宫颈癌患者预后预测列线图的建立  

Nomogram prediction of overall survival for cervical cancer

作　　者：欧燕兰[1,2] 张琳[3] 张秀[1,2] 黄千峰[1,2] 王苑[1,2] 罗喜平[1,2] 

机构地区：[1]广州医科大学附属广东省妇幼保健医院体检科 [2]广东省妇产医院,广东广州510010 [3]中山大学肿瘤防治中心检验科.华南肿瘤学国家重点实验室,广东广州510060

出　　处：《中华肿瘤防治杂志》2015年第16期1303-1307,共5页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的探讨宫颈癌患者生存时间的影响因素，构建宫颈癌患者生存时间的预测列线图。方法回顾性分析2002—01—01—2006—12—30广东省妇幼保健院病理确诊为ⅠA～ⅡB期的307例宫颈癌患者的临床资料，分析年龄、FIG0分期和病理类型等因素对宫颈癌患者预后的影响，通过Cox模型分析影响患者肿瘤复发的影响因素并建立宫颈癌患者预后预测列线图模型。结果患者平均年龄43．6岁。鳞癌289例，腺癌13例，腺鳞癌5例。出现淋巴结转移93例，局部肿瘤浸润214例。单纯手术治疗患者172例，化疗135例。将单因素有显著性相关的5个因素纳入多因素Cox风险比例模型分析发现，年龄（HR=1．879，95％CI为1．069～3．301，P=0．028）、FIGO分期（HR=2．549，95％CI为1．524～4．830，P=0．005）、病理分型（HR=2．945，95％CI为1．445～6．001，P=0．019）、淋巴结转移（HR=1．912，95％CI为1．103～3．314，P=0．021）以及化疗（HR=2．940，95％CI为1．819～4．328，P=0．006）与宫颈癌患者生存时间显著相关，均是独立预后影响因素，建立用于预测宫颈癌患者预后预测列线图的一致系数为0．845。结论基于年龄、FIG0分期和病理分型等5个临床病理治疗资料构建预测宫颈癌患者总生存时间的列线图有助于个体化的预测患者的预后，有利于针对性地治疗预后较差的宫颈癌患者。OBJECTIVE To investigate the factors affecting the overall survival time of patients with cervical cancer and build predictive nomogram of Overall survival for cervical cancer. METHODS A retrospective analysis from January 2002 to December 2006 in Guangdong Province was done which included 307 pathological diagnosed cervical cancer pa- tients as research subjects. The clinical data were collected, factors including age, FIGO stage, and so on were analyzed with Cox survival model to predict overall survival of cervical cancer patients and establish prognostic nomogram model. RESULTS The average age of patients was 43.6 years, 289 of 307 patients were Squamous cell carcinoma, 13 patients were adenocarcinoma, 5 patients were squamous cell carcinoma. Furthermore 93 patients had lymph node metastasis. To- tally 172 patients had simple surgical treatment and 135 patients had surgical with chemotherapy treatment. Univariate a- nalysis of overall survival time of patients with cervical cancer and multivariate analysis showed that age （ HR = 1. 879, 95%CI：1. 069--3. 301, P=0. 028）, FIGO stage （HR=2. 549, 95% CI： 1. 524-4. 830,P=0. 005）, pathological type （HR=2. 945, 95%CI：1. 445-6. 001,P=0. 019）, lymph node metastasis （HR=1. 912, 95%CI： 1. 103-3. 314,P= 0.021） and concurrent chemotherapy （ HR= 2. 940, 95% CI： 1. 819- 4. 328, P = 0. 006） were significantly correlated with survival time of patients with cervical cancer, and were independent prognostic factors. The C-index of nomogram for predicting prognosis in patients with cervical cancer was 0. 845. CONCLUSION A nomogram based on the age, FIGO stage, pathological type, lymph node metastasis and concurrent chemotherapy to predict overall survival in patients with cervical cancer is individualized benefit to the patients with predicted poor prognosis.

关 键 词：列线图 宫颈癌 预后分析 回顾性分析 COX风险模型 

分 类 号：R737.33[医药卫生—肿瘤]