摘要
目的构建脉络膜黑色素瘤预后预测模型。方法收集美国国家癌症研究所SEER数据库中2010—2015年2235例诊断为脉络膜黑色素瘤患者的临床资料数据(年龄、性别、婚姻状况、种族、TNM分期、病理学类型、骨转移、肺转移、肝转移、手术信息、放化疗情况、生存时间、生存状态等信息),将所有患者以7∶3的比例,随机分为建模组1584例及验证组651例。首先将建模组中的临床资料数据利用R4.1.2软件中“survival”包的Cox风险比例回归模型进行单因素及多因素分析,得出影响脉络膜黑色素瘤患者预后的独立影响因素。基于筛选出的影响因素使用R4.1.2软件中“rms”包构建脉络膜黑色素瘤预后预测模型。在建模组和验证组中通过C指数、ROC以及校准曲线评价该预测模型的区分度和一致性。结果年龄、病理学类型、T分期、M分期、局部放疗为影响脉络膜黑色素瘤预后的独立影响因素,基于以上因素,构建脉络膜黑色素瘤预后预测模型。在建模组和验证组中预后预测模型C指数分别为0.732(95%CI:0.710,0.761)和0.713(95%CI:0.670,0.756)。建模组中预后预测模型预测1年、2年、3年预后的ROC下面积分别为0.780、0.766、0.777;在验证组中预后预测模型预测1、2、3年预后的ROC下面积分别为0.890、0.755、0.734,两组数据均高于0.7,说明具有良好的区分度。建模组和验证组的校准曲线均与平面直角坐标系中45°的直线重合度较高,说明具有良好的一致性。结论脉络膜黑色素瘤预后预测模型建立成功,其对患者预后具有良好的预测效能。
Objective To construct the prognostic prediction model for choroidal melanoma.Methods The clini⁃cal data(age,gender,marital status,race,TNM stage,pathological type,bone metastasis,lung metastasis,liver metas⁃tasis,surgery information,radiotherapy and chemotherapy,survival time,and survival status,etc.)of 2235 patients di⁃agnosed with melanoma of choroid from 2010 to 2015 were collected from the National Cancer Institute surveillance,epide⁃miology,and end results(SEER)database.All data were randomly divided into the model group of 1584 cases and verifi⁃cation group of 651 cases at a ratio of 7:3.First,the clinical data in the model group were analyzed using the Cox hazard proportional regression model of the"survival"package in the R4.1.2 software to conduct univariate and multivariate anal⁃ysis to obtain independent factors affecting the prognosis of patients with melanoma of choroid.The selected influencing fac⁃tors were used to construct the prognostic prediction model of melanoma of choroid using the"rms"package in the R4.1.2 software.The discrimination and consistency of the prediction model were evaluated by C index,ROC and calibration curve in the model group and the verification group.Results Age,pathological type,T stage,M stage,and local radio⁃therapy were independent factors affecting the prognosis of melanoma of choroid.Based on the above factors,a prognostic prediction model for melanoma of choroid was constructed.The C indices of the prognostic prediction model in the model group and the verification group were 0.732(95%CI:0.710,0.761)and 0.713(95%CI:0.670,0.756),respective⁃ly.The area under the ROC curve of the model group for 1 year,2 years,and 3 years was 0.780,0.766,and 0.777 re⁃spectively;the area under the ROC curve of the verification group for 1,2,and 3 years was 0.890,0.755,and 0.734,respectively.The data of both groups were higher than 0.7,indicating good discrimination.The calibration curves of the model group and the verification group had a high degree of coincidence with the 45°straight line in the plane cartesian coordinate system,indicating good consistency.Conclusion The prognostic prediction model of melanoma of choroid is successfully established,and it has a good predictive effect on the prognosis of patients.
作者
吴小清
刘向玲
苏绍波
赵淑宁
宋子宣
WU Xiaoqing;LIU Xiangling;SU Shaobo;ZHAO Shuning;SONG Zixuan(Department of Ophthalmology,The Affiliated Hospital of Xinxiang Medical University,Xinxiang 453000,China;不详)
出处
《山东医药》
CAS
2023年第15期33-37,共5页
Shandong Medical Journal
基金
国家自然科学基金委员会面上项目(31471122)。
