基于外周血hTERT、UCA1表达的列线图模型对老年膀胱尿路上皮癌术后无病生存的预测价值  

Value of the Nomogram model based on hTERT and UCA1 expression in peripheral blood for predicting disease-free survival in elderly patients with bladder urothelial carcinoma after surgery

作　　者：高雪[1] 杨秋月 崔颖 Gao Xue;Yang Qiuyue;Cui Ying(Department of Urology,Beijing Friendship Hospital,Capital Medical University,Beijing 100050,China)

机构地区：[1]首都医科大学附属北京友谊医院泌尿外科,北京100050

出　　处：《广西医科大学学报》2023年第10期1720-1727,共8页Journal of Guangxi Medical University

基　　金：北京市卫生科技发展专项基金资助项目(No.2019-2-644)。

摘　　要：目的:探讨基于围术期数据及外周血人端粒酶反转录酶(hTERT)、尿路上皮癌抗原1(UCA1)表达的列线图模型对老年膀胱尿路上皮癌术后无病生存的预测价值。方法:选取2017年4月至2019年4月首都医科大学附属北京友谊医院收治的268例老年膀胱尿路上皮癌患者,均行根治性膀胱切除术,随机分为建模人群和验证人群,根据术后3年无病生存率分为死亡组和存活组,比较两组一般资料和围术期数据。采用实时荧光定量PCR(RT-qPCR)法检测外周血hTERT、UCA1基因表达。采用Lasso、Cox回归方程分析老年膀胱尿路上皮癌术后无病生存的影响因素,构建列线图模型,绘制受试者工作特征曲线(ROC)、校准曲线及决策曲线分析预测性能。结果:患者术后3年无病生存率为55.77%。外周血hTERT、UCA1表达,输尿管切缘、年龄、肿瘤分期和淋巴结转移均为老年膀胱尿路上皮癌术后无病生存的影响因素(均P<0.05),基于上述因素构建的列线图模型在建模人群和验证人群中C-index分别为0.857、0.949,经校准曲线分析,0.2~1.0、0.1~1.0范围内该模型在建模人群和验证人群中预测净获益值较高。结论:外周血hTERT、UCA1高表达为老年膀胱尿路上皮癌患者术后无病生存的危险因素,所构建模型对患者术后无病生存状况有一定的预测价值。Objective:To investigate the value of the Nomogram model based on perioperative data,human peripheral blood telomerase reverse transcriptase(hTERT)and uroepithelial carcinoma antigen 1(UCA1)for predicting disease-free survival in elderly patients with bladder urothelial carcinoma after surgery.Methods:A total of 268 elderly patients with bladder urothelial carcinoma admitted to Beijing Friendship Hospital,Capital Medical University from April 2017 to April 2019,all of whom underwent radical cystectomy,were selected and randomly divided into modeling and validation populations,and were divided into death and survival groups according to 3-year disease-free survival rate after surgery.General and perioperative data of the two groups were compared.Real-time fluorescence quantitative polymerase chain reaction(RT-qPCR)was used to detect hTERT and UCA1 gene expression in peripheral blood.Lasso and Cox regression equations were used to analyze the factors affecting disease-free survival in elderly patients with bladder uroepithelial carcinoma after surgery.The Nomogram model was constructed,and receiver operating characteristic(ROC)curve,calibration curve and decision curve were drawn to analyze the predictive performance.Results:The 3-year disease-free survival rate after surgery was 55.77%.The expression of hTERT and UCA1 in peripheral blood,ureteral incisal margin,age,tumor stage and lymph node metastasis were all influencing factors for disease-free survival in elder-ly patients with bladder urothelial carcinoma after surgery(all P<0.05).The C-index of the Nomogram model constructed based on the above factors was 0.857 and 0.949 in the modeling population and the verification population,respectively.After calibration curve analysis,the predicted net benefit value of this model was higher in the range of 0.2-1.0 and 0.1-1.0 in the modeling population and the verification population.Conclusion:The high expression of hTERT and UCA1 in peripheral blood is a risk factor for disease-free survival in elderly patients with

关 键 词：膀胱尿路上皮癌 人端粒酶反转录酶 尿路上皮癌抗原1 淋巴结转移 列线图 

分 类 号：R737.14[医药卫生—肿瘤]