| 方 瑜,滕 慧,孙 艳,等.预测子宫内膜癌根治术后生存的列线图模型[J].肿瘤学杂志,2023,29(7):573-579. |
| 预测子宫内膜癌根治术后生存的列线图模型 |
| Construction of A Nomogram for Predicting Survival of Patients with Endometrial Cancer After Radical Resection |
| 投稿时间：2023-04-02 |
| DOI：10.11735/j.issn.1671-170X.2023.07.B005 |
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| 中文关键词: 子宫内膜癌 根治术 生存率 列线图预测模型 比例危险度模型 |
| 英文关键词:endometrial carcinoma radical operation survival rate nomogram prediction model proportional hazard model |
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| 中文摘要: |
| 摘 要： ［目的］ 分析影响子宫内膜癌根治术后生存的相关因素，建立列线图预测模型。［方法］ 选取2013年8月至2015年8月收治的子宫内膜癌患者300例作为建模组，2015年9月至2016年9月收治的52例子宫内膜癌患者作为验证组。采用Kaplan-Meier法计算术后3年及5年生存率，Cox回归模型筛选术后生存率的独立影响因素。基于预后相关独立影响因素建立列线图预测模型。 ［结果］ 术后对300例患者实施5年随访，失访14例，286例患者3年、5年生存率分别为95.45%、86.71%。多因素Cox风险回归分析显示，手术病理分期、组织学分级、肌层浸润深度、淋巴结转移是子宫内膜癌患者术后生存率的独立危险因素（P＜0.05）。基于影响术后生存的危险因素建立列线图预测模型，列线图预测模型预测3年、5年生存率的ROC曲线下面积分别为0.859（95%CI：0.820~0.892）、0.849（95%CI：0.805~0.880）；校准曲线为斜率近似于1的直线。验证组列线图预测3年、5年生存率的ROC曲线下面积分别为0.858（95%CI：0.803~0.903）、0.827（95%CI：0.758~0.876）。Kaplan-Meier生存曲线结果显示，高危组患者5年生存率为78.63%，明显低于低危组患者的92.31%（P＜0.05）。［结论］ 基于子宫内膜癌根治术后生存率的影响因素建立列线图预测模型预测术后3年、5年生存率的区分度与一致性良好，可为子宫内膜癌的术后辅助治疗提供一定参考价值。 |
| 英文摘要: |
| Abstract： ［Objective］ To analyze the related factors affecting the survival of patients with endometrial carcinoma after radical resection and to construct a nomogram for survival prediction. ［Methods］ Three hundred patients with endometrial cancer admitted from August 2013 to August 2015 were selected as the training set， and 52 endometrial cancer patients admitted from September 2015 to September 2016 were selected as the validation set. Kaplan-Meier method was used to calculate postoperative 3-year and 5-year survival rates. Cox regression model was used to screen independent influencing factors for postoperative survival， based on which a prediction nomogram was developed and validated. ［Results］ In training set 286 patients were followed up after surgery for 5 years， and the 3-year survival rate and 5-year survival rate were 95.45% and 86.71%， respectively. Multivariate Cox regression analysis showed that surgical pathological stage， histological grade， depth of myometrial invasion and lymph node metastasis were independent risk factors for survival rate of patients with endometrial cancer after radical hysterectomy(P<0.05). A nomogram prediction model was established based on the above risk factors， the area under the ROC curve(AUC) of the nomogram for predicting 3-year and 5-year survival rate was 0.859(95%CI： 0.820~0.892) and 0.849(95%CI： 0.805~0.880)， respectively. The calibration curve was a straight line with slope of approximately 1. In the validation set the AUC for 3-year and 5-year survival was 0.858（95%CI：0.803~0.903） and 0.827（95%CI：0.758~0.876）， respectively. Kaplan-Meier survival curve showed that the 5-year survival rate of high-risk group was 78.63%， which was significantly lower than that of low-risk group(92.31%)(P<0.05). ［Conclusion］ The prediction nomogram based on the risk factors can effectively predict the 3-year and 5-year postoperative survival rates of patients with endometrial cancer，which is of certain reference value for postoperative adjuvant treatment of endometrial cancer. |
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