基于 SEER 数据库的预测口腔舌部角化鳞状细胞癌患者生存的列线图。
A nomogram for predicting survival in Patients with oral tongue keratinized squamous cell carcinoma: A SEER-based study.
机构信息
The First Clinical Medical College, Lanzhou University, Lanzhou,730000, China; School/Hospital of Stomatology, Lanzhou university, Lanzhou,730000, China.
School/Hospital of Stomatology, Lanzhou university, Lanzhou,730000, China.
出版信息
J Stomatol Oral Maxillofac Surg. 2023 Sep;124(4):101422. doi: 10.1016/j.jormas.2023.101422. Epub 2023 Feb 11.
OBJECTIVE
Oral tongue keratinized squamous cell carcinoma (OTKSCC), a relatively rare form of tongue cancer (TC) in clinical practice, accompanied by features of cell keratosis, is an uncommon histological subtype. However, its specific clinicopathological features and prognosis have not been adequately described. In this study, we aimed to create a nomogram using R language software to predict overall survival (OS) of patients with OTKSCC to assess the prognosis of OTKSCC patients.
METHODS
We extracted clinical and related prognostic data of OTKSCC patients from 1975 to 2019 from the Surveillance, Epidemiology, and End Results database. Independent prognostic factors were selected using univariate and multivariate Cox analyses, and a nomogram was constructed using R software. The C-index, area under the curve (AUC) of receiver operating characteristic curves, calibration curves, and decision curve analysis (DCA) were used to assess the clinical utility of the nomogram. Finally, OS was assessed using the Kaplan-Meier method.
RESULTS
A total of 2450 OTKSCC patients were included in the study. Univariate and multivariate Cox regression analyses were used to identify age, T stage, N stage, surgery, and radiation therapy as independent risk factors (p<0.05). In the training cohort, the calibration index of the nomogram was 0.725, while the AUC values for nomogram, age, T stage, N stage, surgery and radiation therapy were 0.878, 0.639, 0.781, 0.661, 0.724 and 0.354, respectively. At the same time, in the verification queue, the calibration index of the nomogram was 0.726, while the AUC values for nomogram, age, T stage, N stage, surgery and radiation therapy were 0.859,0.612,0.826,0.675,0.758 and 0.303, respectively. Ideal uniformity of the models from the training and validation cohorts was demonstrated in the calibration and DCA curves. Univariate survival analysis showed that age, T stage, N stage, surgery, and radiotherapy were statistically significant for prognosis (p<0.05).
CONCLUSION
Age, T stage, N stage, surgery, and radiation therapy are independently associated with the OS, and the established nomogram is an effective visualization tool for predicting the OS of OTKSCC patients.
目的
口腔舌角化鳞状细胞癌（OTKSCC）是临床实践中一种相对罕见的舌癌（TC）形式，伴有细胞角化特征，是一种罕见的组织学亚型。然而，其特定的临床病理特征和预后尚未得到充分描述。在本研究中，我们旨在使用 R 语言软件创建一个列线图，以预测 OTKSCC 患者的总生存期（OS），从而评估 OTKSCC 患者的预后。
方法
我们从 1975 年至 2019 年从监测、流行病学和最终结果数据库中提取了 OTKSCC 患者的临床和相关预后数据。使用单因素和多因素 Cox 分析选择独立的预后因素，并使用 R 软件构建列线图。使用 C 指数、受试者工作特征曲线（ROC）下面积（AUC）、校准曲线和决策曲线分析（DCA）评估列线图的临床实用性。最后，使用 Kaplan-Meier 方法评估 OS。
结果
共纳入 2450 例 OTKSCC 患者。单因素和多因素 Cox 回归分析确定年龄、T 分期、N 分期、手术和放疗为独立危险因素（p<0.05）。在训练队列中，列线图的校准指数为 0.725，而列线图、年龄、T 分期、N 分期、手术和放疗的 AUC 值分别为 0.878、0.639、0.781、0.661、0.724 和 0.354。同时，在验证队列中，列线图的校准指数为 0.726，而列线图、年龄、T 分期、N 分期、手术和放疗的 AUC 值分别为 0.859、0.612、0.826、0.675、0.758 和 0.303。训练和验证队列的模型校准和 DCA 曲线显示了理想的均匀性。单因素生存分析显示，年龄、T 分期、N 分期、手术和放疗对预后有统计学意义（p<0.05）。
结论
年龄、T 分期、N 分期、手术和放疗与 OS 独立相关，建立的列线图是预测 OTKSCC 患者 OS 的有效可视化工具。
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