Department of Otolaryngology-Head and Neck Surgery, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
School of Medicine, Xiamen University, Xiamen, China.
Sci Rep. 2024 Mar 18;14(1):6484. doi: 10.1038/s41598-024-56687-x.
Depending on the source of the blastophore, there are various subtypes of laryngeal cancer, each with a unique metastatic risk and prognosis. The forecasting of their prognosis is a pressing issue that needs to be resolved. This study comprised 5953 patients with glottic carcinoma and 4465 individuals with non-glottic type (supraglottic and subglottic). Five clinicopathological characteristics of glottic and non-glottic carcinoma were screened using univariate and multivariate regression for CoxPH (Cox proportional hazards); for other models, 10 (glottic) and 11 (non-glottic) clinicopathological characteristics were selected using least absolute shrinkage and selection operator (LASSO) regression analysis, respectively; the corresponding survival models were established; and the best model was evaluated. We discovered that RSF (Random survival forest) was a superior model for both glottic and non-glottic carcinoma, with a projected concordance index (C-index) of 0.687 for glottic and 0.657 for non-glottic, respectively. The integrated Brier score (IBS) of their 1-year, 3-year, and 5-year time points is, respectively, 0.116, 0.182, 0.195 (glottic), and 0.130, 0.215, 0.220 (non-glottic), demonstrating the model's effective correction. We represented significant variables in a Shapley Additive Explanations (SHAP) plot. The two models are then combined to predict the prognosis for two distinct individuals, which has some effectiveness in predicting prognosis. For our investigation, we established separate models for glottic carcinoma and non-glottic carcinoma that were most effective at predicting survival. RSF is used to evaluate both glottic and non-glottic cancer, and it has a considerable impact on patient prognosis and risk factor prediction.
根据胚泡的来源,喉癌有多种亚型,每种亚型的转移风险和预后都不同。预测其预后是一个亟待解决的问题。本研究纳入了 5953 例声门型喉癌患者和 4465 例非声门型(包括声门上型和声门下型)患者。采用单因素和多因素 CoxPH(Cox 比例风险)回归筛选声门型和非声门型喉癌的 5 种临床病理特征;对于其他模型,分别采用最小绝对收缩和选择算子(LASSO)回归分析选择 10 种(声门型)和 11 种(非声门型)临床病理特征;建立相应的生存模型;并评估最佳模型。结果发现,随机生存森林(RSF)在声门型和非声门型喉癌中均为较好的模型,声门型的预测一致性指数(C-index)为 0.687,非声门型为 0.657。其 1 年、3 年和 5 年时间点的综合 Brier 评分(IBS)分别为 0.116、0.182、0.195(声门型)和 0.130、0.215、0.220(非声门型),表明模型有效校正。我们在 SHAP 图中表示了显著变量。然后将两个模型结合起来预测两个不同个体的预后,在预测预后方面有一定的效果。在本研究中,我们分别为声门型和非声门型喉癌建立了最有效的生存预测模型。RSF 用于评估声门型和非声门型癌症,对患者预后和风险因素预测有较大影响。