基于SEER数据库成人骨肉瘤肺转移病人的预后分析  

Prognosis of Adult Patients with Pulmonary Metastasis of Osteosarcoma Based on SEER Database

作　　者：何涛 唐冰 熊敏[1] 韩珩[1] He Tao;Tang Bing;Xiong Min;Han Heng(Department of Spine Surgery,Dongfeng General Hospital Affiliated to Hubei Medical College,Shiyan 442000,China;Department of Orthopedics,Yunmeng County People's Hospital,Xiaogan 432500,China)

机构地区：[1]湖北医药学院附属国药东风总医院脊柱外科,湖北十堰442000 [2]云梦县人民医院骨科,湖北孝感432500

出　　处：《骨科》2024年第6期534-540,共7页ORTHOPAEDICS

摘　　要：目的探讨影响成人骨肉瘤肺转移病人预后的影响因素,并构建预后的预测模型。方法回顾性分析SEER数据库中987例无肺转移的成人骨肉瘤病人和164例肺转移的成人骨肉瘤病人的临床资料。利用Logistic模型探究成人骨肉瘤病人发生肺转移的危险因素,应用Cox模型寻找成人骨肉瘤肺转移病人预后的预测因子,并对这些独立的预后因素进行建模。结果较晚的T分期、N分期是成人骨肉瘤病人并发肺转移的危险因素,而手术、放化疗是保护性因素。年龄、手术和化疗是影响成人骨肉瘤肺转移病人总体生存期的独立因素,利用这3个重要因素构建的预测模型具有较好的预测价值(测试集AUC:0.734;验证集AUC:0.729)和校准度。此外,性别、手术和化疗是预测成人骨肉瘤肺转移病人肿瘤特异性生存的独立因素,构建的列线图也具有较好的预测价值(测试集AUC:0.683;验证集AUC:0.728)和校准度。结论本次基于SEER数据库构建的成人骨肉瘤肺转移病人生存风险的预测模型具有良好的预测价值和校准度,有助于成人骨肉瘤肺转移病人的个体化诊疗。Objective To explore the factors influencing the prognosis of adult patients with pulmonary metastasis of osteosarcoma,and to construct a predictive model for survival.Methods The SEER database was searched and the clinicopathological data of 987 adult osteosarcoma patients without metastasis and 164 osteosarcoma patients with lung metastasis were retrospectively analyzed.Logistic model was used to explore the risk factors of lung metastasis in adult patients with osteosarcoma.Cox model was used to find the prognostic factors of adult patients with pulmonary metastasis of osteosarcoma,and these independent prognostic factors were selected for the construction of predictive model.Results Advanced T stage and N stage were the risk factors of pulmonary metastasis in adult patients with osteosarcoma,while surgery,radiotherapy and chemotherapy were protective factors.Age,surgery and chemotherapy were independent factors affecting the overall survival of adult patients with osteosarcoma pulmonary metastasis.The predictive model using these three important factors had good predictive value(test set AUC:0.734;validation set AUC:0.729)and calibration ability.In addition,gender,surgery and chemotherapy were independent factors to predict the tumor specific formation of osteosarcoma lung metastasis.The cancer specific survival nomogram also had good predictive value(test set AUC:0.683;validation set AUC:0.728)and calibration ability.Conclusion The survival nomogram based on SEER database for predicting survival risk of adult patients with pulmonary metastasis of osteosarcoma has good predictive value and calibration ability,which is helpful to the individualized diagnosis and treatment of patients with pulmonary metastasis of osteosarcoma.

关 键 词：骨肉瘤 肺转移 SEER数据库 预后 列线图 

分 类 号：R738.1[医药卫生—肿瘤]