基于人群资料构建肾肉瘤样癌Nomogram预后模型  

A Nomogram prognostic model of renal sarcomatoid carcinoma:a population-based study

作　　者：李浩[1] 贾占奎[2] 李健[1] 彭浩[1] LI Hao;JIA Zhan-kui;LI Jian;PENG Hao(Department of Urology,Zhoukou Central Hospital,Zhoukou 466000;Department of Urology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]周口市中心医院泌尿外科,河南周口466000 [2]郑州大学第一附属医院泌尿外科,河南郑州450052

出　　处：《现代泌尿外科杂志》2020年第11期998-1002,1042,共6页Journal of Modern Urology

摘　　要：目的基于人群资料构建肾肉瘤样癌预后预测模型,进行个体化预后评估。方法筛选2004至2016年美国Surveillance、Epidemiology及End Results数据库中的984例肾肉瘤样癌患者作为研究对象,采用单因素和多因素Fine and Gray和Cox比例风险回归模型确定肾肉瘤样癌的独立预后风险因素,并用Nomogram构建预测模型,同时运用Calibration检测预测一致性。结果所有患者进行了根治性肾切除术,中位总生存期为11个月,多因素竞争风险模型回归分析提示肿瘤直径(HR=1.03,95%CI:1.01~1.06,P<0.001)、肿瘤T分期(T3相对T1;HR=1.56,95%CI:1.17~2.08,P<0.001)、N分期(HR=1.70,95%CI:1.43~2.04,P<0.001)、M分期(HR=2.09,95%CI:1.78~2.46,P<0.001)是肉瘤样癌预后的独立预测因素。根据其结果建立Nomogram模型,该模型预测能力较好(C-index=0.763)。结论成功构建肉瘤样癌肿瘤特异性死亡风险预后预测模型,为该类疾病提供个体化预后预测信息,有一定临床实际应用价值;同时该研究存在一定的局限性,需要外部数据进行验证。Objective To develop a Nomogram prognostic model for patients with renal sarcomatoid carcinoma based on population data.Method The data of 984 patients with renal sarcomatoid carcinoma were obtained from Surveillance,Epidemiology,and End Results(SEER)during 2004 and 2016.The independent prognostic risk factors were analyzed with univariate and multivariate Fine and Gray and Cox proportional hazard regression models.A Nomogram prognostic model was established and the consistency was assessed with Calibration test.Results All patients received radical nephrectomy and the median overall survival was 11 months.Multivariate Fine and Grey regression analysis revealed that the tumor diameter(HR=1.03,95%CI:1.01-1.06,P<0.001),tumor T stage(T3 vs.T1,HR=1.56,95%CI:1.17-2.08,P<0.001),N stage(HR=1.70,95%CI:1.43-2.04,P<0.001),and M stage(HR=2.09,95%CI:1.78-2.46,P<0.001)were the independent predictors of cancer-specific survival.The Nomogram model had good prediction ability(C-index=0.763).Conclusion A prognostic model to predict cancer-specific survival was developed.It has certain clinical application value as well as limitations.External data are needed to verify its prediction ability.

关 键 词：肾肉瘤样癌 SEER数据库 NOMOGRAM 预测模型 人群资料 

分 类 号：R737[医药卫生—肿瘤]