一种预测肾透明细胞癌患者远处转移风险的列线图模型  

A nomogram model for predicting the risk of distant metastasis in patients with clear cell renal cell carcinoma

作　　者：刘浪 宋超[1] 廖文彪[1] 熊云鹤[1] 孟令超[1] 杨嗣星[1] LIU Lang;SONG Chao;LIAO Wenbiao;XIONG Yunhe;MENG Lingchao;YANG Sixing(Dept.of Urology,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]武汉大学人民医院泌尿外科,湖北武汉430060

出　　处：《武汉大学学报（医学版）》2022年第4期678-685,共8页Medical Journal of Wuhan University

摘　　要：目的:建立一种肾透明细胞癌(ccRCC)患者远处转移风险的预测模型。方法:从SEER数据库收集19393例ccRCC患者临床病理资料,随机分为训练组和验证组,检验临床病理特征与ccRCC远处转移的关系。利用LASSO回归模型筛选危险因素建立预测模型。一致性指数(C-Index)、校准曲线、受试者工作特征(ROC)曲线和决策曲线分析(DCA)对列线图进行准确性和稳定性评估。结果:年龄、性别、种族、Fuhrman分级、T分期、N分期、肿瘤大小与ccRCC的远处转移有显著相关性。LASSO回归选取5个临床病理特征(年龄、性别、种族、Fuhrman分级、T分期)构建预测ccRCC远处转移风险的列线图。训练组和验证组的曲线下面积(AUC)值为0.840和0.835,C-Index为0.846和0.843,校准曲线表现出良好的一致性。决策曲线分析表明训练组和验证组分别在1%~70%和1%~69%广大风险范围内,显示出很大的正向收益率。结论:我们建立起一个相对准确的列线图,预测ccRCC患者的远处转移风险,帮助临床医师采取个性化治疗措施。Objective:To establish a model for predicting the risk of distant metastasis in patients with clear cell renal cell carcinoma(ccRCC).Methods:The clinicopathological data of 19393 patients with ccRCC were collected from SEER database and randomly divided into training group and verification group.Lasso regression model was used to screen risk factors and establish prediction model.Consistency index(C-index),calibration curve,receiver operating curve(ROC)and decision curve analysis(DCA)were used to evaluate the accuracy and stability of nomogram.Results:Age,gender,race,Fuhrman grade,T stage,N stage,and tumor size were significantly correlated with distant metastasis of ccRCC.Five clinicopathological features(age,gender,race,Fuhrman grade,and T stage)were selected by LASSO regression to construct a nomogram to predict the risk of distant metastasis of ccRCC.The area under curve(AUC)values of the training group and the verification group were0.840 and 0.835,respectively,and the c-index values were 0.846 and 0.843,respectively.The calibration curves showed good consistency.The decision curve analysis showed that the training group and the verification group had a large positive rate of return in the wide risk range of 1%-70% and 1%-69%,respectively.Conclusion:We established a relatively accurate nomogram to predict the risk of distant metastasis in patients with ccRCC and help clinicians take personalized treatment measures.

关 键 词：肾透明细胞癌 LASSO回归 列线图 

分 类 号：R692.9[医药卫生—泌尿科学]