胃癌肺转移的风险分层:使用整体存活率名录并与之前的分期进行比较
Zhi-Ren Chen1, Mei-Fang Yang2, Zhi-Yuan Xie3
1Department of Science and Education, Xuzhou Medical University, Xuzhou Clinical College, Xuzhou 221000, Jiangsu Province, China.
World journal of gastrointestinal surgery
|March 11, 2024
概括
这项研究开发了一种新的名谱,用于预测肺转移 (GCLM) 的胃癌患者的整体存活率 (OS). 该模型准确识别高风险患者,有助于治疗决策.
科学领域:
- 在瘤学瘤学.
- 医学统计 医学统计
背景情况:
- 胃癌 (GC) 与肺转移 (GCLM) 表明疾病已晚,预后不佳.
- 确定GCLM的预后因素对于开发有效的整体生存 (OS) 和累积发病率预测 (CIP) 预测模型至关重要.
研究的目的:
- 调查GCLM的预测因子,并使用癌症特异性生存率 (CSS) 数据开发OS和CIP的诺米克图.
- 将新预后模型的临床实用性与现有的AJCC分期系统进行比较.
主要方法:
- 利用来自SEER数据库的1652名GCLM患者 (2000-2020) 的数据.
- 采用考克斯多变量回归,决策曲线分析 (DCA) 和校准曲线来确定预后因素和评估模型性能.
- 与使用净重新分类改进 (NRI) 和综合歧视改进 (IDI) 的第七版AJCC分阶段系统进行了对比.
主要成果:
- 确定了GCLM的11个显著预后因素,包括转移部位,主要部位,手术,化疗和淋巴结状况.
- 开发的OS名图显示了高预测效率 (AUC>0.7),超过了传统的Cox-AJCC模型 (新模型AUC=0.83).
- 诺米图准确地预测了1年和3年的生存状况,并有效地将患者分为高风险和低风险组.
结论:
- 开发的OS nomogram是预测GCLM患者生存率的宝贵工具.
- 该模型可以帮助临床医生对患者进行分类,并指导个性化治疗策略.
- 该名录图改进了GCLM中风险分层的现有分阶段系统.
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