头颈部腺样囊性癌预后预测列线图模型的构建  

Construction of nomogram prognostic prediction model for adenoid cystic carcinoma of the head and neck

作　　者：郭歌 董栋[1] 黄书满[1] 尹通男 乔新杰 胡好杰 宋一彤 赵玉林[1] GUO Ge;DONG Dong;HUANG Shuman;YIN Tongnan;QIAO Xinjie;HU Haojie;SONG Yitong;ZHAO Yulin(Department of Rhinology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院鼻科,郑州450052

出　　处：《郑州大学学报(医学版)》2023年第6期774-780,共7页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金项目(82071023)。

摘　　要：目的:构建预测头颈部腺样囊性癌(ACCHN)患者生存情况的列线图。方法:选择2000年至2017年SEER数据库的2 108例ACCHN患者作为建模队列,通过Cox回归分析筛选影响患者预后的独立因素,构建预测患者3 a、5 a总生存率(OS)和癌症特异性生存率(CSS)的列线图。选取2000年至2017年确诊的149例ACCHN患者作为外部验证队列,采用一致性指数(C指数)、ROC曲线和校准曲线评估列线图的性能。结果:年龄、性别、单原发癌、手术、化疗、原发部位、T分期、N分期、M分期是OS的影响因素。年龄、单原发癌、手术、化疗、原发部位、AJCC分期、T分期、N分期、M分期是CSS的影响因素。以上特征均整合在预测3 a和5 a OS和CSS的列线图中,内部验证C指数(95%CI)分别为0.770(0.754~0.786)和0.602(0.584~0.620),外部验证C指(95%CI)分别为0.796(0.795~0.797)和0.781(0.780~0.782)。内部验证中预测3 a和5 a OS的AUC(95%CI)分别为0.826(0.803~0.849)和0.814(0.792~0.835),预测3 a和5 a CSS的AUC(95%CI)分别为0.845(0.820~0.871)和0.834(0.811~0.857);外部验证中预测3 a和5 a OS的AUC(95%CI)分别为0.855(0.779~0.932)和0.838(0.768~0.909),预测3 a和5 a CSS的AUC(95%CI)分别为0.806(0.701~0.911)和0.806(0.726~0.886)。结论:本研究所构建的列线图可以准确预测ACCHN患者的OS和CSS,有助于个性化的预后评估和临床决策。Aim:To construct a nomogram for predicting the survival outcomes of patients with adenoid cystic carcinoma of the head and neck(ACCHN).Methods:A total of 2 108 ACCHN patients(modeling cohort) was screened in the SEER database from 2000 to 2017 in this study.Independent prognostic factors influencing outcomes were identified through Cox regression analysis.Nomograms were constructed to predict 3-and 5-year overall survival(OS) and cancer-specific survival(CSS) rates.Totally 149 ACCHN patients confirmed from 2000 to 2017 were selected as the external validation cohort.And then consistency index(C-index),ROC curve and calibration curve were used to evaluate the performances of nomogram.Results:Age,gender,single primary tumor,surgery,chemotherapy,primary site,and TNM stages were identified as influencing factors for OS.Age,single primary tumor,surgery,chemotherapy,primary site,AJCC stage,and TNM stages were influencing factors for CSS.The characteristics above were integrated into the nomograms for predicting 3-and 5-year OS and CSS.The internal validation revealed C-index(95%CI) of 0.770(0.754-0.786) and 0.602(0.584-0.620) for OS and CSS,respectively,whereas the external validation exhibited C-index(95%CI) of 0.796(0.795-0.797) and 0.781(0.780-0.782).In the internal validation,the AUC(95%CI) for predicting 3-and 5-year OS were 0.826(0.803-0.849) and 0.814(0.792-0.835),and for CSS were 0.845(0.820-0.871) and 0.834(0.811-0.857).In the external validation,the AUC(95%CI) for predicting 3-and 5-year OS were 0.855(0.799-0.932) and 0.838(0.768-0.909),and for CSS were 0.806(0.701-0.911) and 0.806(0.726-0.886).Conclusion:The nomograms constructed in this study can accurately predict the OS and CSS of ACCHN patients and is beneficial for individualized prognostic evaluation and clinical decision-making.

关 键 词：头颈部腺样囊性癌 列线图 预测模型 SEER数据库 

分 类 号：R762[医药卫生—耳鼻咽喉科]