EORTC QLQ-C30汇总评分对中国结直肠癌患者预后预测价值  

Prognostic predictive value of the EORTC QLQ-C30 summary score for Chinese colorectal cancer patients

作　　者：黄子寅 凯比努尔·艾尔肯 培尔顿·米吉提[1] HUANG Ziyin;Kaibinuer Aierken;Peijerdun Mijiti(School of Public Health,Xinjiang Medical University,Urumqi,Xinjiang 830011,China;Second Ward of Gynecological Radiotherapy Department,Third Affiliated Hospital of Xinjiang Medical University,Urumqi,Xinjiang 830011,China)

机构地区：[1]新疆医科大学公共卫生学院,新疆乌鲁木齐830011 [2]新疆医科大学第三附属医院妇科放疗科二病区,新疆乌鲁木齐830011

出　　处：《中华肿瘤防治杂志》2024年第10期625-631,共7页Chinese Journal of Cancer Prevention and Treatment

基　　金：省部共建国家重点实验室流行病与卫生统计学专项目(SKL-HIDCA-2020-ER6)。

摘　　要：目的探讨欧洲癌症研究治疗组织(EORTC)研制的生命质量量表体系(QLQ)问卷EORTC QLQ-C30汇总评分与整体生活质量(QL)维度分数的预后价值,以及汇总评分的最佳截断值。方法采用方便抽样法选取2016-06-01-2017-08-31新疆医科大学第三附属医院住院治疗的295例结直肠癌患者临床资料,采用中文EORTC QLQ-C30量表(第3版)对患者健康相关生活质量进行问卷调查,并对其进行随访。将患者的汇总评分及QL维度得分以每10分为截断转化为十分类变量代入1、3和5年的单因素及多因素Cox风险回归,对2个分数的预测效能进行比较。通过将汇总评分根据不同截断值转化为二分类变量代入结直肠癌患者1、3和5年单因素Cox回归中,比较不同截断值划分时汇总评分的预测效能,确定其在预后分析中的最佳截断值。Kaplan-Meier法比较根据最佳截断值划分的高生活质量组与低生活质量组间生存情况差异。结果在1、3和5年生存期内死亡病例的汇总评分低于非死亡病例(P<0.05),且在1、3和5年的单因素Cox回归分析中受试者工作特征曲线下面积(AUC)汇总评分(AUC_(1年)=0.692,AUC_(3年)=0.670,AUC_(5年)=0.670)相较于QL维度(AUC_(1年)=0.458,AUC_(3年)=0.587,AUC_(5年)=0.587)展现了更好的预测效能。QL维度得分在结直肠癌患者1年生存期内非死亡患者与死亡患者分数的差异性分析,以及患者预后的单因素和多因素Cox回归分析中差异均无统计学意义,均P>0.05。通过比较不同截断值时二分类汇总评分的预测效能,得到75分为汇总评分在结直肠癌患者预后分析中的最佳截断值,Kaplan-Meier生存曲线及1、3和5年单因素Cox分析结果显示,以该截断值划分的二分类变量(AUC_(1年)=0.623,AUC_(3年)=0.711,AUC_(5年)=0.710)预后价值优于直接带入的十分制的十分类变量。结论EORTC QLQ-C30汇总评分在中国结直肠癌患者生活质量与生存预后的相关研究中展现出良好的适用Objective To explore the prognostic value of the European Organization for Research and Treatment of Cancer(EORTC)Quality of Life Questionnaire(QLQ)EORTC QLQ-C30 summary score and the overall quality of life(QL)dimension scores,as well as to determine the optimal cutoff value for the summary score.Methods The clinical data of 295colorectal cancer patients hospitalized at the Third Affiliated Hospital of Xinjiang Medical University from June 1,2016 to August 31,2017 were collected by convenient sampling method.The Chinese version of the EORTC QLQ-C30 questionnaire(version 3)was used to conduct a survey on the health-related quality of life of the patients,and follow-up was performed.The summary scores and QL dimension scores of the patients were converted into 10-point ordinal variables,and were entered into the univariate and multivariate Cox regression analyses for 1-year,3-year and 5-year prognosis,to compare the predictive efficacy of the two scores.The summary scores were then converted into binary variables using different cutoff values,and entered into the univariate Cox regression for 1-year,3-year and 5-year prognosis of colorectal cancer patients to determine the optimal cutoff value for the summary score in prognostic analysis.The Kaplan-Meier method was used to compare the survival differences between the high and low quality of life groups divided by the optimal cutoff value.Results The summary scores for the deceased cases within 1,3,and 5 years were lower than those for the surviving cases(P<0.05).In the univariate Cox regression analysis for 1,3,and 5 years,the summary score(AUC_(1 year)=0.692,AUC_(3 year)=0.670,AUC_(5 year)=0.670)demonstrated better predictive efficiency compared to the QL dimension(AUC_(1 year)=0.458,AUC_(3 year)=0.587,AUC_(5 year)=0.587).The QL dimension score showed no significant difference in the analysis of the score differences between surviving and deceased colorectal cancer patients within 1 year or in the univariate and multivariate Cox regression analyses for prognosis,

关 键 词：结直肠癌 健康相关生活质量 欧洲癌症研究与治疗组织生命质量量表 预后 汇总评分 

分 类 号：R735.3[医药卫生—肿瘤]