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基于 SEER 亚洲人群的食管癌患者预后列线图的建立和验证。

Development and validation of a prognostic nomogram for esophageal cancer patients based on SEER Asian population.

机构信息

Department of Radiotherapy, Taixing People's Hospital Affiliated to Yangzhou University, No. 1, Changzheng Road, Taixing City, 225400, Jiangsu Province, China.

Department of Radiotherapy, Huainan Chaoyang Hospital, Huainan, China.

出版信息

Sci Rep. 2024 Sep 14;14(1):21475. doi: 10.1038/s41598-024-72730-3.

Abstract

This study aims to develop and validate a nomogram for predicting overall survival (OS) in Asian patients with Esophageal Cancer (EC). Data from Asian EC patients were collected from the Surveillance, Epidemiology, and End Results (SEER) database. The patients were randomly divided into training and validation cohorts in a 7:3 ratio. The Least Absolute Shrinkage and Selection Operator (LASSO) regression was used for initial variable selection, followed by multivariate Cox regression analysis to identify independent prognostic factors. A nomogram was subsequently constructed based on these factors. The predictive performance of the nomogram was evaluated using receiver operating characteristic (ROC) curves and calibration curves, while the clinical utility of the nomogram was assessed through decision curve analysis (DCA). The LASSO regression and multivariate Cox regression analysis identified age, sex, marital status, tumor size, M stage, surgery, and chemotherapy as independent prognostic factors. The ROC curve results demonstrated that the area under the curve (AUC) values for predicting 1-year, 3-year, and 5-year OS in the training cohort were 0.770, 0.756, and 0.783, respectively. In the validation cohort, the AUC values were 0.814, 0.763, and 0.771, respectively. Calibration curves indicated a high concordance between predicted and actual OS. The DCA demonstrated that the nomogram has significant clinical applicability. This nomogram provides reliable predictions and valuable guidance for personalized survival estimates and high-risk patient identification.

摘要

本研究旨在开发和验证一个列线图,用于预测亚洲食管癌(EC)患者的总生存期(OS)。从监测、流行病学和最终结果(SEER)数据库中收集亚洲 EC 患者的数据。将患者按照 7:3 的比例随机分为训练和验证队列。使用最小绝对收缩和选择算子(LASSO)回归进行初始变量选择,然后进行多变量 Cox 回归分析以确定独立的预后因素。随后基于这些因素构建列线图。通过接收者操作特征(ROC)曲线和校准曲线评估列线图的预测性能,通过决策曲线分析(DCA)评估列线图的临床实用性。LASSO 回归和多变量 Cox 回归分析确定年龄、性别、婚姻状况、肿瘤大小、M 期、手术和化疗是独立的预后因素。ROC 曲线结果表明,在训练队列中预测 1 年、3 年和 5 年 OS 的曲线下面积(AUC)值分别为 0.770、0.756 和 0.783。在验证队列中,AUC 值分别为 0.814、0.763 和 0.771。校准曲线表明预测与实际 OS 之间具有高度一致性。DCA 表明该列线图具有显著的临床适用性。该列线图提供了可靠的预测,并为个性化生存估计和高危患者识别提供了有价值的指导。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9170/11401934/c3cd62ccc603/41598_2024_72730_Fig1_HTML.jpg

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