晚期结直肠癌初诊脑转移特征、危险因素和列线图——基于SEER数据库的研究  

Characteristics,risk factors and nomogram for brain metastasis in advanced colorectal cancer:a study based on SEER database

作　　者：孙逸初 杨涛[1] 练炼[2] 周冲[3] 夏铀铀[1] Sun Yichu;Yang Tao;Lian Lian;Zhou Chong;Xia Youyou(Department of Radiotherapy,Lianyungang Clinical College of Nanjing Medical University/the First People’s Hospital of Lianyungang,Lianyungang 222000,China;Department of Oncology,Xiangcheng People’s Hospital,Suzhou 215000,China;Department of Radiotherapy,Xuzhou Central Hospital,Xuzhou 221000,China)

机构地区：[1]南京医科大学连云港临床医学院(连云港市第一人民医院放疗科),连云港222000 [2]苏州市相城人民医院肿瘤内科,苏州215000 [3]徐州市中心医院放疗科,徐州221000

出　　处：《中华转移性肿瘤杂志》2022年第3期201-208,共8页Chinese Journal of Metastatic Cancer

基　　金：吴阶平医学基金临床科研项目(320.6750.2020-10-73)

摘　　要：目的探讨SEER数据库中晚期转移性结直肠癌(CRC)患者初诊脑转移发生率、预后影响因素,并建立预测生存的列线图。方法分析SEER数据库中2010—2015年207464例CRC患者,筛选出477例初诊脑转移患者。采用Kaplan-Meier法生存分析,Cox模型预后因素分析,并生成列线图来预测生存率。Harrell一致性指数(C指数)用于列线图的性能评估。结果初诊脑转移患者占所有CRC患者0.230%(477/207464),占转移性CRC患者1.60%(477/29812)。脑转移患者中位生存期为5.0个月,6、12个月生存率分别为45.3%、30.4%。诊断年份、年龄、分级、化疗、手术和肝转移是影响患者预后的独立因素。列线图提示化疗是影响预后的最重要因素,C指数为0.86(95%CI0.74~0.78)。结论CRC初诊脑转移患者的发生率低,预后差。本列线图模型可以有效地预测生存率。Objective To investigate the incidence,prognostic factors and create a nomogram to estimate the overall survival(OS)in intermediate-stage/advanced colorectal cancer(CRC)individuals with preliminary diagnosed with brain metastasis(BM).Methods Overall 207464 individuals with CRC were identified from the SEER data resource between 2010 and 2015,of which 477 patients were preliminary diagnosed with BM.Kaplan-Meier analysis was employed to determine the OS.Multivariate Cox proportional hazards regression was employed to determine the independence of the prognostic factors and generate nomogram to predict survival.Harrell’s C-index was used as performance measures of nomograms.Results The 477 patients represented 0.230%(477/207464)of the CRC data set and 1.60%(477/29812)of the individuals with metastatic CRC.Median OS time of individuals with BM was 5.0 months,and the 6-and 12-month OS of CRC individuals with BM was 45.3%and 30.4%,respectively.The year of diagnosis,age,grade,chemotherapy,surgery and liver metastasis were independent prognostic factors.The nomogram model illustrated that chemotherapy had the most remarkable influence on prognosis.Besides,the C-index of OS estimation was 0.86(95%CI:0.74-0.78).Conclusions Herein,we established the incidence and prognostic factors for synchronous BM in CRC patients.The nomogram model could effectively predict the survival and aid clinicians in improving cancer management.

关 键 词：脑转移 结直肠癌 危险因素 列线图 SEER数据库 

分 类 号：R73[医药卫生—肿瘤]