后患者预后相关独立危险因素有13个,包括一般人口学(性别、年龄、婚姻状态)、肿瘤特征学[肿瘤原发部位、肿瘤分期、T分期、N分期、神经侵犯、癌胚抗原(CEA)水平、远处转移(肝转移、肺转移、骨转移)]及化疗(P<0。05)。基于这些独立危险因素构建了直肠癌术后患者生存预测的列线图模型,通过训练集及验证集C指数、AUC及校准曲线显示该预测模型的预测值与实际值具有较好的一致性。结论 基于SEER数据库构建的直肠癌术后患者生存预测的列线图效果良好,且将直肠癌肿瘤原发部位划分后发现发生在直肠的肿瘤较直肠乙状结肠交界处的肿瘤预后更差。
Construction of a survival prediction columnar plot for postoperative rectal cancer patients based on SEER database and its validation
Objective The influencing factors for the overall survival of postoperative rectal cancer patients were analyzed,and the nomogram model of risk prediction was constructed.Method A total of 14,201 patients diagnosed with rectal cancer and undergoing surgical treatment,from 2010 to 2015,was screened from the SEER(surveillance,epidemiology,and end results)database.According to the ratio of 7∶3,9,941 cases were randomly divided into a training set and 4,260 cases in a validation set;In addition,376 patients with postoperative rectal cancer consistent with the SEER database extraction criteria from January 1,2017 to December 31,2021 in the Second Hospital of Lanzhou University were collected as an external validation set.Univariate and multivariate COX regression analysis was used to determine the independent risk factors affecting the overall survival of rectal cancer patients after surgery,and a nomogram prediction model was constructed.The model's discriminatory ability was evaluated through the C-index and area under curve(AUC),while the calibration curve evaluated the degree of closeness between the predicted value and the actu-al value(ideal curve)of the predictive model.Results Multivariate COX regression analysis showed that there were 13 independent risk factors for the prognosis of postoperative rectal cancer patients,including general demographics(gender,age,marital status),tumor characteristics(primary tumor site,tumor stage,T stage,N stage,nerve invasion,carcinoembryonic antigen),distant metastasis(liver metastasis,lung metastasis,bone metastasis)and chemotherapy(P<0.05).A column chart model for predicting the survival of postoperative rec-tal cancer patients was constructed based on these factors.The training and validation sets of C-index,AUC and calibration curves showed that the predicted value of the model was in good agreement with the actual value.Conclusion In this study,we constructed a good column-line graph for survival prediction of postopera-tive rectal cancer patients based on the SEER database,and for the first time,we analyzed the further division of rectal cancer tumors into their primary sites to conclude that tumors occurring in the rectum have a worse prognosis than tumors at the rectosigmoid junction.

rectal cancersurveillance,epidemiology and end results databasenomogramprognosis

杨庆娥、王霄、汪营营、杨波、马晨哲、王彤昕、李玉民

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兰州大学 第二临床医学院,甘肃 兰州 730030

甘肃省环境肿瘤学重点实验室,甘肃 兰州 730030

直肠癌 SEER数据库 列线图 预后

甘肃省重大科技资助项目甘肃省重大科技资助项目甘肃省重大科技资助项目

20ZD7FA00322ZD6FA05022JR9KA002

2024

兰州大学学报(医学版)
兰州大学

兰州大学学报(医学版)

CSTPCD
影响因子:0.641
ISSN:1000-2812
年,卷(期):2024.50(3)
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