开发和验证用于预测局部晚期直垂体结癌患者的存活率的诺姆图:一个SEER数据库分析分析
Sirui Zhu1, Yuncan Xing1, Jiawei Tu1
1Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Translational cancer research
|June 18, 2025
概括
这项研究开发了名图,以预测局部晚期直交结癌 (LARSJC) 患者的生存率. 这些工具比目前的分期系统提供了更好的准确性,有助于个性化治疗和更好的患者结果.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 癌症预后 癌症预后
背景情况:
- 局部先进的直交结癌 (LARSJC) 由于其解剖位置而带来了独特的预后和治疗挑战.
- 现有的分期系统可能无法完全捕捉LARSJC异质性,需要改进的预后工具.
- 准确的预后对于指导治疗决策和改善LARSJC患者的治疗结果至关重要.
研究的目的:
- 调查与LARSJC相关的风险因素.
- 开发和验证用于预测LARSJC患者的整体存活率 (OS) 和癌症特异性存活率 (CSS) 的诺姆图.
- 通过提高预后准确度,提高LARSJC患者的临床结果.
主要方法:
- 使用了来自监测,流行病学和最终结果 (SEER) 数据库 (2010-2017) 的数据,用于II期和III期LARSJC的患者.
- 使用考克斯回归,C指数,ROC曲线,校准图和决策曲线分析 (DCA) 开发和验证了名ograms.
- 包括诸如年龄,性别,瘤阶段,年级,大小,CEA水平和围神经侵入等预测因素.
主要成果:
- 确定了独立的风险因素,包括T阶段,N阶段,不良的瘤等级,较大的瘤大小,年龄,组织学,阳性CEA,瘤沉积和围神经侵入.
- 与AJCC第七阶段分级系统 (C指数0.63) 相比,开发的OS名图显示出更高的预测准确性 (C指数0.74-0.75).
- 诺米图表显示出良好的校准,并且有利于临床应用,在风险组之间观察到显著的OS差异.
结论:
- 在LARSJC患者中开发了准确的nomograms来预测OS和CSS.
- 这些名ograms可以帮助个性化治疗计划和识别高风险个体.
- 建议在前性研究中进一步验证和纳入生物标志物,以提高预后准确性.
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