基于SEER数据库构建初诊结直肠癌脑转移患者的生存预测模型  

Nomogram for prediction of survival of synchronous brain metastasis in newly diagnosed colorectal cancer:an analysis based on SEER

作　　者：李莉 柯亚妮 谢杰斌[3] 庞月珊 LI Li;KE Yani;XIE Jiebin;PANG Yueshan(Department of Geriatrics,Nanchong Central Hospital,Nanchong 637000,Sichuan,China;Nanchong Social Welfare Center,Nanchong 637000,Sichuan,China;Department of Gastrointestinal Surgery,The Affiliated Hospital of North Sichuan Medical College,Nanchong 637000,Sichuan,China)

机构地区：[1]南充市中心医院老年科,四川南充637000 [2]南充市社会福利中心,四川南充637000 [3]川北医学院附属医院胃肠外科,四川南充637002

出　　处：《西部医学》2022年第9期1361-1365,共5页Medical Journal of West China

基　　金：南充市市校科技战略合作项目课题(18SXHZ0357,19SXHZ0088);南充市科技局项目(16YFZJ0017)。

摘　　要：目的构建初诊结直肠癌脑转移患者(SBCRC)生存预测模型。方法回顾性分析SEER数据库2010~2016年SBCRC患者临床病理及治疗数据。用多因素Cox比例风险模型确定独立预后因素;然后用R软件建立列线图预测模型及验证。结果单因素分析结果显示年龄、肿瘤位置、CEA、放疗、化疗、是否手术是SBCRC预后危险因素(P<0.05),而组织分化程度、性别、T分期、N分期与SBCRC预后无关(P>0.05)。多因素分析结果显示年龄、化疗、骨转移、CEA阳性和是否手术治疗是影响SBCRC患者的独立预后因素(P<0.05)。列线图预后模型的C-index为0.749(95%CI:0.726~0.772),半年及1年ROC曲线下面积分别为0.823和0.788,同时校准曲线显示列线图预测半年、1年生存率与实际观察半年和1年生存率有很好的一致性。结论基于年龄、CEA、骨转移、是否手术及化疗建立的列线图预测效果良好。Objective To establish a prediction model for predicting the prognosis of synchronous brain metastasis in newly diagnosed colorectal cancer(SBCRC).Methods The clinicopathological and treatment data of SBCRC patients from 2010 to 2016 in SEER database were retrospectively analyzed.Independent prognostic factors were identified using multivariate Cox proportional hazard model.Then R software was used to establish the nomogram prediction model,and verify the model.Results Univariate analysis showed that age,tumor location,carcino-embryonic antigen(CEA),radiotherapy,chemotherapy,liver metastasis,lung metastasis and bone metastasis were prognostic risk factors of SBCRC patients(all P<0.05).But the degree of tissue differentiation,race,gender,T stage and N stage were not correlated with the prognosis of SBCRC patients(all P>0.05).Multivariate analysis showed that age,chemotherapy,operation,bone metastasis and positive CEA were independent prognostic factors of SBCRC patients(all P<0.05).The C-index of the prognosis model of the nomogram was 0.749(95%CI:0.726-0.772),and the areas under the ROC curves were 0.823 and 0.788,respectively.Meanwhile,the calibration curve showed that the predicted 6-month and 1-year survival rate by the nomogram was in good agreement with the observed 6-month and 1-year survival rate.Conclusion The nomogram based on the age,CEA,bone metastases,operation and chemotherapy were tested to have an effective predictive prognosis power in SBCRC patients.

关 键 词：结直肠癌 SEER数据库 脑转移癌 列线图 肿瘤 

分 类 号：R735.3[医药卫生—肿瘤]