摘要
目的分析胆囊鳞癌和腺鳞癌的预后影响因素并构建预后预测模型。方法回顾性分析2012年1月至2021年12月东方肝胆外科医院行外科手术切除的114例胆囊鳞癌及腺鳞癌患者的临床资料。通过单因素和多因素Cox回归分析确定胆囊鳞癌和腺鳞癌的预后影响因素,并构建列线图(Nomogram)预测模型。应用C-指数、ROC曲线以及校准曲线对模型进行评估。结果单因素分析结果提示,T分期、TNM分期、切缘性质、血管侵犯、联合肝切除、淋巴结清扫是胆囊鳞癌和腺鳞癌患者术后生存的影响因素。多因素Cox回归分析提示,只有T分期、联合肝切除是鳞癌和腺鳞癌患者术后生存的重要影响因素,此时赤池信息测量准则(AIC)值最小(720.66),并据此建立胆囊鳞癌和腺鳞癌Nomogram预测模型。该模型C-指数为0.614(95%Ci 0.585~0.643)。1年、2年、3年ROC曲线下面积分别为0.605、0.598、0.592。校准曲线图可见实际观测值与预测值具有较好的一致性。结论T分期、联合肝切除是胆囊鳞癌和腺鳞癌患者术后生存的重要影响因素,据此建立的Nomogram具有一定的区分度和准确度,有一定的临床参考价值。
objective To develop a Nomogram to predict the overall survival(OS)of patients with gallbladder squamous or adenosquamous carcinoma.Methods The clinical data of 114 patients with gallbladder squamous or adenosquamous carcinoma who underwent surgical resection in Eastern Hepatobiliary Surgery Hospital between Jan.2012 and Dec.2021 were retrospectively analyzed.Univariate and multivariate Cox analyses were used to explore the independent prognostic factors and to establish a Nomogram.The C-index,ROC curve,and calibration curves were used to evaluate the Nomogram.Results Univariate Cox analysis showed that,T classification,TNM stage,resection margin,vascular invasion,combined hepatectomy,and lymphadenectomy were prognostic factors associated with OS.T classification and combined hepatectomy were two important prognostic variables furtherly confirmed by multivariate Cox analysis.A Nomogram was constructed successfully based on the T classification and combined hepatectomy and the Akaike information critertion(AIC)value was the lowest(720.66).The C-index of the Nomogram was 0.614(95%Ci 0.585-0.643).The AUCs were 0.605,0.598,and 0.592 for predicting 1-,2-,and 3-year OS,respectively.The calibration curve revealed that the Nomogram had a good ability to predict OS.Conclusion T classification and hepatectomy are confirmed as critital prognostic variables for OS.The Nomogram based on T classification and combined hepatectomy provides certain discrimination and accuracy.
作者
谢智华
刘明奇
王敬晗
张吉祥
于勇
施学兵
李炜
储开健
葛瑞良
程庆保
姜小清
Xie Zhihua;Liu Mingqi;Wang Jinghan;Zhang Jixiang;Yu Yong;Shi Xuebing;Li Wei;Chu Kaijian;GE Ruiliang;Cheng Qingbao;Jiang Xiaoqing(Department of Biliary Tract Surgery I,Eastern Hepatobiliary Surgery Hospital,Naval Medical University,Shanghai 200438,China;Department of Hepatobiliary and Pancreatic Surgery,East Hospital,Tongji University,Shanghai 200120,China)
出处
《肝胆胰外科杂志》
CAS
2023年第2期90-95,共6页
Journal of Hepatopancreatobiliary Surgery
基金
国家自然科学基金项目(81972256)。
关键词
胆囊鳞癌
胆囊腺鳞癌
临床病理特征
列线图
预测模型
gallbladder squamous carcinoma
gallbladder adenosquamous carcinoma
clinicopathological characteristics
Nomogram
prediction model
