膀胱原位癌预后的危险因素分析及列线图构建  

Analysis of risk factors for prognosis of bladder carcinoma in situ and construction of nomogram

作　　者：张子威 杨帅[2] 陈健友 ZHANG Ziwei;YANG Shuai;CHEN Jianyou(Department of Urology,Changhai Hospital,Naval Medical University,Shanghai 200433,China;Department of Urology,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233000,China;Department of Urology,Dazhou Integrated TCM&Western Medicine Hospital,Dazhou,Sichuan 635000,China)

机构地区：[1]海军军医大学附属长海医院泌尿外科,上海200433 [2]蚌埠医学院第一附属医院泌尿外科,安徽蚌埠233000 [3]达州市中西医结合医院泌尿外科,四川达州635000

出　　处：《现代医药卫生》2024年第5期753-758,共6页Journal of Modern Medicine & Health

基　　金：四川省达州市科技局重点研发计划项目(21ZDYF0028)。

摘　　要：目的探讨影响膀胱原位癌(CIS)患者预后可靠的危险因素,并建立列线图直观地预测膀胱CIS患者的预后情况。方法收集监测、流行病学和最终结果数据库2010-2015年的数据,筛选出832例膀胱CIS患者的临床资料。应用单因素和多因素Cox比例风险模型分析影响膀胱CIS患者肿瘤特异性生存期和总生存期的独立危险因素,采用R语言绘制列线图实现对生存模型的可视化,最后通过一致性指数(C-index)和校准曲线验证模型的准确性。结果影响膀胱CIS患者肿瘤特异性生存期的独立危险因素包括年龄和肿瘤分级(P<0.05)。影响膀胱CIS患者总生存期的独立危险因素包括年龄、肿瘤分级、原发灶数(P<0.05)。二者的C-index分别为0.745和0.709。结论年龄、肿瘤分级、原发灶数在膀胱CIS患者预后中具有重要的预测价值,通过列线图的构建可更好地为膀胱CIS患者制定临床决策。Objective To explore the risk factors affecting the prognosis of patients with bladder carcinoma in situ(CIS),and to establish a nomogram to intuitively predict the prognosis of patients with bladder CIS.Methods The clinical data of 832 patients with bladder CIS were selected from the database of surveillance,epidemiology and final results from 2010 to 2015.Univariate and multivariate Cox proportional hazard models were used to analyze the independent risk factors affecting tumor-specific survival and overall survival in patients with bladder CIS.The nomogram was drawn by R language to visualize the survival model.Finally,the accuracy of the model was verified by consistency index and calibration curve.Results The independent risk factors affecting the tumor-specific survival of patients with bladder CIS included age and tumor grade(P<0.05).The independent risk factors affecting the overall survival of patients with bladder CIS include age,tumor grade,and number of primary tumors(P<0.05).The consistency indexes of the two were 0.745 and 0.709,respectively.Conclusion Age,tumor grade and number of primary tumors have important predictive value in the prognosis of patients with bladder CIS.The construction of nomogram can better make clinical decisions for patients with bladder CIS.

关 键 词：膀胱原位癌 预后 危险因素 列线图 

分 类 号：R737.14[医药卫生—肿瘤]