摘要
目的分析HPV感染相关型(HPVA)和非HPV感染相关型(NHPVA)的独立预后因素,构建并验证预测患者癌症特异性生存率(CSS)的列线图。方法回顾性分析SEER数据库中2004年~2015年确诊的1219例HPVA和701例NHPVA患者的临床资料并对其病历资料进行回顾性分析。构建单因素及多因素COX回归模型,分析临床病理因素对宫颈腺癌患者预后的影响。绘制列线图评估多指标联合预测疾病进展的价值。采用一致性指数(C-index)、受试者工作特征(ROC)曲线及校准图评价模型的预测精度及判别能力。采用Kaplan-Meier曲线进行生存分析。结果HPVA患者的多因素COX回归分析结果显示发病年龄,肿瘤分化程度,肿瘤大小,TNM分期,FIGO分期,手术范围,及辅助治疗方式是CSS的独立影响因素。NHPVA患者的多因素COX回归分析结果显示发病年龄,肿瘤分化程度,肿瘤大小,M分期,FIGO分期,手术范围,淋巴结清扫与否是CSS的独立影响因素。构建了HPVA和NHPVA的个体化预测生存率列线图,一致性指数分析结果显示列线图具有良好的区分度。结论基于SEER数据库确立了HPVA和NHPVA患者的独立预后因素,列线图预测效果良好,具有快速准确评估患者生存预后的应用价值。
Objective Independent prognostic factors for HPVA and NHPVA were analyzed,and nomograms of the predicted patient cancer-specific survival(CSS)were constructed and validated.Methods The clinical data of 1219 patients with HPVA and 701 NHPVA diagnosed between 2004 and 2015 in the SEER database were retrospectively analyzed on their medical records.A univariate and multivariate COX regression model was constructed to analyze the impact of clinicopathological factors on the prognosis of patients with cervical adenocarcinoma.Nomograms to evaluate the value of multiple-indicator combined predictions of disease progression.The prediction accuracy and discrimination ability of the model were evaluated using the consistency index(C-index),subject working characteristic(ROC)curves,and calibration plots.Survival analysis was performed using the Kaplan-Meier curve.Result The results of multivariate COX regression analysis in HPVA patients showed that age,grade,tumor size,TNM stage,FIGO stage,scope of surgery,and adjuvant treatment modalities were independent risk factors of CSS.The results of multivariate regression analysis in NHPVA patients showed that age,grade,tumor size,M stage,FIGO stage,scope of surgery,and lymph node dissection were independent risk factors of CSS.Lograms of individualized predicted survival for HPVA and NHPVA were constructed,and the consistency index analysis showed good discrimination.Conclusion Independent prognostic factors for HPVA and NHPVA patients were established based on the SEER database,and the nomogram had good prediction effect and applied value for rapid and accurate evaluation of patient survival prognosis.
作者
周丽
刘亚
季星利
李晓妹
彭豆豆
崔家旗
邓丹
马立
陈婷婷
杨帆
ZHOU Li;LIU Ya;JI Xingli;LI Xiaomei;PENG Doudou;CUI Jiaqi;DENG Dan;MA Li;CHEN Tingting;YANG Fan(Department of Pathology,Chengdu Fifth People's Hospital,The Fifth People's Hospital Affiliated to Chengdu University of Traditional Chinese Medicine,Chengdu 611130,China)
出处
《西部医学》
2023年第1期135-142,共8页
Medical Journal of West China
基金
成都市卫生与健康委员会科研课题(2020120)
成都中医药大学课题(YYZX2020010)。
关键词
宫颈腺癌
HPV感染相关型
非HPV感染相关型
生存分析
列线图
Cervical adenocarcinoma
HPV-associated adenocarcinoma
Non-HPV-associated adenocarcinoma
Survival analysis
Nomograms
