Wang Dan, Shi Xin-Lin, Xu Wei, Shi Rui-Hua
Medical School, Southeast University, Nanjing 210009, Jiangsu Province, China.
Department of Gastroenterology, Zhongda Hospital, Affiliated Hospital of Southeast University, Nanjing 210009, Jiangsu Province, China.
World J Gastrointest Oncol. 2023 Mar 15;15(3):533-545. doi: 10.4251/wjgo.v15.i3.533.
Increasingly extranodal marginal B-cell lymphoma of mucosa-associated lymphoid tissue, known as mucosa-associated lymphoid tissue (MALT) lymphoma, is a type of non-Hodgkin's lymphoma. The prognosis of primary gastric MALT (GML) patients can be affected by many factors. Clinical risk factors, including age, type of therapy, sex, stage and family hematologic malignancy history, also have significant effects on the development of the disease. The available data are mainly focused on epidemiology; in contrast, few studies have investigated the prognostic variables for overall survival (OS) in patients with primary GML. Based on the realities above, we searched a large amount of data on patients diagnosed with primary GML in the Surveillance, Epidemiology and End Results (SEER) database. The aim was to develop and verify a survival nomogram model that can predict the overall survival prognosis of primary GML by combining prognostic and determinant variables.
To create an effective survival nomogram for patients with primary gastric GML.
All data of patients with primary GML from 2004 to 2015 were collected from the SEER database. The primary endpoint was OS. Based on the LASSO and COX regression, we created and further verified the accuracy and effectiveness of the survival nomogram model by the concordance index (C-index), calibration curve and time-dependent receiver operating characteristic (td-ROC) curves.
A total of 2604 patients diagnosed with primary GML were selected for this study. A total of 1823 and 781 people were randomly distributed into the training and testing sets at a ratio of 7:3. The median follow-up of all patients was 71 mo, and the 3- and 5-year OS rates were 87.2% and 79.8%, respectively. Age, sex, race, Ann Arbor stage and radiation were independent risk factors for OS of primary GML (all < 0.05). The C-index values of the nomogram were 0.751 (95%CI: 0.729-0.773) and 0.718 (95%CI: 0.680-0.757) in the training and testing cohorts, respectively, showing the good discrimination ability of the nomogram model. Td-ROC curves and calibration plots also indicated satisfactory predictive power and good agreement of the model. Overall, the nomogram shows favorable performance in discriminating and predicting the OS of patients with primary GML.
A nomogram was developed and validated to have good survival predictive performance based on five clinical independent risk factors for OS for patients with primary GML. Nomograms are a low-cost and convenient clinical tool in assessing individualized prognosis and treatment for patients with primary GML.
黏膜相关淋巴组织边缘区B细胞淋巴瘤（也称为黏膜相关淋巴组织（MALT）淋巴瘤）是一种非霍奇金淋巴瘤，其发病率日益增加。原发性胃MALT（GML）患者的预后可能受多种因素影响。临床风险因素，包括年龄、治疗类型、性别、分期和家族血液系统恶性肿瘤病史，也对该疾病的发展有显著影响。现有数据主要集中在流行病学方面；相比之下，很少有研究调查原发性GML患者总生存期（OS）的预后变量。基于上述现实情况，我们在监测、流行病学和最终结果（SEER）数据库中搜索了大量诊断为原发性GML患者的数据。目的是开发并验证一种生存列线图模型，该模型可通过结合预后和决定因素变量来预测原发性GML的总生存预后。
为原发性胃GML患者创建有效的生存列线图。
从SEER数据库收集2004年至2015年原发性GML患者的所有数据。主要终点为OS。基于LASSO和COX回归，我们通过一致性指数（C指数）、校准曲线和时间依赖性受试者工作特征（td-ROC）曲线创建并进一步验证了生存列线图模型的准确性和有效性。
本研究共纳入2604例诊断为原发性GML的患者。共1823例和781例患者以7:3的比例随机分配到训练集和测试集。所有患者的中位随访时间为71个月，3年和5年OS率分别为87.2%和79.8%。年龄、性别、种族、Ann Arbor分期和放疗是原发性GML患者OS的独立危险因素（均P<0.05）。列线图在训练队列和测试队列中的C指数值分别为0.751（95%CI：0.729-0.773）和0.718（95%CI：0.6８0-0.757），显示了列线图模型良好的区分能力。Td-ROC曲线和校准图也表明模型具有令人满意的预测能力和良好的一致性。总体而言，列线图在区分和预测原发性GML患者的OS方面表现良好。
基于原发性GML患者OS的五个临床独立危险因素，开发并验证了一种具有良好生存预测性能的列线图。列线图是评估原发性GML患者个体化预后和治疗的低成本且便捷的临床工具。
