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预测阑尾来源的假性黏液瘤腹膜假性黏液瘤患者总生存期的列线图:一项回顾性队列研究。

Nomogram to predict overall survival of patients with pseudomyxoma peritonei of appendiceal origin: A retrospective cohort study.

机构信息

Department of Clinical Laboratory, Aerospace Center Hospital, Beijing, China.

Department of Myxoma, Aerospace Center Hospital, Beijing, China.

出版信息

J Surg Oncol. 2021 Dec;124(8):1459-1467. doi: 10.1002/jso.26671. Epub 2021 Oct 11.

Abstract

BACKGROUND

Pseudomyxoma peritonei (PMP) is a rare disease, with the rate of overall survival (OS) influenced by many factors. The present study aimed to define independent predictors and establish a nomogram for individual risk prediction in PMP patients.

METHODS

One hundred forty-seven PMP patients were consecutively included between June 1, 2013, and November 22, 2019. The log-rank test was used to compare the OS rate between groups; subsequently, variables with p < .10 were subjected to multivariate Cox modeling for defining independent prediction indicators. Finally, a nomogram was established based on independent prognosticators and assessed for internal validation.

RESULTS

Multivariate Cox analysis showed that D-dimer level, carbohydrate antigen (CA) 125 level, CA 19-9 level, degree of radical surgery, and histological grade were all independently associated with OS in PMP patients. A nomogram was plotted and underwent internal validation. The discrimination ability of the nomogram revealed a good predictive ability as indicated by the C-index value (0.825), and calibration plots confirmed good consistency between the predicted and observed survival probabilities.

CONCLUSIONS

Five independent prognostic factors for predicting the survival of PMP patients were identified, and the nomogram based on these independent indicators showed a reasonable discrimination ability for individual risk prediction.

摘要

背景

假性黏液瘤腹膜(PMP)是一种罕见疾病,总生存率(OS)受多种因素影响。本研究旨在确定独立预测因子,并为 PMP 患者建立个体风险预测的列线图。

方法

2013 年 6 月 1 日至 2019 年 11 月 22 日连续纳入 147 例 PMP 患者。使用对数秩检验比较各组的 OS 率;随后,对 p<.10 的变量进行多变量 Cox 建模,以确定独立的预测指标。最后,基于独立预后因素建立列线图,并进行内部验证。

结果

多变量 Cox 分析显示,D-二聚体水平、糖链抗原(CA)125 水平、CA 19-9 水平、根治性手术程度和组织学分级均与 PMP 患者的 OS 独立相关。绘制了列线图并进行了内部验证。列线图的判别能力显示出良好的预测能力,C 指数值为 0.825,校准图证实了预测和观察生存概率之间的良好一致性。

结论

确定了 5 个预测 PMP 患者生存的独立预后因素,基于这些独立指标的列线图对个体风险预测具有合理的判别能力。

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