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列线图模型和风险评分预测霍奇金淋巴瘤患者的总生存并指导临床决策:一项基于 SEER 人群的观察性研究。

Nomogram model and risk score predicting overall survival and guiding clinical decision in patients with Hodgkin's lymphoma: an observational study using SEER population-based data.

机构信息

School of Laboratory Medicine, Hangzhou Medical College, Hangzhou, People's Republic of China.

Department of Reproductive Medical Center, Guangdong Women and Children Hospital, Guangzhou, People's Republic of China.

出版信息

BMJ Open. 2022 Jun 7;12(6):e055524. doi: 10.1136/bmjopen-2021-055524.

Abstract

INTRODUCTION

This study developed a prognostic nomogram of Hodgkin lymphoma (HL) for purpose of discussing independent risk factors for HL patients with Surveillance, Epidemiology and End Results (SEER) database.

METHODS

We collected data of HL patients from 2010 to 2015 from the SEER database and divided it into two cohorts: the training and the verification cohort. Then the univariate and the multivariate Cox regression analyses were conducted in the training, the verification as well as the total cohort, after which the intersection of variables with statistical significance was taken as independent risk factors to establish the nomogram. The predictive ability of the nomogram was validated by the Concordance Index. Additionally, the calibration curve and receiver operating characteristic curve were implemented to evaluate the accuracy and discrimination. Finally, we obtained 1-year, 3-year and 5-year survival rates of HL patients.

RESULTS

10 912 patients were eligible for the study. We discovered that Derived American Joint Committee on Cancer (AJCC) Stage Group, lymphoma subtype, radiotherapy and chemotherapy were four independent risk factors affecting the prognosis of HL patients. The 1-year, 3-year and 5-year survival rates for high-risk patients were 85.4%, 79.9% and 76.0%, respectively. It was confirmed that patients with stage I or II had a better prognosis. Radiotherapy and chemotherapy had a positive impact on HL outcomes. However, patients with lymphocyte-depleted HL were of poor prognosis.

CONCLUSIONS

The nomogram we constructed could better predict the prognosis of patients with HL. Patients with HL had good long-term outcomes but novel therapies are still in need for fewer complications.

摘要

简介

本研究旨在通过利用监测、流行病学和最终结果(SEER)数据库,为霍奇金淋巴瘤(HL)患者建立预后列线图,以探讨其独立危险因素。

方法

我们从 SEER 数据库中收集了 2010 年至 2015 年 HL 患者的数据,并将其分为两个队列:训练队列和验证队列。然后在训练、验证和总队列中进行单因素和多因素 Cox 回归分析,之后将具有统计学意义的变量交集作为独立危险因素建立列线图。采用一致性指数验证列线图的预测能力。此外,还进行了校准曲线和受试者工作特征曲线评估以评估准确性和区分度。最后,我们得到了 HL 患者的 1 年、3 年和 5 年生存率。

结果

共有 10912 名患者符合研究条件。我们发现,美国癌症联合委员会(AJCC)分期组、淋巴瘤亚型、放疗和化疗是影响 HL 患者预后的四个独立危险因素。高危患者的 1 年、3 年和 5 年生存率分别为 85.4%、79.9%和 76.0%。证实了Ⅰ期或Ⅱ期患者的预后较好。放疗和化疗对 HL 结局有积极影响。然而,淋巴细胞耗竭型 HL 患者预后较差。

结论

我们构建的列线图可以更好地预测 HL 患者的预后。HL 患者具有良好的长期预后,但仍需要新的治疗方法,以减少并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/432e/9174788/d53065041a38/bmjopen-2021-055524f01.jpg

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