基于临床及影像学资料构建胰腺癌患者生存率的预测模型  

Construction of a prediction model of survival rate of pancreatic cancer patients based on clinical and imaging data

作　　者：蒋异凡 汤绍梅 覃山羽[1] JIANG Yifan;TANG Shaomei;QIN Shanyu(Department of Gastroenterology,the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,China;Department of Gastroenterology,Guangxi Medical University Cancer Hospital,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院消化内科,南宁530021 [2]广西医科大学附属肿瘤医院消化内科,南宁530021

出　　处：《广西医科大学学报》2024年第5期734-741,共8页Journal of Guangxi Medical University

基　　金：国家自然科学基金资助项目(No.82260539)。

摘　　要：目的:探讨胰腺癌患者独立预后因素并建立生存率预测模型。方法:回顾性分析2020年1月至2021年12月在广西医科大学第一附属医院诊断的141例胰腺癌患者临床资料。收集2022年6月至2023年12月在广西医科大学附属肿瘤医院诊断的44例胰腺癌患者临床资料作为外部验证。通过log-rank检验及Cox比例风险模型进行单因素及多因素分析,得到胰腺癌预后的独立影响因素。根据多因素分析结果构建列线图预测模型。计算一致性指数(C-指数),绘制受试者工作特征曲线(ROC)、Calibrate曲线以及决策分析(DCA)曲线对预测模型进行验证及评价。结果:胰腺癌患者中位生存时间为7个月(95%CI:5.5~8.5),半年生存率为55.2%,1年生存率为29.5%。单因素及多因素Cox回归分析模型显示,胰腺癌患者发病年龄、肿瘤分期、治疗方式、糖类抗原125(CA125)、糖类抗原19-9(CA19-9)数值是远期生存时间的独立影响因素(P<0.05)。结论:胰腺癌患者预后差,其发病年龄、肿瘤分期、治疗方式、CA125、CA19-9与生存预后相关,构建预测半年、1年生存率列线图具有较好的预测能力、校准度和临床实用性。Objective:To explore the independent prognostic factors of pancreatic cancer patients and establish a survival prediction model.Methods:The data of 141 patients with pancreatic cancer diagnosed in the First Affiliated Hospital of Guangxi Medical University from January 2020 to December 2021 were analyzed retrospectively.The clinical data of 44 patients with pancreatic cancer diagnosed in Guangxi Medical University Cancer Hospital from June 2022 to December 2023 were collected as external validation.Log-rank test and Cox proportional hazards model were used to conduct single factor and multiple factor analysis to obtain independent prognostic factors of pancreatic cancer.A nomogram prediction model was constructed based on the results of multiple factor analysis.The consistency index(C-index),receiver operating characteristic(ROC)curve,calibrate curve,and decision curve analysis(DCA)were calculated to validate and evaluate the prediction model.Results:The median survival time of pancreatic cancer patients was 7 months(95%CI:5.5-8.5),the half-year survival rate was 55.2%,and the one-year survival rate was 29.5%.Cox regression analysis model of single factor and multiple factor showed that the age of onset,tumor stage,treatment mode,carbohydrate antigen 125(CA 125),carbohydrate antigen 19-9(CA 19-9)values of patients with pancreatic cancer were independent influencing factors of longterm survival time(P<0.05).Conclusion:The prognosis of pancreatic cancer patients is poor.The age of onset,tumor stage,treatment mode,CA125,and CA19-9 of ancreatic cancer are related to the survival prognosis.The construction of a nomogram for predicting half-year and one-year survival rates has good predictive ability,calibration and clinical practicability.

关 键 词：胰腺癌 预后分析 列线图 

分 类 号：R735.9[医药卫生—肿瘤]