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用于预测老年肝细胞癌患者生存情况的预后评分模型的开发。

Development of a prognostic scoring model for predicting the survival of elderly patients with hepatocellular carcinoma.

作者信息

Wan Sizhe, Nie Yuan, Zhu Xuan

机构信息

Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Nanchang, China.

出版信息

PeerJ. 2020 Feb 4;8:e8497. doi: 10.7717/peerj.8497. eCollection 2020.

Abstract

BACKGROUND

The number of elderly hepatocellular carcinoma (HCC) patients is increasing, and precisely assessing of the prognosis of these patients is necessary. We developed a prognostic scoring model to predict survival in elderly HCC patients.

METHODS

We extracted data from 4,076 patients ≥65 years old from the Surveillance, Epidemiology, and End Results (SEER) database and randomly divided them into training and validation groups. Cox regression analysis was used to screen for meaningful independent prognostic factors. The receiver operating characteristic curve reflected the model's discrimination power.

RESULTS

Age, race, American Joint Committee on Cancer stage, degree of tumour differentiation, tumour size, alpha-fetoprotein and tumour therapy were independent prognostic factors for survival in elderly HCC patients. We developed a prognostic scoring model based on the seven meaningful variables to predict survival in elderly HCC patients. The AUCs of the model were 0.805 (95% CI [0.788-0.821]) and 0.788 (95% CI [0.759-0.816]) in the training and validation groups, respectively. We divided the patients into low-risk groups and high-risk groups according to the optimal cut-off value. The Kaplan-Meier survival curve showed that in the training and validation groups, the survival rate of the low-risk group was significantly higher than that of the high-risk group ( < 0.001).

CONCLUSION

Based on a large population, we constructed a prognostic scoring model for predicting survival in elderly HCC patients. The model may provide a reference for clinicians for preoperative and postoperative evaluations of elderly HCC patients.

摘要

背景

老年肝细胞癌(HCC)患者数量不断增加,准确评估这些患者的预后很有必要。我们开发了一种预后评分模型来预测老年HCC患者的生存情况。

方法

我们从监测、流行病学和最终结果(SEER)数据库中提取了4076例年龄≥65岁患者的数据,并将他们随机分为训练组和验证组。采用Cox回归分析筛选有意义的独立预后因素。受试者工作特征曲线反映了模型的辨别能力。

结果

年龄、种族、美国癌症联合委员会分期、肿瘤分化程度、肿瘤大小、甲胎蛋白和肿瘤治疗是老年HCC患者生存的独立预后因素。我们基于这七个有意义的变量开发了一种预后评分模型来预测老年HCC患者的生存情况。该模型在训练组和验证组中的曲线下面积(AUC)分别为0.805(95%可信区间[0.788 - 0.821])和0.788(95%可信区间[0.759 - 0.816])。我们根据最佳临界值将患者分为低风险组和高风险组。Kaplan-Meier生存曲线显示,在训练组和验证组中,低风险组的生存率显著高于高风险组(P < 0.001)。

结论

基于大量人群,我们构建了一种预测老年HCC患者生存情况的预后评分模型。该模型可为临床医生对老年HCC患者进行术前和术后评估提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a988/7006515/50013fd8af1d/peerj-08-8497-g001.jpg

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