摘要
目的:利用列线图建立胃印戒细胞癌(SRCC)患者的生存预测模型。方法:收集SEER数据库中2004~2014年诊断为胃SRCC的病例,通过COX分析,选择与总生存率显著相关的参数建立列线图,并用一致性指数(C-index)、校准曲线、受试者工作特征曲线(ROC)和决策曲线分析(DCA)验证该列线图的功能。结果:经分析年龄、手术中切除淋巴结数目、TNM分期、T分级、N分级、放疗、肿瘤大小(cm),淋巴结清扫数量和骨转移成为与预后密切相关的独立变量,用这些变量构建胃SRCC患者5年的预后列线图。经验证,该列线图模型的C-index为0.753(95%HR:0.730~0.775)。结论:建立并验证了第一个胃SRCC预后的列线图,该模型具有良好的性能和临床应用价值。
Objective The purpose of this study was to construct a survival prediction model for patients with stomach SRCC by nomogram.Methods We investigated the Surveillance,Epidemiology,and End Results(SEER)database for stomach SRCC patients diagnosed between 2004 and 2014.Univariate and multivariable COX analyses was performed to select the parameters significantly correlating with OS and used to create a nomogram.The performance of nomogram was validated with Harrell’s concordance index(C-index),calibration curves,receiver operating characteristic curve(ROC)and decision curve analysis(DCA).An independent external validation cohort was subsequently used to assess the predictive performance of the model.Results In this study,we included 1459 patients diagnosed with stomach SRCC and randomly divided them into training group(n=730)and verification group(n=729).After analysis,age at diagnosis,Lymph nodes for surgery,TNM stage,T,N,Radiation,Tumor Size(cm),Lymph node dissection and Bone metastasis became independent variables intimately related to the prognosis and was used to construct 5-year prognosis nomograms.This nomogram had a C-index of 0.753(95%CI 0.730~0.775)in the training cohort.Internal and external calibration curves indicated satisfactory agreement between nomogram prediction and actual survival,and DCA indicated its valuable clinical usefulness.Conclusion We established and validated a novel nomogram that can provide individual prediction of OS for patients with stomach SRCC.
作者
范天晴
胡国潢
Fan Tian-qing;Hu Guo-huang(Changsha Hospital of Hunan Normal University,Changsha 410006,China)
出处
《湖南师范大学学报（医学版）》
2020年第4期14-17,共4页
Journal of Hunan Normal University(Medical Sciences)
基金
湖南省自然科学基金科卫联合项目(2018JJ6126)
关键词
胃癌
印戒细胞癌
SEER
列线图
gastric carcinoma
signet ring cell carcinoma
SEER
nomogram
作者简介
通讯作者:胡国潢,E-mail:huguohuanghn@163.com
