基于 SEER 的人群研究:预测胰腺导管腺癌远处转移的列线图。
Nomogram for Predicting Distant Metastasis of Pancreatic Ductal Adenocarcinoma: A SEER-Based Population Study.
机构信息
Department of General Surgery, Renmin Hospital of Wuhan University, Wuhan 430060, China.
Department of General Surgery, The First Affiliated Hospital of the University of Science and Technology of China, Hefei 230001, China.
出版信息
Curr Oncol. 2022 Oct 28;29(11):8146-8159. doi: 10.3390/curroncol29110643.
(1) Background: The aim of this study was to identify risk factors for distant metastasis of pancreatic ductal adenocarcinoma (PDAC) and develop a valid predictive model to guide clinical practice; (2) Methods: We screened 14328 PDAC patients from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. Lasso regression analysis combined with logistic regression analysis were used to determine the independent risk factors for PDAC with distant metastasis. A nomogram predicting the risk of distant metastasis in PDAC was constructed. A receiver operating characteristic (ROC) curve and consistency-index (C-index) were used to determine the accuracy and discriminate ability of the nomogram. A calibration curve was used to assess the agreement between the predicted probability of the model and the actual probability. Additionally, decision curve analysis (DCA) and clinical influence curve were employed to assess the clinical utility of the nomogram; (3) Results: Multivariate logistic regression analysis revealed that risk factors for distant metastasis of PDAC included age, primary site, histological grade, and lymph node status. A nomogram was successfully constructed, with an area under the curve (AUC) of 0.871 for ROC and a C-index of 0.871 (95% CI: 0.860-0.882). The calibration curve showed that the predicted probability of the model was in high agreement with the actual predicted probability. The DCA and clinical influence curve showed that the model had great potential clinical utility; (4) Conclusions: The risk model established in this study has a good predictive performance and a promising potential application, which can provide personalized clinical decisions for future clinical work.
(1) 背景:本研究旨在确定胰腺导管腺癌(PDAC)远处转移的危险因素,并建立有效的预测模型以指导临床实践;(2) 方法:我们从 2010 年至 2015 年的监测、流行病学和最终结果(SEER)数据库中筛选出 14328 例 PDAC 患者。使用套索回归分析结合逻辑回归分析确定 PDAC 远处转移的独立危险因素。构建预测 PDAC 远处转移风险的列线图。通过受试者工作特征(ROC)曲线和一致性指数(C 指数)来确定列线图的准确性和区分能力。校准曲线用于评估模型预测概率与实际概率之间的一致性。此外,还采用决策曲线分析(DCA)和临床影响曲线来评估列线图的临床实用性;(3) 结果:多因素逻辑回归分析显示,PDAC 远处转移的危险因素包括年龄、原发部位、组织学分级和淋巴结状态。成功构建了一个列线图,ROC 曲线下面积(AUC)为 0.871,C 指数为 0.871(95%CI:0.860-0.882)。校准曲线表明,模型的预测概率与实际预测概率高度一致。DCA 和临床影响曲线表明,该模型具有很大的潜在临床应用价值;(4) 结论:本研究建立的风险模型具有良好的预测性能和有前途的潜在应用,可为未来的临床工作提供个性化的临床决策。