摘要
目的构建食管癌单纯骨转移预后预测模型。方法通过使用SEER Stat8.3.5软件提取2017年4月发布的SEER数据库中(2010-2015年)食管癌骨转移患者的数据,获得183例食管癌单纯性骨转移患者信息,对相关临床资料进行回顾性分析。采用秩和检验、cox比例风险模型和加速失效模型对食管癌骨转移患者的预后因素进行分析。结果年龄28~70岁的患者的预后生存时间(平均10.0个月,95%CI:7.758~12.338)较71~91岁患者(平均6.4个月,95%CI:4.365~8.428)的生存时间长(χ^2=4.077,P=0.043)。未婚患者预后(平均7.0个月)比已婚患者(平均10.5个月)差(χ^2=12.841,P<0.001)。不同病理类型的预后中,腺癌(平均10.2个月,95%CI:7.797~12.548),鳞癌(平均6.4个月,95%CI:3.895~8.899)和其他类型(平均4.0个月,95%CI:4.000~4.000)的差异具有统计学意义(χ^2=7.171,P=0.028)。不同T分期患者的预后生存差异具有统计学意义(χ^2=8.833,P=0.032)。列线图一致性指数(C-index)为0.675(95%CI:0.626~0.725)。结论单纯骨转移食管癌的预后差,婚姻、T分期与病理类型是影响预后的独立因素,而N分期对预后未显示明显的影响,列线图预测效果良好。
Objective To construct a model for predicting the prognosis of esophageal cancer bone metastasis. Methods The clinical data of 183 patients with esophageal cancer bone metastasis were analyzed retrospectively, and the prognostic factors of patients were analyzed by log-rank method and Cox proportional hazard model. Nomogram was constructed with the accelerated failure-time model.Results The average survival time(10.0 months, 95% CI:7.758-12.338) of patients aged 28-70 years was longer than that of patients aged 71-91(6.4 months, 95% CI:4.365-8.428)(χ~2=4.077, P=0.043). The prognosis of unmarried patients(average 7.0 months) was worse than that of the married(10.5 months on average)(χ~2=12.841, P<0.001). As for prognoses of different pathological types, the differences between adenocarcinoma(average 10.2 months, 95% CI:7.797-12.548), squamous cell carcinoma(average 6.4 months,95%CI:3.895-8.899) and other types(average 4.0 months, 95% CI:4.000-4.000) were statistically significant(χ~2=7.171, P=0.028).There were also significant differences between the prognoses of patients with different T stage(χ~2=8.833, P=0.032). Nomogram was constructed with the risk factors above and the C-index reached 0.675(95%CI: 0.626-0.725). Conclusion The prognosis of esophageal cancer bone metastasis was poor. Marriage, T stage, histological grade and pathological types were risk factors affecting prognosis, while N stage didn’t appear to show obvious effect on prognosis. The nomogram was tested to have a good predictive capacity.
作者
程志远
孙枫原
孟茜茜
王天骄
林寒
辛磊
张玲
王洛伟
李兆申
CHENG Zhi-yuan;SUN Feng-yuan;MENG Qian-qian;WANG Tian-jiao;LIN Han;XIN Lei;ZHANG Ling;WANG Luo-wei;LI Zhao-shen(College of Basic Medical Sciences,Naval Medical University,Shanghai 200433,China)
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2019年第7期624-629,共6页
Chinese Journal of Practical Internal Medicine
关键词
食管癌
SEER数据库
列线图
肿瘤转移
骨
esophageal cancer
SEER database
nomogram
neoplasm metastasis
bone
