Lin Zejin, Lin Zeyu, Yi Taijun, Liang Yongling, Mai Ziyan, Li Xingyu, Zhong Chengrui, Wan Yunle, Li Guolin
Department of General Surgery (Hepatobiliary, Pancreatic and Splenic Surgery), The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Biomedical Innovation Center, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Sci Rep. 2025 Apr 28;15(1):14783. doi: 10.1038/s41598-025-99399-6.
Liver metastasis(LM) is the primary cause of mortality in patients with colorectal cancer. The incidence of liver metastasis in patients with stage T-T colorectal cancer is uncommon, and there is limited research available. While nomograms have been increasingly utilized in oncology, there is a lack of studies focusing on the diagnosis and prognostic assessment of liver metastasis in patients with stage T-T colorectal cancer. The data of patients with stage T-T colorectal cancer diagnosed between 2010 and 2015 were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate logistic regression analyses were conducted to identify the independent risk factors for liver metastasis in patients with stage T-T colorectal cancer. Additionally, both univariate and multivariate Cox proportional hazards regression analyses were performed to determine the independent prognostic factors in patients with stage T-T colorectal cancer who had liver metastasis. Subsequently, two nomograms were developed and the results were assessed using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA). A total of 11,116 patients diagnosed with stage T-T colorectal cancer were studied, among whom 190 (1.71%) developed liver metastasis. The identified independent risk factors for liver metastasis in these patients included age, sex, primary tumor size, serum CEA levels, N stage, and histological type. Furthermore, sex, race, primary tumor size, serum CEA levels, and chemotherapy were found to be independent factors influencing the prognosis of patients with stage T-T colorectal cancer who developed liver metastasis. The accuracy of predicting the risk and prognosis of liver metastasis in these patients was confirmed through various analyses such as ROC curves, calibration curves, DCA curves, and Kaplan-Meier survival curves on both training and validation sets using two nomograms. The two nomograms are considered effective tools for predicting the risk of liver metastasis in patients with stage T-T colorectal cancer, as well as predicting the prognosis of patients with liver metastasis. These tools can aid in clinical decision-making.
肝转移（LM）是结直肠癌患者死亡的主要原因。T-T期结直肠癌患者发生肝转移的情况并不常见，且相关研究有限。虽然列线图在肿瘤学中越来越多地被使用，但缺乏针对T-T期结直肠癌患者肝转移的诊断和预后评估的研究。从监测、流行病学和最终结果（SEER）数据库中提取了2010年至2015年期间诊断为T-T期结直肠癌患者的数据。进行单因素和多因素逻辑回归分析，以确定T-T期结直肠癌患者肝转移的独立危险因素。此外，还进行了单因素和多因素Cox比例风险回归分析，以确定发生肝转移的T-T期结直肠癌患者的独立预后因素。随后，绘制了两个列线图，并使用受试者操作特征（ROC）曲线、校准曲线和决策曲线分析（DCA）对结果进行评估。共研究了11116例诊断为T-T期结直肠癌的患者，其中190例（1.71%）发生了肝转移。这些患者中确定的肝转移独立危险因素包括年龄、性别、原发肿瘤大小、血清癌胚抗原（CEA）水平、N分期和组织学类型。此外，性别、种族、原发肿瘤大小、血清CEA水平和化疗被发现是影响发生肝转移的T-T期结直肠癌患者预后的独立因素。通过使用两个列线图在训练集和验证集上进行的各种分析，如ROC曲线、校准曲线、DCA曲线和Kaplan-Meier生存曲线，证实了预测这些患者肝转移风险和预后的准确性。这两个列线图被认为是预测T-T期结直肠癌患者肝转移风险以及预测肝转移患者预后的有效工具。这些工具有助于临床决策。
