术前系统性炎症标志物评分联合病理T分期预测根治性膀胱切除术后膀胱癌患者预后列线图模型的建立与验证
Establishing and validating a nomogram model for predicting the prognosis of bladder cancer patients based on the score of systemic inflammatory markers before radical cystectomy combined with pathological T stage
李港 1李海龙 2王泽伟 1高志民 1温儒民2
作者信息
- 1. 徐州医科大学附属医院泌尿外科,江苏徐州 221000;徐州医科大学研究生院,江苏徐州 221004
- 2. 徐州医科大学附属医院泌尿外科,江苏徐州 221000
- 折叠
摘要
目的 建立系统性炎症标志物(SIM)对接受根治性膀胱切除术(RC)的膀胱癌患者预后的预测模型并进行验证,为临床进行个体化治疗提供参考.方法 回顾性收集2011年12月—2020年11月徐州医科大学附属医院泌尿外科收治的行RC治疗的233例膀胱癌患者的临床资料,计算SIM评分并进行分组.Kaplan-Meier分析评估无进展生存期(PFS),log-rank检验比较组间差异.采用Cox比例风险模型分析探讨影响患者PFS的因素,入组患者按7:3随机分为训练组(n=164)和验证组(n=69),建立并验证列线图模型.结果 多因素Cox回归分析显示SIM评分和病理T分期是膀胱癌患者RC术后PFS的独立预测因素(P＜0.05).RC术后预后预测模型基于SIM评分和病理T分期建立,预测1、3、5年PFS的受试者工作特征(ROC)曲线下面积(AUC)分别为0.939、0.943和0.943.将建立的模型应用于验证组评价,表现依旧稳定.结论 基于SIM评分和临床病理T分期建立的预测模型能准确预测膀胱癌患者RC术后的生存预后.
Abstract
Objective To evaluate the value of systemic inflammatory markers(SIM)in the prognosis of patients with bladder cancer undergoing radical cystectomy.Methods Clinical data of 233 patients with bladder cancer who underwent radical cystectomy in the Affiliated Hospital of Xuzhou Medical University during Dec.2011 and Nov.2020 were retrospectively collected,the SIM score was calculated and patients were grouped.Progression-free survival(PFS)was assessed with Kaplan-Meier analysis,and differences between groups were compared with log-rank test.Factors affecting PFS were analyzed with Cox proportional risk model.The patients were randomly divided into a training set(n=164)and a verification set(n=69)according to 7:3 ratio,and a nomogram model was established and verified.Results Cox regression analysis showed that SIM score and pathological T staging were independent predictors of PFS(P＜0.05).A predictive model was established based on SIM score and pathological T staging.The area under the receiver operating characteristic(AUC)curve for predicting 1-year,3-year,and 5-year PFS were 0.939,0.943,and 0.943,respectively.After the model was applied to evaluate the validation set,the performance was still stable.Conclusion The prediction model based on SIM score and clinicopathological T staging can accurately predict the survival of patients with bladder cancer after radical cystectomy,and can be used to guide individualized treatment of patients.
关键词
膀胱癌/系统炎症标志物/预后/列线图模型/病理T分期Key words
bladder cancer/systemic inflammatory markers/prognosis/nomogram model/pathological T staging引用本文复制引用
出版年
2024
NETL
NSTL
万方数据