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胰腺导管腺癌术后生存的动态评估

Dynamic evaluation of postoperative survival in pancreatic ductal adenocarcinoma.

作者信息

Zheng Bo-Wen, Yang Xin-Yu, Zheng Jun, Yao Ru-Cheng

机构信息

Department of Hepato-Pancreato-Biliary Surgery, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, China.

Yichang Central People's Hospital, Yichang, Hubei, China.

出版信息

Medicine (Baltimore). 2025 Mar 21;104(12):e41942. doi: 10.1097/MD.0000000000041942.

Abstract

The pancreatic ductal adenocarcinoma has a high degree of malignancy, and traditional prognostic assessment methods have limited evaluative capacity. This study is based on the Kallikrein-related peptidase 7 (KLK7) expression and uses conditional survival algorithms to perform dynamic survival assessments of patients. The Cox proportional hazards model was employed for identifying and adjusting for potential confounders. The Kaplan-Meier technique was utilized to estimate the overall survival rate. The computation of the likelihood of patients surviving an additional year after X years of survival was achieved using the equation CS1 = OS(X + 1)/OS(X). A subgroup analysis based on CS1 was conducted for each individual risk factor. A total of 243 eligible patients were included in the study. Conditioned survival (CS) refers to the years a patient has already survived and the predicted years they are likely to survive in the future, while conducting a time-varying analysis of the factors influencing prognosis. The survival probability assessed by CS1 increased year by year, with the 1-, 2-, and 3-year survival rates rising from 50.4% to 91.2%. In contrast, the actuarial overall survival (OS) decreased from 81.9% at 1 year to 38.6% at 3 years post-surgery. The results of the conditional analysis indicate that patients who survive longer within a certain timeframe have better survival expectations in the future. Adverse factors, including KLK7, have a decreasing impact on survival over time. Conditional survival analysis based on KLK7 can provide more accurate survival predictions for patients who has identified KLK7.

摘要

胰腺导管腺癌具有高度恶性,传统的预后评估方法评估能力有限。本研究基于激肽释放酶相关肽酶7(KLK7)表达,使用条件生存算法对患者进行动态生存评估。采用Cox比例风险模型识别并调整潜在混杂因素。利用Kaplan-Meier技术估计总生存率。使用公式CS1 = OS(X + 1)/OS(X)计算患者在生存X年后再存活一年的可能性。对每个个体风险因素进行基于CS1的亚组分析。本研究共纳入243例符合条件的患者。条件生存(CS)是指患者已经存活的年数以及对其未来可能存活年数的预测,同时对影响预后的因素进行时变分析。通过CS1评估的生存概率逐年增加,1年、2年和3年生存率从50.4%升至91.2%。相比之下,精算总生存率(OS)从术后1年的81.9%降至3年的38.6%。条件分析结果表明,在特定时间段内存活时间较长的患者未来生存期望更好。包括KLK7在内的不利因素对生存的影响随时间推移而降低。基于KLK7的条件生存分析可为已识别出KLK7的患者提供更准确的生存预测。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/31c4/11936588/cb2a04f1073d/medi-104-e41942-g001.jpg

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