Objective To explore the predictive value of secretogranin Ⅱ(SCG2)for the prognosis of pancreatic neuroendocrine tumors(pNET)and to construct a nomogram prediction model based on SCG2.Methods One hundred and thirty-three patients with pNET who underwent radical surgery at the Fourth Hospital of Hebei Medical University from August 2013 to December 2021 were retrospectively collected.The cohort,including 60 males and 73 females with a mean age of(53.70±12.08)years,was divided into a training set(n=93)and a validation set(n=40).Clinical data such as gender,age,tumor size,lymph node metastasis,TNM stage,liver metastasis,surrounding tissue invasion,tumor histological grade,and carcinoembryonic antigen(CA)19-9 levels were gathered.Immunohistochemical staining was performed to detect SCG2 expression.Patient survival information was obtained through outpatient records or telephone follow-up.The Cox proportional hazard model was used to analyze prognostic factors.A nomogram was crea-ted based on the multivariate Cox regression analysis results.The calibration curve and the area under the receiver operating characteristic(ROC)curve were used to evaluate the nomogram s accuracy and discrimi-nation.Results The SCG2 expression in pNET patients with AJCC stage Ⅲ-Ⅳ was higher than in those with stage Ⅰ-Ⅱ.Similarly,patients with histological grade G3 had higher SCG2 levels compared to those with grades G1-G2.SCG2 expression was also elevated in patients older than 60 years compared to those 60 years or younger,and in patients with CA19-9＞30 U/L compared to those with CA19-9≤30 U/L.These differences were all statistically significant(all P＜0.05).Multivariate Cox regression analysis revealed that lymph node metastasis(HR=3.132,95％CI:1.212-8.096,P=0.017),liver metastasis(HR=2.685,95％CI:1.002-7.192,P=0.049),histological grade G3(HR=3.692,95％CI:1.229-11.088,P=0.011),and high SCG2 expression(HR=52.181,95％CI:38.476-108.118,P=0.002)were associ-ated with significantly higher risks of shorter disease free survival.Additionally,patients with longer tumor diameters(HR=1.297,95％CI:1.088-1.545,P=0.004),histological grade G3(HR=19.625,95％CI:5.276-88.634,P＜0.001),and high SCG2 expression(HR=39.454,95％CI:17.317-97.263,P＜0.001)had a higher risk of shorter overall survival.A nomogram prediction model was constructed using these above factors.The calibration curve demonstrated good alignment between predicted and actual out-comes in both the training and validation sets.The areas under the ROC curves for the disease-free survival and overall survival nomogram models for predicting 1-,3-,and 5-year survival of pNET patients in both sets were above 0.8.Conclusion High SCG2 expression is an independent risk factor for poor prognosis in pNET patients.The nomogram model based on SCG2 has high predictive efficacy for pNET patient prognosis.
维普
万方数据
