摘要
目的利用监测、流行病学和结果数据库(SEER数据库)进行胃腺癌患者生存预后Nomogram图的构建,从而预测胃腺癌患者的总生存率。方法从SEER数据库中提取2004–2014年期间的胃腺癌患者共3 272例,随机划分为建模组和验证组。采用Cox比例风险回归模型分析建模组患者的预后影响因素,再构建Nomogram图。利用一致性指数(C-index)和校正曲线对Nomogram图进行内部(建模组数据)与外部验证(验证组数据),评估其预测价值。结果建模组的Cox比例风险回归模型结果表明:年龄、人种、肿瘤分化等级、组织学类型、美国癌症联合委员会(AJCC)分期及手术治疗均是胃腺癌患者的预后影响因素(P<0.05),均被用于构建Nomogram图。Nomogram图的内部与外部验证结果表明,建模组的C指数为0.751 [95%CI为(0.738,0.764)],验证组为0.753 [95%CI为(0.734,0.772)];2组的校正曲线均表现出良好的一致性。结论本研究构建的胃腺癌患者生存预后的Nomogram图具有良好的预测价值,可为临床医师提供较为准确及实用的预测工具,利于个体化地对患者的生存预后作出快速准确的评估。
Objective Establishing Nomogram to predict the overall survival（OS） rate of patients with gastric adenocarcinoma by utilizing the database of the Surveillance, Epidemiology, and End Results（SEER） Program.Methods Obtained the data of 3 272 gastric adenocarcinoma patients who were diagnosed between 2004 and 2014 from the SEER database. These patients were randomly divided into training（n=2 182） and validation（n=1 090） cohorts. The Cox proportional hazards regression model was performed to evaluate the prognostic effects of multiple clinicopathologic factors on OS. Significant prognostic factors were combined to build Nomogram. The predictive performance of Nomogram was evaluated via internal（training cohort data） and external validation（validation cohort data） by calculating index of concordance（C-index） and plotting calibration curves. Results In the training cohort, the results of Cox proportional hazards regression model showed that, age at diagnosis, race, grade, 6 th American Joint Committee on Cancer（AJCC） stage, histologic type, and surgery were significantly associated with the survival prognosis（P〈0.05）. These factors were used to establish Nomogram. The Nomograms showed good accuracy in predicting OS rate, with C-index of 0.751 [95% CI was（0.738, 0.764）] in internal validation and C-index of 0.753 [95% CI was（0.734, 0.772）] in external validation. All calibration curves showed excellent consistency between prediction by Nomogram and actual observation.Conclusion Novel Nomogram for patients with gastric adenocarcinoma was established to predict OS in our study has good prognostic significance, it can provide clinicians with more accurate and practical predictive tools which can quickly and accurately assess the patients＇ survival prognosis individually, and can better guiding clinicians in the follow-up treatment of patients.
作者
刘鹏弟
张亚飞
陆宏伟
吉鸿
洪若丰
黎一鸣
LIU Pengdi;ZHANG Yafei;LU Hongwei;JI Hong;HONG Ruofeng;LI Yiming(Department of General Surgery,The Second Affiliated Hospital of Xi＇an Jiaotong University,Xi＇an 710004,P.R.China)
出处
《中国普外基础与临床杂志》
CAS
2018年第10期1183-1189,共7页
Chinese Journal of Bases and Clinics In General Surgery
关键词
胃腺癌
监测、流行病学和结果数据库
生存分析
Nomogram图
gastric adenocarcinoma
database of the Surveillance, Epidemiology, and End Results Program
survival analysis
Nomogram
