局限性肾透明细胞癌预后相关模型的建立  

Establishment of prognosis related model of localized clear cell renal cell carcinoma

作　　者：张轩瑀 宿钟化 卜仁戈[1] ZHANG Xuanyu;SU Zhonghua;BU Ren′ge(Department of Urinary Surgery,Shengjing Hospital Affiliated to China Medical University,Shenyang,Liaoning,110004;Department of Gynecology,Shengjing Hospital Affiliated to China Medical University,Shenyang,Liaoning,110004)

机构地区：[1]中国医科大学附属盛京医院泌尿外科,辽宁沈阳110004 [2]中国医科大学附属盛京医院妇科,辽宁沈阳110004

出　　处：《实用临床医药杂志》2021年第7期107-110,114,共5页Journal of Clinical Medicine in Practice

摘　　要：目的建立并评估局限性肾透明细胞癌(cc RCC)患者术后预后相关预测模型。方法回顾性分析526例行肾根治术或肾部分切除术的cc RCC患者的临床资料。采用单因素及多因素Cox回归分析,并建立诺模图(Nomogram)。通过吻合线、决策曲线分析(DCA)和Harrell’s一致性指数(CI)评估模型价值。结果单因素分析显示,年龄、临床症状、高血压病史、高脂血症、D-二聚体、白蛋白、贫血、术前肌酐、病理分级、肿瘤大小是无病生存期(DFS)的独立危险因素(P<0.05)。最终预测模型包括年龄、症状、贫血、D-二聚体和肿瘤大小。Nomogram的CI为0.78(95%CI为0.71~0.85)。术后3、5年的吻合线表明模型表现良好,DCA表明模型有临床获益。结论本研究构建的预测模型能够预测局限性cc RCC患者术后预后情况,可以为相关患者的术后随访及个性化疾病管理提供参考。Objective To establish and evaluate postoperative prognosis related predictive model for patients with localized clear cell renal cell carcinoma(ccRCC).Methods The clinical materials of 526 ccRCC patients with radical nephrectomy or partial nephrectomy were retrospectively analyzed.Univariate and multivariate Cox regression analysis were used to establish Nomograms.The value of the model was evaluated by calibration plots,decision curve analysis(DCA)and Harrell’s consistency index(CI).Results Univariate analysis showed that age,clinical symptoms,history of hypertension,hyperlipidemia,D-dimer,albumin,anemia,preoperative creatinine,pathological grading and tumor size were independent risk factors for disease-free survival(DFS)(P<0.05).The final predictive model included age,symptoms,anemia,D-dimer and tumor size.The CI of Nomogram was 0.78(95%CI,0.71 to 0.85).The calibration plots at 3 and 5 years after operation showed that the model performed well,and DCA showed that the model had clinical benefits.Conclusion The predictive model constructed in this study can predict the prognosis of patients with localized ccRCC,and it can provide reference for postoperative follow-up and personalized disease management of related patients.

关 键 词：肾透明细胞癌 诺模图 吻合线 决策曲线分析 

分 类 号：R692[医药卫生—泌尿科学] R965.1[医药卫生—外科学]