Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, People's Republic of China.
BMC Gastroenterol. 2022 Jul 16;22(1):347. doi: 10.1186/s12876-022-02419-2.
Primary gastric lymphoma (PGL) is the most common extranodal non-Hodgkin lymphoma (NHL). Due to the rarity of the disease, it is important to create a predictive model that provides treatment and prognosis for patients with PGL and physicians.
A total of 8898 and 127 patients diagnosed with PGL were obtained from the SEER database and from our Cancer Center as training and validation cohorts, respectively. Univariate and multivariate Cox proportional hazards models were used to investigate independent risk factors for the construction of predictive survival nomograms, and a web nomogram was developed for the dynamic prediction of survival of patients with PGL. The concordance index (C-index), calibration plot, and receiver operating characteristics (ROC) curve were used to evaluate and validate the nomogram models.
There were 8898 PGL patients in the SEER cohort, most of whom were married men over the age of 60, 16.1% of the primary tumors were localized in the antrum and pylori of the stomach, which was similar to the composition of 127 patients in the Chinese cohort, making both groups comparable. The Nomogram of overall survival (OS) was compiled based on eight variables, including age at diagnosis, sex, race, marital status, histology, stage, radiotherapy and chemotherapy. Cancer-specific survival (CSS) nomogram was developed with eight variables, including age at diagnosis, sex, marital status, primary tumor site, histology, stage, radiotherapy and chemotherapy. The C-index of OS prediction nomogram was 0.948 (95% CI: 0.901-0.995) in the validation cohort, the calibration plots showed an optimal match and a high area below the ROC curve (AUC) was observed in both training and validation sets. Also, we established the first web-based PGL survival rate calculator ( https://yangjinru.shinyapps.io/DynNomapp/ ).
The web dynamic nomogram provided an insightful and applicable tool for evaluating PGL prognosis in OS and CSS, and can effectively guide individual treatment and monitoring.
原发性胃淋巴瘤（PGL）是最常见的结外非霍奇金淋巴瘤（NHL）。由于该疾病罕见，因此为 PGL 患者和医生创建一个提供治疗和预后的预测模型非常重要。
从 SEER 数据库和我们的癌症中心分别获得了 8898 例和 127 例诊断为 PGL 的患者作为训练和验证队列。使用单变量和多变量 Cox 比例风险模型来研究独立的风险因素，以构建预测生存的列线图，并开发了一个用于动态预测 PGL 患者生存的网络列线图。使用一致性指数（C-index）、校准图和接受者操作特征（ROC）曲线来评估和验证列线图模型。
SEER 队列中有 8898 例 PGL 患者，其中大多数是 60 岁以上已婚男性，16.1%的原发肿瘤局限于胃的胃窦和幽门，这与中国队列的 127 例患者的构成相似，使两组具有可比性。基于 8 个变量（包括诊断时的年龄、性别、种族、婚姻状况、组织学、分期、放疗和化疗）编制了总体生存（OS）列线图。建立了癌症特异性生存（CSS）列线图，包含 8 个变量，包括诊断时的年龄、性别、婚姻状况、原发肿瘤部位、组织学、分期、放疗和化疗。OS 预测列线图的 C-index 在验证队列中为 0.948（95%CI：0.901-0.995），校准图显示了最佳匹配，并且在训练和验证集中均观察到 ROC 曲线下面积（AUC）较高。此外，我们建立了第一个基于网络的 PGL 生存率计算器（https://yangjinru.shinyapps.io/DynNomapp/）。
网络动态列线图为 OS 和 CSS 中的 PGL 预后评估提供了一个有洞察力和实用的工具，可以有效指导个体化治疗和监测。
