Ren Chao, Ma Yifei, Jin Jiabin, Ding Jiachun, Jiang Yina, Wu Yinying, Li Wei, Yang Xue, Han Liang, Ma Qingyong, Wu Zheng, Shi Yusheng, Wang Zheng
Department of Hepatobiliary and Pancreatic Surgery, The Affiliated Jinhua Hospital of Zhejiang University School of Medicine, Jinhua, China.
Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Front Oncol. 2022 Aug 12;12:927107. doi: 10.3389/fonc.2022.927107. eCollection 2022.
We aimed to develop a nomogram to predict the survival and prognosis of adenosquamous carcinoma of the pancreas (ASCP).
Adenosquamous carcinoma of the pancreas (ASCP) is a relatively rare histological subtype of pancreatic exocrine neoplasms. It was reported a worse survival in ASCP than in pancreatic adenocarcinoma (PDAC). Prediction of ASCP prognosis is of great importance.
Histologically confirmed ASCP patients from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) Program database were finally enrolled and divided into development and internal validation cohorts. Moreover, a multi-center cohort of 70 patients from China was registered as the external validation. A nomogram was developed based on independent predictors of ASCP determined in multivariable analysis.
A total of 233 patients from SEER were finally included. Univariate and Multivariate analysis showed that tumor size, radiotherapy, chemotherapy, and lymph node ratio (LNR) were considered the independent prognostic indicators. We developed a nomogram according to these four parameters. The C index of the nomogram in the development cohort was 0.696. Through analysis of the area under the curve (AUC) of the different cohorts, we observed that the predictive efficacy of the nomogram for 1-, and 2-year overall survival (OS) were better than those of the American Joint Committee on Cancer (AJCC) TNM (8) staging system both in the development and validation cohort. External validation confirmed that 1-year survival is 67.2% vs. 29.7%, similar to the internal cohort analysis.
The nomogram showed good performance in predicting the survival of ASCP. It could help surgeons to make clinical decisions and develop further plans.
我们旨在开发一种列线图，以预测胰腺腺鳞癌（ASCP）的生存和预后。
胰腺腺鳞癌（ASCP）是胰腺外分泌肿瘤中一种相对罕见的组织学亚型。据报道，ASCP的生存率比胰腺腺癌（PDAC）更差。预测ASCP的预后非常重要。
最终纳入了来自美国国家癌症研究所监测、流行病学和最终结果（SEER）计划数据库中经组织学确诊的ASCP患者，并将其分为开发队列和内部验证队列。此外，来自中国的70例患者的多中心队列被登记作为外部验证。基于多变量分析确定的ASCP独立预测因素开发了一种列线图。
最终纳入了来自SEER的233例患者。单因素和多因素分析表明，肿瘤大小、放疗、化疗和淋巴结比率（LNR）被认为是独立的预后指标。我们根据这四个参数开发了一种列线图。开发队列中列线图的C指数为0.696。通过分析不同队列的曲线下面积（AUC），我们观察到在开发队列和验证队列中，列线图对1年和2年总生存期（OS）的预测效能均优于美国癌症联合委员会（AJCC）TNM（第8版）分期系统。外部验证证实1年生存率为67.2% 对29.7%，与内部队列分析相似。
该列线图在预测ASCP的生存方面表现良好。它可以帮助外科医生做出临床决策并制定进一步的计划。
