Wang Feng, Gao Shu-Geng, Xue Qi, Tan Feng-Wei, Gao Yu-Shun, Wang Da-Li, Mao You-Sheng, Zhao Jun, Li Yin, Yu Xiang-Yang, Cheng Hong, Zhao Chen-Guang, Yang Ding, Mu Ju-Wei
Department of Thoracic Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
J Thorac Dis. 2021 Mar;13(3):1315-1326. doi: 10.21037/jtd-20-3084.
The purpose of this study was to explore the prognostic factors of oesophageal signet ring cell (SRC) carcinoma and to construct a nomogram for predicting the outcome of SRC carcinoma of oesophagus.
A total of 968 cases of oesophageal SRC carcinoma were extracted from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2016. Cases were divided into training cohort and validation cohort. Univariate and multivariable Cox analyses was performed to select the predictors of overall survival (OS for the nomogram. The performance of nomogram was validated with Harrell's concordance index (C-index), calibration curves and decision curve analysis (DCA).
The 1- and 5-year OS in the training cohort were 0.446 and 0.146, respectively, and the 1- and 5-year OS in the validation cohort were 0.459 and 0.138. The independent prognostic factors for establishing the nomogram were marital status, invasion of the surrounding tissue, lymph node metastasis, distant metastasis, surgery and chemotherapy. The Harrell's c-index value of the training cohort and validation cohort were 0.723 and 0.708. In the calibration curves, the predicted survival probability and the actual survival probability have a considerable consistency. DCA indicated the favourable potential clinical utility of the nomogram.
A nomogram to predict the OS of patients with oesophageal SRC carcinoma was established. The validation of the nomogram fully demonstrates its great performance.
本研究旨在探讨食管印戒细胞（SRC）癌的预后因素，并构建用于预测食管SRC癌预后的列线图。
从2004年至2016年的监测、流行病学和最终结果（SEER）数据库中提取了968例食管SRC癌病例。将病例分为训练队列和验证队列。进行单因素和多因素Cox分析以选择总生存（OS）的预测因素用于列线图。通过Harrell一致性指数（C指数）、校准曲线和决策曲线分析（DCA）验证列线图的性能。
训练队列中的1年和5年总生存率分别为0.446和0.146，验证队列中的1年和5年总生存率分别为0.459和0.138。用于构建列线图的独立预后因素为婚姻状况、周围组织侵犯、淋巴结转移、远处转移、手术和化疗。训练队列和验证队列的Harrell C指数值分别为0.723和0.708。在校准曲线中，预测生存概率与实际生存概率具有相当的一致性。DCA表明列线图具有良好的潜在临床应用价值。
建立了一种预测食管SRC癌患者总生存的列线图。列线图的验证充分证明了其良好的性能。
