Department of Public Health, Qinghai University School of Medicine, Xining, China.
Qinghai Provincial People's Hospital, Xining, China.
Medicine (Baltimore). 2024 Nov 1;103(44):e40382. doi: 10.1097/MD.0000000000040382.
Poor prognosis in patients with distant metastasis of gastric signet ring cell carcinoma (GSRC), and there are few studies on the development and validation of the diagnosis and prognosis of distant metastasis of GSRC. The Surveillance, Epidemiology, and End Results database was used to identify patients with GSRC from 2004 to 2019. Univariate and multivariate logistic regression analysis were used to identify independent risk factors for distant metastasis of GSRC, while univariate and multivariate Cox proportional hazard regression analysis were used to determine independent prognostic factors for patients with distant metastasis of GSRC. Two nomograms were established, and model performance was evaluated using receiver operating characteristic curves, calibration plots, and decision curve analysis. A total of 9703 cases with GSRC were enrolled, among which 2307 cases (23.78%) were diagnosed with distant metastasis at the time of diagnosis. Independent risk factors for distant metastasis included age, race, and T stage. Independent prognostic factors included T stage, chemotherapy, and surgery. The receiver operating characteristic curve, calibration curve, decision curve analysis curve, and Kaplan-Meier survival curve of the training set and validation set confirmed that the 2 nomograms could accurately predict the occurrence and prognosis of distant metastasis in GSRC. Two nomograms can serve as effective prediction tools for predicting distant metastasis in GSRC patients and the prognosis of patients with distant metastasis. They have a certain clinical reference value.
胃印戒细胞癌(GSRC)患者的预后较差,且针对 GSRC 远处转移的诊断和预后开发和验证的研究较少。本研究使用 Surveillance, Epidemiology, and End Results 数据库从 2004 年至 2019 年期间确定了 GSRC 患者。使用单因素和多因素逻辑回归分析确定 GSRC 远处转移的独立危险因素,使用单因素和多因素 Cox 比例风险回归分析确定远处转移 GSRC 患者的独立预后因素。建立了两个列线图,并使用接收者操作特征曲线、校准图和决策曲线分析评估模型性能。共纳入 9703 例 GSRC 患者,其中 2307 例(23.78%)在诊断时即被诊断为远处转移。远处转移的独立危险因素包括年龄、种族和 T 分期。独立的预后因素包括 T 分期、化疗和手术。训练集和验证集的接收者操作特征曲线、校准曲线、决策曲线分析曲线和 Kaplan-Meier 生存曲线均证实了这两个列线图能够准确预测 GSRC 远处转移的发生和预后。这两个列线图可以作为预测 GSRC 患者远处转移和远处转移患者预后的有效预测工具,具有一定的临床参考价值。