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淋巴结阳性数量与阳性淋巴结对数比值联合预测手术治疗后淋巴结阳性腮腺癌患者的长期生存:一项 SEER 人群研究。

Number of positive lymph nodes combined with the logarithmic ratio of positive lymph nodes predicts long-term survival for patients with node-positive parotid gland carcinoma after surgery: a SEER population-based study.

机构信息

Department of Otolaryngology, Fujian Medical University Union Hospital, No. 29, Xinquan Road, Fuzhou, 350001, Fujian, China.

出版信息

Eur Arch Otorhinolaryngol. 2023 May;280(5):2541-2550. doi: 10.1007/s00405-023-07848-7. Epub 2023 Jan 30.

Abstract

PURPOSE

To evaluate the prognostic value of the number of positive lymph nodes (NPLN), the ratio of positive lymph nodes (pLNR), and the logarithmic ratio of positive lymph nodes (LODDS) in patients with parotid gland carcinoma. On this basis, establishing and validating an optimal nomogram.

METHODS

A total of 895 patients with T1-4N1-3M0 parotid gland carcinoma were included in our study from the Surveillance, Epidemiology, and End Results (SEER) database. Patients' data were randomly assigned to the training cohort and the validation cohort by a ratio of 7:3. Univariate and multivariate COX regression analysis were used to explore the relationship between the study factors and the prognosis of parotid gland carcinoma, including overall survival (OS) and cause-specific survival (CSS). The Akaike Information Criterion (AIC) was used to evaluate model fit. Harrell's concordance index (C-index), integrated discrimination improvement (IDI), and net reclassification index (NRI) were used to evaluate the predictive ability of these models. The decision curve analysis was used to evaluate the clinical benefit of the nomograms compared with the TNM stage.

RESULTS

NPLN, pLNR, and LODDS are independent risk factors for the prognostic of PGC. According to the AIC, C index, IDI, and NRI, the models combined with NPLN and LODDS were the best. The decision curves suggested that our nomograms had good predictive abilities for the prognosis of parotid gland carcinoma.

CONCLUSION

The two nomograms which contained NPLN and LODDS had the potential to predict OS and CSS in patients with parotid gland carcinoma.

摘要

目的

评估阳性淋巴结数量(NPLN)、阳性淋巴结比例(pLNR)和阳性淋巴结对数比(LODDS)在腮腺癌患者中的预后价值。在此基础上建立并验证最优列线图。

方法

本研究纳入了来自监测、流行病学和最终结果(SEER)数据库的 895 例 T1-4N1-3M0 腮腺癌患者。患者数据按 7:3 的比例随机分配到训练队列和验证队列中。采用单因素和多因素 COX 回归分析探讨研究因素与腮腺癌总生存(OS)和特定原因生存(CSS)之间的关系。Akaike 信息准则(AIC)用于评估模型拟合度。Harrell 一致性指数(C-index)、综合判别改善(IDI)和净重新分类指数(NRI)用于评估这些模型的预测能力。决策曲线分析用于评估列线图与 TNM 分期相比的临床获益。

结果

NPLN、pLNR 和 LODDS 是 PGC 预后的独立危险因素。根据 AIC、C 指数、IDI 和 NRI,联合 NPLN 和 LODDS 的模型是最佳的。决策曲线表明我们的列线图对腮腺癌的预后具有良好的预测能力。

结论

包含 NPLN 和 LODDS 的两个列线图具有预测腮腺癌患者 OS 和 CSS 的潜力。

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