胃肠道混合神经内分泌-非神经内分泌肿瘤患者的发病率、生存率和预后因素:一项 SEER 基于人群的研究。

Incidence, survival, and prognostic factors for patients with gastrointestinal mixed neuroendocrine non-neuroendocrine neoplasms: a SEER population-based study.

机构信息

Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China.

出版信息

J Cancer Res Clin Oncol. 2023 Nov;149(17):15657-15669. doi: 10.1007/s00432-023-05356-z. Epub 2023 Sep 1.

Abstract

BACKGROUND

Mixed neuroendocrine non-neuroendocrine neoplasms (MiNENs) are a group of rare tumors with limited research currently available. This study aimed to analyze the incidence, survival, and prognostic factors of gastrointestinal MiNENs.

METHODS

We included data from the Surveillance, Epidemiology, and End Results (SEER) database between 2000 and 2019. We compared the clinicopathologic characteristics and survival rates between MiNENs and neuroendocrine tumors (NETs), and calculated the incidence of MiNENs. We utilized univariate and multivariate Cox analysis to assess independent factors of prognosis and established a nomogram to predict 1-, 2-, and 3-year cancer-specific survival (CSS). Calibration and receiver operating characteristic (ROC) curves were drawn to validate the accuracy and reliability of the model. Decision curve analysis (DCA) was used to assess the clinical utility of the model.

RESULTS

Patients with gastrointestinal MiNENs had a poorer prognosis than those with NETs. The overall incidence of gastrointestinal MiNENs has been increasing annually. Multivariate Cox regression analysis revealed that tumor size, lymph node metastasis, distant metastasis, and surgery were independent risk factors for CSS in MiNENs patients. Based on these risk factors, the 1-, 2-, and 3-year CSS nomogram model for MiNENs patients was established. Calibration, ROC, and DCA curves of the training and validation sets demonstrated that this model had good accuracy and clinical utility.

CONCLUSION

Gastrointestinal MiNENs are rare tumors with an increasing incidence rate. The nomogram model is expected to be an effective tool for personalized prognosis prediction in MiNENs patients, which may benefit clinical decision-making.

摘要

背景

混合性神经内分泌-非神经内分泌肿瘤(MiNENs)是一组罕见的肿瘤,目前研究有限。本研究旨在分析胃肠道 MiNENs 的发病率、生存率和预后因素。

方法

我们纳入了 2000 年至 2019 年期间监测、流行病学和最终结果(SEER)数据库的数据。我们比较了 MiNENs 和神经内分泌肿瘤(NETs)的临床病理特征和生存率,并计算了 MiNENs 的发病率。我们利用单因素和多因素 Cox 分析评估预后的独立因素,并建立了一个预测 1、2 和 3 年癌症特异性生存率(CSS)的列线图。绘制校准和接收者操作特征(ROC)曲线以验证模型的准确性和可靠性。决策曲线分析(DCA)用于评估模型的临床实用性。

结果

胃肠道 MiNENs 患者的预后比 NETs 患者差。胃肠道 MiNENs 的总体发病率呈逐年上升趋势。多因素 Cox 回归分析显示,肿瘤大小、淋巴结转移、远处转移和手术是 MiNENs 患者 CSS 的独立危险因素。基于这些危险因素,建立了 MiNENs 患者的 1、2 和 3 年 CSS 列线图模型。训练集和验证集的校准、ROC 和 DCA 曲线表明该模型具有良好的准确性和临床实用性。

结论

胃肠道 MiNENs 是罕见的肿瘤,发病率呈上升趋势。列线图模型有望成为 MiNENs 患者个性化预后预测的有效工具,可能有益于临床决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d5f9/10620255/f4b9d7646bcb/432_2023_5356_Fig1_HTML.jpg

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