胸腺瘤患者预后列线图预测模型的建立和验证  

Establishment and validation of a nomogram to predict progression free survival of patients with thymoma

作　　者：杜鑫 于磊[1] 于涛[1] 张云峰[1] 张葆勋[1] 柯冀[1] 余振[1] 杨兴国[1] 李飞[1] 于鑫韬 崔健 Du Xin;Yu Lei;Yu Tao;Zhang Yunfeng;Zhang Baoxun;Ke Ji;Yu Zhen;Yang Xingguo;Li Fei;Yu Xintao;Cui Jian(Department of Thoracic Surgery,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院胸外科,北京100730

出　　处：《中华胸心血管外科杂志》2023年第4期228-233,共6页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：北京市自然科学基金(19JCZDJC64400);北京市科协金桥工程种子资金(ZZ22006);北京同仁医院院基金(2021YJJPY011)。

摘　　要：目的探讨影响胸腺瘤切除术后患者预后的危险因素, 利用列线图建立胸腺瘤患者无进展生存预测模型。方法回顾性分析2010年1月至2019年12月期间在北京同仁医院行胸腺瘤切除术的267例患者的临床病历资料, 对可能影响无进展生存期(PFS)的相关因素进行单因素和多因素Cox回归分析, 利用筛选出的独立危险因素建立胸腺瘤切除术后患者PFS的列线图预测模型, 评价模型的预测能力。结果单因素Cox回归分析结果显示, 年龄、手术方式、切除完整程度、WHO病理分型、TNM分期、术后辅助治疗与胸腺瘤患者术后PFS显著相关(P<0.05)。多因素Cox回归分析结果显示, 仅年龄和TNM分期是影响胸腺瘤患者术后PFS的独立危险因素(P<0.05)。在此基础上建立的胸腺瘤患者预后的列线图预测模型的一致性指数(C-index)为0.866(95%CI:0.809~0.923), 该模型具有显著的预测效能。结论本研究建立并验证了基于年龄和TNM分期构建的列线图预测模型, 排除了其他临床病理因素对预后评估的干扰, 便于临床医师对胸腺瘤切除术后患者预后进行快速个体化评估。Objective To explore the prognostic risk factors of thymoma patients after resection,and establish a novel nomogram to predict progression free survival(PFS)of patients with thymoma.Methods A retrospectively analysis was performed on clinicopathological datas of 267 cases of thymoma patients underwent thymoma resection in Beijing Tongren Hospital from January 2010 to December 2019.The univariate and multivariate Cox risk ratio models were used to analyze the related factors that might affect PFS,and the prediction nomogram of PFS after thymoma resection was established using the screened independent risk factors.Then the predictive ability of the model was evaluated.Results The univariate analysis showed that age,type of surgery,completeness of resection,WHO histologic classification,TNM stage and postoperative adjuvant therapy were significantly correlated with PFS after thymoma resection(P<0.05).The multivariate analysis showed that only age and TNM stage were independent prognostic factors affecting PFS after thymoma resection(P<0.05).The concordance index(C-index)of the prediction model for the prognosis of thymoma patients established by this method was 0.866(95%CI:0.809-0.923),which had remarkable predictive efficiency.Conclusion The nomogram model is constructed and verified based on age and TNM stage,excluding the interference of other clinicopathological factors on prognosis assessment,and which is convenient for clinicians to quickly and individually evaluate the prognosis of patients after thymoma resection.

关 键 词：胸腺瘤 预后 无进展生存期 危险因素 列线图 

分 类 号：R736.3[医药卫生—肿瘤]