摘要
目的借助监测、流行病学和结果数据库(SEER数据库)探讨胃印戒细胞癌患者预后的影响因素,构建胃印戒细胞癌患者预后的列线图(Nomogram图),预测胃印戒细胞癌患者的生存率。方法从SEER数据库中提取2010—2015年诊断为胃印戒细胞癌的2439例患者,采用Kaplan-Meier法评估患者生存率,进行单因素Log-rank检验分析。根据多因素Cox风险回归模型确定患者预后的影响因素,并构建Nomogram图,通过受试者操作特征(ROC)曲线和校正曲线,评估Nomogram图的预测精度和判别能力。结果胃印戒细胞癌多因素Cox风险回归模型结果表明:年龄、肿瘤分期、肿瘤大小、淋巴结转移、手术方式是胃印戒细胞癌患者预后的影响因素(均P<0.05),均被用于构建Nomogram图。绘制ROC曲线,1 a生存时间曲线下面积(AUC)为0.747(95%CI:0.745~0.749),3 a生存时间AUC为0.784(95%CI:0.782~0.786),5 a生存时间AUC为0.788(95%CI:0.786~0.790)。生存率的校正曲线与Nomogram图预测结果吻合较好。结论年龄、肿瘤分期、肿瘤大小、淋巴结转移、手术方式是胃印戒细胞癌患者预后的独立危险因素。依此建立的Nomogram图预后模型内部验证的准确性较高,可为评估胃印戒细胞癌患者预后生存率提供参考。
Objective This study accessed the Surveillance,Epidemiology and End Results(SEER)database to determine factors that influence the survival prognosis in patients with gastric signet ring cell carcinoma,and to construct the Nomogram of the survival prognosis in these patients to be able to predict the total survival rate of patients with this carcinoma.Methods Data of 2439 patients with gastric signet ring cell carcinoma from 2010 to 2015 were extracted from SEER database.The Kaplan-Meier method was used to evaluate the survival rate of the patients and to conduct the univariate Log-rank testing analysis.The multivariate Cox risk regression model was used to analyze the prognostic factors influencing patients with gastric signet ring cell carcinoma and the Nomogram was constructed.The prediction accuracy and discrimination ability of the Nomogram were evaluated by the receiver operator characteristic(ROC)curve and calibration correction curve.Results The multivariate Cox risk regression model for gastric signet ring cell carcinoma showed that the prognostic factors of patients with gastric signet ring cell carcinoma include age,tumor stage,tumor size,lymph node metastasis,surgery(all P<0.05),all of which were used to construct the Nomogram.In the Nomogram,the one-year survival time area under the curve(AUC)was 0.747(95%CI:0.745-0.749),the three-year survival time AUC was 0.784(95%CI:0.782-0.786),and the five-year survival time AUC was 0.788(95%CI:0.786-0.790).The correction curve of survival rate was in good agreement with the Nomogram prediction.Conclusion The independent prognostic risk factors of patients with gastric signet ring cell carcinoma are age,tumor stage,tumor size,lymph node metastasis,surgery.The Nomogram constructed by the above-mentioned data has high accuracy of internal verification in its prognostic model and can provide a reference for the prognostic survival rates of patients with gastric signet ring cell carcinoma.
作者
王震
赵春临
毛浩勋
WANG Zhen;ZHAO Chun-lin;MAO Hao-xun(Department of Gastrointestinal Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《河南医学研究》
CAS
2020年第20期3649-3653,共5页
Henan Medical Research
