基于LODDS的Siewert II型AEG患者预测整体存活率的新型名图的构建:基于Siewert数据库和外部验证的研究
Xiaohan Yu1, Chenglin Bai2, Yang Yu3
1General Surgery Department, Dandong Central Hospital, China Medical University, Dandong, Liaoning, China.
Frontiers in oncology
|June 24, 2024
概括
一个新的诺米图准确地预测了Siewert II型食管胃结 (AEG) 腺癌患者的整体存活率. 该工具有助于临床医生评估死亡风险和个性化治疗策略,以改善AEG患者的治疗结果.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 生物统计学 生物统计学
背景情况:
- 胃食道结合 (AEG) 的腺癌,特别是西沃特II型,显示了全球发病率的上升.
- 尽管治疗取得了进展,但AEG患者的预后仍然是一个重大问题.
- 确定可靠的预后因素和开发预测模型对于改善患者的治疗结果至关重要.
研究的目的:
- 开发和验证用于预测西沃特II型AEG患者的整体存活期 (OS) 的预后性名谱.
- 在这个患者队列中确定影响OS的独立预后因素.
- 为了比较开发的名图的预测性能与已建立的TNM分期系统.
主要方法:
- 利用SEER数据库 (2004-2015) 和医院数据 (2012-2018) 进行培训,内部和外部验证队列.
- 采用单变量和多变量考克斯回归分析,以及LASSO回归,以确定独立的预测因素.
- 为操作系统预测构建了一个名ogram,并使用ROC曲线,校准曲线,决策曲线分析,NRI和IDI评估其性能.
主要成果:
- 年龄,分化等级,T阶段,M阶段和阳性淋巴结 (LODDS) 的日志几率被确定为OS的独立预后因素.
- 与所有验证集的TNM分期相比,该名图显示出更高的预测准确性 (AUC > 0.7).
- 校准曲线证实了预测和观察到的生存时间之间的良好一致性,高风险和低风险组之间的生存时间有显著差异.
结论:
- 一个经过验证的诺姆图有效地预测Siewert II型AEG患者的整体存活率.
- 诺姆图表是临床医生评估个体死亡风险的宝贵工具.
- 个性化治疗策略可以通过利用这个名图来改善AEG患者管理来增强.
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