Sun Nan, Tan Bi-Bo, Li Yong
Department of Blood Transfusion, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hubei Province, China.
Third Department of General Surgery, the Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China.
World J Gastrointest Surg. 2024 Feb 27;16(2):518-528. doi: 10.4240/wjgs.v16.i2.518.
BACKGROUND: Gastric cancer is a leading cause of cancer-related deaths worldwide. Prognostic assessments are typically based on the tumor-node-metastasis (TNM) staging system, which does not account for the molecular heterogeneity of this disease. , a tumor suppressor gene involved in the Hippo signaling pathway, has been identified as a potential prognostic biomarker in gastric cancer. AIM: To construct and validate a nomogram model that includes expression to predict the survival prognosis of advanced gastric cancer patients following radical surgery, and compare its predictive performance with traditional TNM staging. METHODS: A retrospective analysis of 245 advanced gastric cancer patients from the Fourth Hospital of Hebei Medical University was conducted. The patients were divided into a training group (171 patients) and a validation group (74 patients) to develop and test our prognostic model. The performance of the model was determined using C-indices, receiver operating characteristic curves, calibration plots, and decision curves. RESULTS: The model demonstrated a high predictive accuracy with C-indices of 0.829 in the training set and 0.862 in the validation set. Area under the curve values for three-year and five-year survival prediction were significantly robust, suggesting an excellent discrimination ability. Calibration plots confirmed the high concordance between the predictions and actual survival outcomes. CONCLUSION: We developed a nomogram model incorporating LATS2 expression, which significantly outperformed conventional TNM staging in predicting the prognosis of advanced gastric cancer patients postsurgery. This model may serve as a valuable tool for individualized patient management, allowing for more accurate stratification and improved clinical outcomes. Further validation in larger patient cohorts will be necessary to establish its generalizability and clinical utility.
背景:胃癌是全球癌症相关死亡的主要原因。预后评估通常基于肿瘤-淋巴结-转移(TNM)分期系统,该系统未考虑这种疾病的分子异质性。LATS2是一种参与Hippo信号通路的肿瘤抑制基因,已被确定为胃癌潜在的预后生物标志物。 目的:构建并验证一个包含LATS2表达的列线图模型,以预测晚期胃癌患者根治性手术后的生存预后,并将其预测性能与传统TNM分期进行比较。 方法:对河北医科大学第四医院的245例晚期胃癌患者进行回顾性分析。将患者分为训练组(171例患者)和验证组(74例患者),以开发和测试我们的预后模型。使用C指数、受试者工作特征曲线、校准图和决策曲线来确定模型的性能。 结果:该模型显示出较高的预测准确性,训练集的C指数为0.829,验证集的C指数为0.862。三年和五年生存预测的曲线下面积值显著稳健,表明具有出色的区分能力。校准图证实了预测与实际生存结果之间的高度一致性。 结论:我们开发了一个纳入LATS2表达的列线图模型,在预测晚期胃癌患者术后预后方面显著优于传统TNM分期。该模型可作为个性化患者管理的有价值工具,实现更准确的分层并改善临床结果。需要在更大的患者队列中进一步验证,以确定其普遍性和临床实用性。
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