基于网络的预测甲状腺癌患者肺转移总生存期和癌症特异性生存期的模型:一项基于监测、流行病学和最终结果(SEER)数据库及中国队列的研究
Web-based prediction models for predicting overall survival and cancer specific survival in lung metastasis of patients with thyroid cancer: a study based on the SEER database and a Chinese cohort.
作者信息
Yin Fangxu, Wang Song, Jiang Ziying, Tong Yunbin, Han Lu, Sun Wei, Wang Chengmeng, Sun Daqing
机构信息
Department of Pediatric Surgery, Tianjin Medical University General Hospital, Tianjin, China.
Department of Lung Cancer, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin Lung Cancer Center, Tianjin, China.
出版信息
J Cancer. 2024 Nov 4;15(20):6768-6783. doi: 10.7150/jca.103542. eCollection 2024.
The current high incidence of thyroid cancer (TC) is usually accompanied by poor prognosis of patients who also develop lung metastasis. Therefore, the present study aimed to develop a survival prediction model to guide clinical decision-making. This study retrospectively analyzed 679 patients with TCLM from 2010 to 2015 using the Surveillance, Epidemiology, and End Results (SEER) database. The external validation cohort consisted of 48 patients from Tianjin Medical University General Hospital (TMUGP) and Tianjin Cancer Hospital (TCH). Cox proportional risk regression models were used to analyze prognostic influences on patients and the screened variables were used to build the survival prediction models. The present study used the C-index, time-dependent ROC curves, calibration curves, and decision curve analysis (DCA) were used to assess the performance of the nomogram models. The Cox proportional risk regression model analysis identified independent prognostic factors in patients with TCLM. In the training cohort, the C-index of the nomogram in predicting the overall survival (OS) was 0.813, cancer specific survival (CSS) was 0.822. The area under the receiver operator characteristics curve (AUC) values of the nomogram in prediction of the 1, 3, and 5-year OS were 0.884, 0.879 and 0.883. The AUC values for prediction of the 1, 3, and 5-year CSS were 0.887, 0.885 and 0.886. The C-index, time-dependent ROC curve, calibration curve, and DCA for the training group, internal validation group, and external validation group showed that the Nomogram had a clear advantage. In this study, two new nomograms were constructed to predict the risk of TCLM patients. The nomograms can be applied in clinical practice to help clinicians assess patient prognosis.
目前甲状腺癌(TC)的高发病率通常伴随着发生肺转移患者的预后不良。因此,本研究旨在建立一种生存预测模型以指导临床决策。本研究使用监测、流行病学和最终结果(SEER)数据库对2010年至2015年的679例甲状腺癌肺转移(TCLM)患者进行回顾性分析。外部验证队列由来自天津医科大学总医院(TMUGP)和天津医科大学肿瘤医院(TCH)的48例患者组成。采用Cox比例风险回归模型分析对患者的预后影响,并将筛选出的变量用于构建生存预测模型。本研究使用C指数、时间依赖性ROC曲线、校准曲线和决策曲线分析(DCA)来评估列线图模型的性能。Cox比例风险回归模型分析确定了TCLM患者的独立预后因素。在训练队列中,列线图预测总生存(OS)的C指数为0.813,癌症特异性生存(CSS)为0.822。列线图预测1、3和5年OS的受试者工作特征曲线(AUC)下面积值分别为0.884、0.879和0.883。预测1、3和5年CSS的AUC值分别为0.887、0.885和0.886。训练组、内部验证组和外部验证组的C指数、时间依赖性ROC曲线、校准曲线和DCA显示列线图具有明显优势。在本研究中,构建了两个新的列线图以预测TCLM患者的风险。这些列线图可应用于临床实践,以帮助临床医生评估患者预后。