Yang Shujun, Chang Wei, Zhang Bin, Shang Panfeng
Department of Urology, Lanzhou University Second Hospital, Chengguan District, Lanzhou, 730030, Gansu, China.
J Cancer Res Clin Oncol. 2023 Sep;149(12):10269-10278. doi: 10.1007/s00432-023-04907-8. Epub 2023 Jun 4.
Primary testicular diffuse large B-cell lymphoma (PT-DLBCL) is a relatively rare urological tumor with a high degree of malignancy and a poor prognosis. This study aimed to investigate the prognostic risk factors for survival of patients with PT-DLBCL, and then to construct a predictive model and verify its reliability.
First, we selected subjects from the SEER database (2000-2018) and analyzed the survival of PT-DLBCL patients by Kaplan-Meier test. Then, we analyzed prognostic factors by Cox regression. Finally, the data from the training cohort were used to construct a prediction model and represented with a nomogram. We evaluated the nomogram using the consistency index (C-index), decision curve analysis (DCA), and the area under the subject operating characteristic curve (ROC). In addition, calibration curves were plotted to assess the agreement between the column plot model and the actual model.
We identified five independent risk factors for patient prognosis affecting OS and CSS in patients with PT-DLBCL by univariate and multivariate analysis, including age, transversality, Ann Arbor staging, chemotherapy, and radiotherapy. According to the above factors, we constructed prognostic nomograms, and found that age contributed the most to the survival of patients with PT-DLBCL. The C-indexes for the nomogram of OS and CSS in the training cohort were 0.758 (0.716-0.799) and 0.763 (0.714-0.812), and in the validation cohort were OS and CSS 0.756 (0.697-0.815) and 0.748 (0.679-0.817).
We produced the first nomogram of PT-DLBCL, and it can be used to evaluate the CSS and OS of patients to determine the prognosis of patients.
原发性睾丸弥漫性大B细胞淋巴瘤（PT-DLBCL）是一种相对罕见的泌尿系统肿瘤，恶性程度高，预后差。本研究旨在探讨PT-DLBCL患者生存的预后危险因素，进而构建预测模型并验证其可靠性。
首先，我们从监测、流行病学和最终结果（SEER）数据库（2000 - 2018年）中选取研究对象，通过Kaplan-Meier检验分析PT-DLBCL患者的生存情况。然后，通过Cox回归分析预后因素。最后，利用训练队列的数据构建预测模型并用列线图表示。我们使用一致性指数（C指数）、决策曲线分析（DCA）和受试者工作特征曲线（ROC）下面积评估列线图。此外，绘制校准曲线以评估列线图模型与实际模型之间的一致性。
通过单因素和多因素分析，我们确定了影响PT-DLBCL患者总生存期（OS）和无进展生存期（CSS）的五个独立预后危险因素，包括年龄、横膈位置、Ann Arbor分期、化疗和放疗。根据上述因素，我们构建了预后列线图，发现年龄对PT-DLBCL患者的生存影响最大。训练队列中OS和CSS列线图的C指数分别为0.758（0.716 - 0.799）和0.763（0.714 - 0.812），验证队列中OS和CSS的C指数分别为0.756（0.697 - 0.815）和0.748（0.679 - 0.817）。
我们制作了首个PT-DLBCL列线图，它可用于评估患者的CSS和OS，以确定患者的预后。
