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作 者:蒋志敏 马国武[1,2] 孙波[3] JIANG Zhimin;MA Guowu;SUN Bo(School of Stomatology,Dalian Medical University,Dalian 116044,China;The Affiliated Stomatological Hospital of Dalian Medical University School of Stomatology,Dalian 116021,China;Department of Oral and Maxillofacial Surgery,the Second Affiliated Hospital of Dalian Medical University,Dalian 116023,China)
机构地区:[1]大连医科大学口腔医学院,辽宁大连116044 [2]大连医科大学口腔医学院附属口腔医院,辽宁大连116021 [3]大连医科大学附属第二医院口腔颌面外科,辽宁大连116023
出 处:《口腔医学研究》2023年第1期56-61,共6页Journal of Oral Science Research
摘 要:目的:口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)是口腔癌的主要组织学类型,局部晚期OSCC的治疗仍是挑战。本研究构建并验证预测根治性切除局部晚期OSCC患者预后的列线图。方法:将269例OSCC根治性切除的患者分为训练队列与验证队列。用Cox回归分析患者预后的影响因素,构建可预测患者总生存期(OS)和癌症特异性生存期(CSS)的列线图模型。用一致性指数(C-index)、校准曲线和决策曲线分析(DCA)评价该模型,并在验证队列中验证。结果:年龄、Kaplan-Feinstein(KFI)指数、pT、阳性淋巴结数和全身免疫炎症指数(SII)与OS和CSS显著相关。基于这些因素,构建预测OS和CSS的列线图在训练队列中的C-index分别为0.712和0.709。校准曲线在实际值和预测值间吻合。DCA表明列线图有临床实用性。结果在验证队列中得到证实。结论:该模型可预测根治性切除局部晚期OSCC患者3年和5年的OS和CSS。Objective:To develop and validate nomograms in predicting prognosis in patients with locally advanced oral squamous cell carcinoma(OSCC)after curative resection.Methods:Two hundred and sixty-nine patients with OSCC after curative resection were assigned to the training and validation cohort.Cox regression analyses were conducted to determine the prognostic factors for overall survival(OS)and cancer specific survival(CSS),which were used to develop nomograms.Nomograms were evaluated by the concordance indicex(C-index),calibration curves,and decision curve analyses(DCA),and validated in the validation cohort.Results:Age,Kaplan-Feinstein(KFI)index,pT,the number of positive nodes,and systemic inflammatory index(SII)were significantly correlated with OS and CSS.Based on these factors,the C-index of the nomograms predicted OS and CSS in the training cohort were 0.712 and 0.709,respectively.Calibration curves exhibited good agreement between observed and predicted survival.DCA indicated the nomograms have clinical utility.These results were validated in the validation cohort.Conclusion:The nomograms can predict 3-and 5-year OS and CSS for patients with OSCC after curative resection.
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