在先进的乳头甲状腺癌中特定原因死亡的风险因素的识别和竞争风险模型的构建:基于SEER的研究
Yunyi Yang1, Xiaoli He1, Xiaoxiao Qu1
1Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
Cancer control : journal of the Moffitt Cancer Center
|April 23, 2025
概括
这项研究开发了一种可靠的竞争性风险模型,用于预测晚期乳头甲状腺癌 (PTC) 的因果特异性死亡率. 该模型准确评估预后,有助于为高级PTC患者提供个性化治疗.
科学领域:
- 在瘤学瘤学.
- 生物统计学 生物统计学
- 医疗信息学 医疗信息学
背景情况:
- 晚期乳头甲状腺癌 (PTC) 与早期阶段相比,具有较高的死亡和复发风险.
- 准确的预后工具对于管理先进的PTC和指导治疗决策至关重要.
研究的目的:
- 构建和验证一种竞争风险模型,用于预测晚期PTC患者因特定原因死亡率 (CSM).
- 在先进的PTC中确定CSM的独立预测因子,以告知风险分层.
主要方法:
- 从SEER数据库 (2010-2015年) 中分析了III-IV阶段的PTC案件.
- 使用单变量和多变量分析开发竞争性风险模型.
- 模型的验证使用培训验证分割 (7:3) 和通过C指数和校准曲线进行评估.
主要成果:
- 竞争风险模型将年龄,种族,性别,学年级,阶段,T阶段,M阶段,手术,化疗和瘤大小确定为CSM的重要风险因素.
- 构造的诺米图表显示出高的预测准确性,AUC值为3,5和8年生存时间从0.902到0.948.
- 该模型显示出优异的校准,预测的估计与训练和验证队伍中观察到的值密切匹配.
结论:
- 开发的竞争性风险模型是评估先进PTC预后的可靠工具.
- 这个模型可以支持个性化治疗策略和临床实践中高级PTC患者的风险管理.
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