宫颈癌同步放化疗后疗效的预测模型构建与效能检验  

Prediction model construction and efficacy test of concurrent chemoradiotherapy for cervical cancer

作　　者：邓宇 李镰 唐洁 杜家虞[1,2] 马晓洁 Deng Yu;Li Lian;Tang Jie(Affiliated Hospital of North Sichuan Medical College,Nanchong 637000;North Sichuan Medical College,Nanchong 637000)

机构地区：[1]川北医学院附属医院,南充637000 [2]川北医学院,南充637000

出　　处：《现代妇产科进展》2022年第2期102-106,共5页Progress in Obstetrics and Gynecology

基　　金：放射肿瘤学四川省重点实验室2020开放基金项目(No:2020-1);川北医学院附属医院院级科研课题项目(No:2019ZD013)。

摘　　要：目的建立关于宫颈癌同步放化疗有效率的预测模型,并对预测模型进行效能检验,以指导临床治疗。方法回顾分析川北医学院附属医院肿瘤科2017年6月至2020年12月收治的122例宫颈癌同期放化疗患者的临床资料及相关影像学资料,根据近期疗效分为有效组和无效组。先对两组数据采取单因素分析,再将单因素分析有意义的指标纳入多因素logistic回归分析。根据相关因素的权重,创建预测模型并进行效能检验。结果单因素分析表明,肿瘤直径(MRI)、宫旁浸润(影像)、鳞状上皮细胞癌相关抗原(SCC)与有效率均显著相关(均P<0.05);将以上3项指标均纳入多因素logistic回归分析,得到预测模型方程Y=-1.545-0.037 X1+2.144 X2+0.0325 X3Y=有效率;X1=肿瘤直径;X2=宫旁浸润(影像);X3=SCC。利用ROC曲线检验模型效能,结果发现,cut-off为0.5时ROC曲线下面积为0.727(P=0.0001),95%CI为0.6292~0.8239;灵敏度为90.9,特异度为48.4;总预测准确度为74.58%,并且Hosmer-Lemeshow拟合优度检验显示,χ2=10.51,P=0.2309,模型拟合效度好(P>0.05),预测价值高。结论通过预测模型的建立发现,标准的同期放化疗模式可能对有宫旁浸润、肿瘤直径大、SCC值高患者治疗效果有限,有待探索进一步治疗模式来提高疗效。Objective:To establish a prediction model for the effective rate of concurrent chemoradiotherapy for cervical cancer,to predict the effective rate of concurrent chemoradiotherapy for cervical cancer,and to guide clinical treatment.Methods:The clinical data and imaging data of 122 patients with cervical cancer treated with concurrent chemoradiotherapy from June 2017 to December 2020 in the Department of Oncology,Affiliated Hospital of North Sichuan Medical College were retrospectively analyzed.The datas of the two groups were analyzed by univariate analysis,and then the significant indicators of univariate analysis were included in multivariate logistic regression analysis.According to the weight of relevant factors,the prediction model was established and the effectiveness was tested.Results:Univariate analysis showed that tumor diameter(MRI),parametrial invasion(imaging),squamous cell carcinoma associated antigen(SCC)were significantly correlated with the effective rate(all P<0.05).The above three indexes were included in the multivariate logistic regression analysis,and the prediction model equation was obtained as follows:Y=-1.545-0.037 X1+2.144 X2+0.0325 X3[Y=effective rate;Y=effective rate;Y=negative rate;X1=tumor diameter;X2=parametrial infiltration(imaging);X3=SCC].The ROC curve was used to test the effectiveness of the model.The results showed that the area under the ROC curve was 0.727(P=0.0001),95%CI:0.6292~0.8239 when the cut-off was 0.5.The sensitivity and specificity were 90.9 and 48.4,respectively.The overall prediction accuracy was 74.58%,and Hosmer lemeshow goodness of fit test showed that,χ2=10.51,P=0.2309.The model had good fitting validity(P>0.05)and high predictive value.Conclusions:Through the establishment of the prediction model,it is found that the standard concurrent chemoradiotherapy mode may have limited therapeutic effect on patients with large tumor diameter,periuterine infiltration and high SCC value,and the possible further treatment mode can be explored to improve the curative eff

关 键 词：宫颈癌 放化疗 预测模型 预后 

分 类 号：R737.33[医药卫生—肿瘤]