宫颈透明细胞腺癌预后因素分析及预测模型构建  

Analysis of prognostic factors and predictive model of clear cell adenocarcinoma of the cervix

作　　者：罗婧 郭永真 张莎 王路路 曾宪旭[1] 郭瑞霞[2] 雷冬梅[1] Luo Jing;Guo Yongzhen;Zhang Sha(Department of Pathology,the Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450000)

机构地区：[1]郑州大学第三附属医院病理科,郑州450000 [2]郑州大学第一附属医院妇科,郑州450000

出　　处：《现代妇产科进展》2023年第2期81-85,共5页Progress in Obstetrics and Gynecology

基　　金：河南省中原千人计划中原名医(No:ZYQR201810107)。

摘　　要：目的:探讨宫颈透明细胞腺癌的临床病理特征及其预后影响因素,构建预测总体生存率的列线图模型。方法:收集SEER数据库中于2000年至2018年诊断为宫颈透明细胞腺癌的319例患者的临床资料。采用单因素和多因素Cox比例风险回归模型分析影响预后的独立危险因素。基于多因素Cox回归分析结果构建预测患者总体生存率的列线图模型。通过一致性指数(C-index指数)、ROC曲线和校准曲线评估列线图的性能。结果:年龄、肿瘤分期、手术、放疗和检出淋巴结状态为影响预后的独立影响因素。预测1、3、5年OS的AUC分别为0.89、0.83和0.82;1、3、5年生存的校准曲线提示模型的实际值和预测值之间具有良好的一致性,列线图预测生存的C-index为0.80。结论:年龄、肿瘤分期、手术、放疗及检出淋巴结状态是影响预后的独立影响因素,构建可个体化预测宫颈透明细胞腺癌(CCAC)患者生存预后的列线图模型,有助于为CCAC患者提供个体化、可视化及量化的生存预测。Objective:To investigate independent prognostic risk factors in patients with clear cell adenocarcinoma of the cervix and develop individual nomogram to predict overall survival.Methods:Datas were retrieved from the Surveillance,Epidemiology,and End Results database,and patients were identified and examined from 2000 to 2018.Cox proportional hazard regression models on univariate and multivariate data were used to identify significant independent factors and develop nomogram prediction models for overall survival.The discrimination and calibration of the nomogram were determined using the concordance index,calibration curves,and receiver operating characteristic curves.Results:Age,summary stage,surgery,radiation,regional lymph nodes were all independent risk factors for clear cell adenocarcinoma of the cervix patient survival and prognosis.The AUC of predicting 1-,3-and 5-year OS were 0.89,0.83 and 0.82 respectively.The calibration curve of 1-,3-and 5-year revealed a satisfactory consistency between the predicted and the actual observations.The nomograms reported concordance index values of 0.80 for predicting overall survival.Conclusions:Age,summary stage,surgery,radiation,regional lymph nodes were all independent risk factors for CCAC patient survival and prognosis.The construction of nomogram that can individually predict the survival and prognosis is beneficial in providing customized,visual,and quantitative survival prediction for CCAC patients.

关 键 词：宫颈透明细胞腺癌 SEER数据库 列线图 总体生存率 

分 类 号：R737.33[医药卫生—肿瘤]