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基于监测、流行病学与最终结果(SEER)数据库建立急性髓系白血病预后因素的预测模型

Prediction model establishment of prognosis factors for acute myeloid leukemia based on the SEER database.

作者信息

Li Gangping, Zhang Di, Fu Yuewen

机构信息

Department of Hematology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China.

Department of Medical Records Management Department, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China.

出版信息

Sci Rep. 2025 Jan 7;15(1):1045. doi: 10.1038/s41598-025-85310-w.

Abstract

Acute myeloid leukemia (AML) with t (9;11) (p22; q23) presents as a varied hematological malignancy. The t (9;11) (p22; q23) translocation is the most common among 11q23/KMT2A rearrangements in AML. This research aimed to develop a nomogram for precise prediction of overall survival (OS) and cancer-specific survival (CSS) in AML with the t (9;11) (p22; q23) translocation. We utilized the Surveillance, Epidemiology, and End Results (SEER) database to identify patients diagnosed with t (9;11) (p22; q23) AML from 2000 to 2021. Prognostic factors for this AML subtype were determined using least absolute shrinkage and selection operator (LASSO) regression, which guided the creation of prognostic nomograms. To evaluate the model's discrimination, accuracy, and effectiveness, we employed the concordance index (C-index), calibration charts, receiver operating characteristic curves (ROC), area under the curve (AUC), and decision-curve analysis (DCA). The research was meticulously planned, executed, and documented in full adherence to the TRIPOD guidelines. The nomogram was developed using key variables including age, race, first primary tumor, and chemotherapy. The concordance indices (C-indices) were 0.704 for OS and for 0.686 for CSS. Patients were classified into high-risk and low-risk groups based on nomogram scores, with significant differences in OS and CSS between these groups (P < 0.001). This study developed innovative nomograms that combine clinical and treatment factors to predict 1-, 3-, and 5-year survival rates for patients with t (9;11) (p22; q23) AML.

摘要

伴有t(9;11)(p22;q23)的急性髓系白血病(AML)表现为一种多样的血液系统恶性肿瘤。t(9;11)(p22;q23)易位是AML中11q23/KMT2A重排中最常见的。本研究旨在开发一种列线图,用于精确预测伴有t(9;11)(p22;q23)易位的AML患者的总生存期(OS)和癌症特异性生存期(CSS)。我们利用监测、流行病学和最终结果(SEER)数据库,识别出2000年至2021年期间被诊断为t(9;11)(p22;q23)AML的患者。使用最小绝对收缩和选择算子(LASSO)回归确定该AML亚型的预后因素,这指导了预后列线图的创建。为了评估模型的辨别力、准确性和有效性,我们采用了一致性指数(C指数)、校准图、受试者工作特征曲线(ROC)、曲线下面积(AUC)和决策曲线分析(DCA)。该研究严格按照TRIPOD指南进行了精心规划、执行和记录。列线图是使用包括年龄、种族、首发原发性肿瘤和化疗在内的关键变量开发的。OS的一致性指数(C指数)为0.704,CSS的一致性指数为0.686。根据列线图评分将患者分为高危和低危组,两组之间的OS和CSS存在显著差异(P<0.001)。本研究开发了创新的列线图,结合临床和治疗因素来预测t(9;11)(p22;q23)AML患者的1年、3年和5年生存率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/94cf/11707327/9a681a3acce4/41598_2025_85310_Fig1_HTML.jpg

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