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阳性淋巴结数量联合阳性淋巴结对数比值可预测非转移性喉鳞状细胞癌患者的生存情况。

Number of Positive Lymph Nodes Combined with the Logarithmic Ratio of Positive Lymph Nodes predicts Survival in Patients with Non-Metastatic Larynx Squamous Cell Carcinoma.

作者信息

Wang Qiyue, Tan Zhuo, Zheng Chuanming, Wang Jiafeng, Zheng Guowan, Huang Ping, Zhang Yiwen, Ge Minghua

机构信息

Jinzhou Medical University, Department of postgraduate education, Jinzhou, Liaoning Province, China.

ENT-Head and Neck Surgery Center, Department of Head and Neck Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China.

出版信息

J Cancer. 2022 Mar 14;13(6):1773-1784. doi: 10.7150/jca.67348. eCollection 2022.

Abstract

Logarithmic ratio of positive lymph nodes (LODDS), number of positive lymph nodes (NPLN), and number of lymph nodes to positive lymph nodes (pLNR) are three lymph node classifications; however, their function in prognosis is unclear. To establish and validate an optimal nomogram according to the comparison among the 7 TNM stage of American Joint Committee on Cancer (AJCC) and the three lymph node classifications. A total of 881 patients from the Surveillance, Epidemiology and End Result (SEER database) with TNM in laryngeal squamous cell carcinoma from 2000 to 2018 were involved. The enrolled patients were allocated randomly into a training cohort and a validation cohort. Univariate cox regression analysis and multivariable cox regression analysis were applied to explore the predictors. The Akaike Information Criterion (AIC) and Harrell's concordance index (C-index) were to measure the predictive value and the accuracy of the prognostic models. Moreover, integrated discrimination improvement (IDI) and net reclassification index (NRI) were also used to assess the predictive abilities to models. According to the optimal model, nomograms were established and compared with 7 TNM stage of AJCC via the decision curve analysis. NPLN, LODDS, and pLNR were three predictors for the overall and cancer-specific survival in the larynx squamous cell carcinoma. According to the AIC, C-index, IDI, and NRI, the model of NPLN combined with LODDS was assumed as the optimal prognostic model. Moreover, the decision curve analysis suggested that the nomogram demonstrated a better predictive performance, compared with the 7 AJCC TNM stage. The proposed nomograms we constructed for larynx squamous cell carcinoma has potential in the prediction of patients after surgery.

摘要

阳性淋巴结对数比(LODDS)、阳性淋巴结数量(NPLN)以及淋巴结与阳性淋巴结数量之比(pLNR)是三种淋巴结分类;然而,它们在预后中的作用尚不清楚。为了根据美国癌症联合委员会(AJCC)的7期TNM分期与这三种淋巴结分类之间的比较来建立和验证最佳列线图。纳入了2000年至2018年来自监测、流行病学和最终结果(SEER数据库)的881例喉鳞状细胞癌TNM患者。将纳入的患者随机分为训练队列和验证队列。应用单变量Cox回归分析和多变量Cox回归分析来探索预测因素。采用赤池信息准则(AIC)和哈雷尔一致性指数(C指数)来衡量预后模型的预测价值和准确性。此外,还使用综合判别改善(IDI)和净重新分类指数(NRI)来评估模型的预测能力。根据最佳模型,建立列线图并通过决策曲线分析与AJCC的7期TNM分期进行比较。NPLN、LODDS和pLNR是喉鳞状细胞癌总生存和癌症特异性生存的三个预测因素。根据AIC、C指数、IDI和NRI,NPLN联合LODDS模型被认为是最佳预后模型。此外,决策曲线分析表明,与AJCC的7期TNM分期相比,列线图具有更好的预测性能。我们构建的用于喉鳞状细胞癌的列线图在预测术后患者方面具有潜力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cddd/8990420/65a7385788ee/jcav13p1773g001.jpg

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