基于SEER Research Plus数据库的膀胱鳞状细胞癌预后分析研究及Nomogram模型构建  

Analysis of prognosis and nomogram construction of bladder squamous cell carcinoma based on SEER Research Plus database

作　　者：夏宇 王培菊 刘溪 徐丹枫[1,2] 黄滔[1] 赵晨晖[1] 杨安卿[1] 马斌斌[1] 崔仁杰 张朝晖[1] Xia Yu;Wang Peiju;Liu Xi;Xu Danfeng;Huang Tao;Zhao Chenhui;Yang Anqing;Ma Binbin;Cui Renjie;Zhang Zhaohui(Department of Urology,Luwan Branch of Ruijin Hospital Affiliated to Shanghai Jiaotong University,Shanghai 200001,China;Department of Urology,Ruijin Hospital,Medical School of Shanghai Jiaotong University,Shanghai 200001,China;General Practice,Shanghai Putuo District Changfeng Street Baiyu Community Health Service Center,Shanghai 200333,China)

机构地区：[1]上海交通大学医学院附属瑞金医院卢湾分院泌尿外科,上海200001 [2]上海交通大学医学院附属瑞金医院泌尿外科,上海200001 [3]上海市普陀区长风街道白玉社区卫生服务中心西医全科,上海200333

出　　处：《国际泌尿系统杂志》2023年第4期599-604,共6页International Journal of Urology and Nephrology

基　　金：上海市黄浦区卫生计生系统专业人才梯队培养计划(2019BJ02)。

摘　　要：目的通过研究膀胱鳞状细胞癌(BSCC)患者的预后独立危险因素,建立可个体化预测BSCC患者生存预后的Nomogram模型。方法收集SEER Research Plus数据库中2000年至2018年诊断为BSCC的1879例患者的临床资料,采用COX回归分析影响BSCC患者预后的独立危险因素,将COX多因素分析所得到的独立危险因素构建成Nomogram模型,采用一致性指数(C-index)和绘制Calibration校准曲线来验证Nomogram模型准确性。结果BSCC患者的1年、3年、5年的肿瘤特异性生存(CSS)率与总体生存(OS)率分别为40.5%、27.3%、24.5%和34.6%、21.3%、17.2%。COX回归分析结果显示T分期、N分期、肿瘤大小、肿瘤原发灶的手术方式及化疗是影响BSCC患者CSS的独立危险因素,而年龄、T分期、N分期、肿瘤大小、肿瘤原发灶的手术方式及化疗是影响BSCC患者OS的独立危险因素(均P<0.05)。Nomogram模型预测1、3、5年患者生存率的Calibration校准曲线与理想曲线具有良好的一致性。CSS的C-index指数为0.752,OS的C-index指数为0.748。结论通过SEER Research Plus数据库可确定年龄、T分期、N分期、肿瘤大小、肿瘤原发灶的手术方式及化疗是影响BSCC患者预后的独立危险因素,以此建立的个体化预测BSCC患者生存预后的Nomogram模型可对不同患者的预后进行个体化精准评估,用于指导临床医师选择合理的治疗方案。Objective To investigate the independent prognostic risk factors of patients with bladder squamous cell carcinoma(BSCC),and to establish a nomogram model that can Individually predict the prognosis of patients with BSCC.Methods Clinical data of 1879 patients diagnosed with BSCC diagnosed from 2000 to 2018 in SEER research plus database were collected.COX regression analysis was performed on selected variables.Independent prognostic risk factors determined in COX multivariate regression analysis were constructed into a survival Nomogram model.The accuracy of Nomogram model was verified by using C-index and Calibration curve.Results The 1-year,3-year,and 5-year cancer specific survival(CSS)and overall survival(OS)rates of BSCC patients were 40.5%,27.3%,24.5%,and 34.6%,21.3%,and 17.2%,respectively.Analysis results showed that T stage,N stage,tumor size and primary tumor operation and chemotherapy were independent risk factors for CSS,while age,T stage,N stage,tumor size and primary tumor operation and chemotherapy were independent risk factors for OS(all P<0.05).The established calibration curve of nomogram model related to CSS and OS had a high consistency with the ideal curve,the C-index was 0.752 and 0.748 respectively.Conclusions SEER Research Plus database was used to determine age,T stage,N stage,tumor size,surgical method of primary tumor and chemotherapy as independent risk factors for prognosis of patients with BSCC,and to establish a reliable Nomogram model for individualized prediction of survival and prognosis of patients with BSCC.Individualized and accurate evaluation of different patients'prognosis is used to guide clinicians to choose reasonable treatment plans.

关 键 词：膀胱肿瘤 癌 鳞状细胞 列线图 预测模型 生存分析 

分 类 号：R737.14[医药卫生—肿瘤]