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预测宫颈癌患者盆腔淋巴结转移及预后的列线图的开发与验证

Development and validation of a nomogram for predicting pelvic lymph node metastasis and prognosis in patients with cervical cancer.

作者信息

Wang Mengting, Ma Min, Yang Liju, Liang Chengtong

机构信息

Department of Obstetrics and Gynecology, The Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, Jiangsu Province, China.

Department of Laboratory Medicine, Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu Province, China.

出版信息

Front Oncol. 2022 Sep 2;12:952347. doi: 10.3389/fonc.2022.952347. eCollection 2022.

Abstract

OBJECTIVE

Cervical cancer (CC) is one of the main causes of death among gynecological malignancies. Patients with CC with lymph node metastasis (LNM) have poor prognoses. We investigated the risk factors and prognosis of LNM in patients with CC patients using data from the SEER database.

METHODS

We collected the information of cervical cancer patients registered in SEER database from 2010 to 2015. The dataset was divided into a training set and a validation set at a 7:3 ratio. LASSO regression analysis was used to evaluate risk factors for LNM in patients with CC. Using the results, we established a nomogram prediction model. C-index, ROC curves, calibration curves, decision curve analysis, and clinical impact curves were used to evaluate the prediction performance of the model.

RESULTS

We included 14,356 patients with CC in the analysis. Among these, 3997 patients were diagnosed with LNM. A training set (10,050 cases) and a validation set (4306 cases) were used for the following analysis. We established nomogram LNM prediction models for the patients with T-stage CC. The C-indices for the internal and external validations of the prediction models were 0.758 and 0.744, respectively. In addition, we established a prognostic nomogram for all CC patients with LNM, and the internal and external validation C-indices were 0.763 and 0.737.

CONCLUSION

We constructed a quantitative and visual predictive nomogram that predicted prognosis of patients with LNM in CC to provide clinicians with a reference for diagnosis and treatment.

摘要

目的

宫颈癌(CC)是妇科恶性肿瘤的主要死因之一。发生淋巴结转移(LNM)的CC患者预后较差。我们使用监测、流行病学和最终结果(SEER)数据库的数据,调查了CC患者发生LNM的危险因素和预后情况。

方法

我们收集了2010年至2015年在SEER数据库中登记的宫颈癌患者信息。数据集按7:3的比例分为训练集和验证集。采用LASSO回归分析评估CC患者发生LNM的危险因素。根据结果,我们建立了列线图预测模型。采用C指数、ROC曲线、校准曲线、决策曲线分析和临床影响曲线来评估模型的预测性能。

结果

我们纳入了14356例CC患者进行分析。其中,3997例患者被诊断为LNM。使用训练集(10050例)和验证集(4306例)进行以下分析。我们为T分期CC患者建立了列线图LNM预测模型。预测模型内部验证和外部验证的C指数分别为0.758和0.744。此外,我们为所有发生LNM的CC患者建立了预后列线图,内部验证和外部验证的C指数分别为0.763和0.737。

结论

我们构建了一个定量且直观的预测列线图,可预测CC患者发生LNM的预后情况,为临床医生的诊断和治疗提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cbb/9479219/2ab98d072b09/fonc-12-952347-g001.jpg

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