Jia Mingzhu, Pi Jiangchuan, Zou Juan, Feng Min, Chen Huiling, Lin Changsheng, Yang Shuqi, Deng Ying, Xiao Xue
Department of Gynecology and Obstetrics, West China Second University Hospital, Sichuan University, Chengdu 610041, China.
Department of Urology, Chengdu Second People's Hospital, Chengdu 610041, China.
J Clin Med. 2023 Feb 3;12(3):1227. doi: 10.3390/jcm12031227.
Combining traditional clinical parameters with neuroendocrine markers to construct a nomogram model to predict the postoperative recurrence of neuroendocrine carcinoma of cervix (NECC).
A total of 257 patients were included in this study. Univariate and multivariate Cox regression analyses were used to establish a nomogram model in the training cohorts, which was further validated in the validation cohorts. The calibration curve was used to conduct the internal and external verification of the model.
Overall, 41 relapse cases were observed in the training (23 cases) and validation (18 cases) cohorts. The univariate analysis preliminarily showed that FIGO stage, stromal invasion, nerve invasion, lymph vascular space invasion, lymph node involvement, cervical-uterine junction invasion and CgA were correlated with NECC recurrence. The multivariate analysis further confirmed that FIGO stage ( = 0.023), stromal invasion ( = 0.002), lymph vascular space invasion ( = 0.039) and lymph node involvement ( = 0.00) were independent risk factors for NECC recurrence, which were ultimately included in the nomogram model. In addition, superior consistency indices were demonstrated in the training (0.863, 95% CI 0.784-0.942) and validation (0.884, 95% CI 0.758-1.010) cohorts.
The established nomogram model combining traditional clinical parameters with neuroendocrine markers can reliably and accurately predict the recurrence risks in NECC patients.
结合传统临床参数与神经内分泌标志物构建列线图模型,以预测宫颈神经内分泌癌(NECC)术后复发情况。
本研究共纳入257例患者。在训练队列中采用单因素和多因素Cox回归分析建立列线图模型,并在验证队列中进一步验证。采用校准曲线对模型进行内部和外部验证。
总体而言,在训练队列(23例)和验证队列(18例)中观察到41例复发病例。单因素分析初步显示,国际妇产科联盟(FIGO)分期、间质浸润、神经浸润、淋巴管间隙浸润、淋巴结受累、宫颈-子宫交界处浸润和嗜铬粒蛋白A(CgA)与NECC复发相关。多因素分析进一步证实,FIGO分期( = 0.023)、间质浸润( = 0.002)、淋巴管间隙浸润( = 0.039)和淋巴结受累( = 0.00)是NECC复发的独立危险因素,最终被纳入列线图模型。此外,训练队列(0.863,95%可信区间0.784 - 0.942)和验证队列(0.884,95%可信区间0.758 - 1.010)显示出较高的一致性指数。
所建立的结合传统临床参数与神经内分泌标志物的列线图模型能够可靠且准确地预测NECC患者的复发风险。