未手术行放化疗的喉原发性鳞状细胞癌患者生存分析及预后模型构建  

Survival analysis and prognostic model construction of patients with primary squamous cell carcinoma of the larynx who underwent non-surgical radiotherapy and chemotherapy

作　　者：赵逸帆 朱江[1] Zhao Yifan;Zhu Jiang(Department of Otolaryngology,Head and Neck Surgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400050,China)

机构地区：[1]重庆医科大学附属第一医院耳鼻咽喉头颈外科,400050

出　　处：《山西医药杂志》2025年第1期35-40,共6页Shanxi Medical Journal

摘　　要：目的对未手术行放化疗的喉原发性鳞状细胞癌患者的生存情况进行分析并构建预后模型。方法采用监测、流行病学和最终结果(SEER)数据库中2000—2020年诊断为喉癌(C32.0)的患者资料814例。按照患者在随访结束时的生存状态分为预后良好组(660例)和预后不良组(154例);对2组患者进行单因素分析;将患者的结局指标分为总生存期(OS)和无病生存期(DFS),绘制Kaplan-Meier生存曲线;将单因素分析中差异具有统计学意义(P<0.05)的指标纳入LASSO回归分析模型;基于筛选出的5个特征变量,进行多因素分析影响患者预后不良的独立危险因素;构建多因素Logistic回归预测模型;受试者工作特征(ROC)曲线及校准曲线评价模型的预测效能。结果随访时间为1~35个月,中位随访时间为15个月,患者1年的累计总生存率约73.4%,1年的累计无病生存率约89.6%;经LASSO和多因素分析调整潜在混杂因素后可知,性别、年龄、T分期、N分期以及M分期均为影响患者预后不良的独立危险因素(P<0.05);建立多因素Logistic回归预测模型,当P=0.87时,约登指数为0.79达到最大,模型预测效果较好;ROC曲线和校准曲线检验得出,预测模型本研究中具有较好的区分度和准确性。结论构建未手术行放化疗的喉原发性鳞状细胞癌患者的预后模型可以有效评估喉原发性鳞状细胞癌患者生存情况,对患者预后存在一定的预测价值。Objective To analyze the survival status of patients with primary squamous cell carcinoma of the larynx who have not undergone surgical radiotherapy and chemotherapy,and to construct a prognostic model.Methods A total of 814 patients diagnosed with laryngeal cancer(C32.0)from 2000 to 2020 were analyzed using the surveillance,epidemiology,and end results(SEER)database.According to the survival status of patients at the end of follow-up,they were divided into a good prognosis group(n=660)and a poor prognosis group(n=154).The univariate analysis was performed on two groups of patients.The outcome indicators of patients were divided into overall survival(OS)and disease-free survival(DFS),and the Kaplan-Meier survival curve was plotted.Indicators with significant differences in the single-factor analysis were included in the LASSO regression analysis model.Based on the 5 selected characteristic variables,a multivariate analysis was conducted to identify independent risk factors that affect poor patient prognosis.Constructing a multi-factor Logistic regression prediction model,and the receiver operating characteristic(ROC)curve and calibration curve were used to evaluate the predictive performance of the model.Results The follow-up time was 1-35 months,with a median follow-up time of 15 months.The cumulative overall survival rate of patients at 1 year was about 73.4%,and the cumulative disease-free survival rate at 1 year was about 89.6%.After adjusting for potential confounding factors through LASSO and multivariate analysis,it was found that gender,age,T stage,N stage,and M stage were all independent risk factors affecting poor prognosis of patients(P<0.05).Establish a multi-factor Logistic regression prediction model,and when P=0.87,the maximum value of the Jordan index is 0.79,indicating good predictive performance of the model.The ROC curve and calibration curve tests show that the predictive model in this study has good discrimination and accuracy.Conclusion Constructing a prognostic model for patients with prima

关 键 词：喉肿瘤 原发性 癌 鳞状细胞 生存分析 预后模型 

分 类 号：R739.65[医药卫生—肿瘤]