Li Wenqiang, He Qian, Huang Qian, Deng Zhiping
Department of Respiratory and Critical Care Medicine, Zigong First People's Hospital, Zigong, China.
Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China.
Transl Cancer Res. 2025 Aug 31;14(8):4867-4881. doi: 10.21037/tcr-2025-206. Epub 2025 Aug 13.
At present, the risk of developing pulmonary metastasis and prognostic factors for choriocarcinoma (CC) remain unclear. This study aimed to investigate the independent risk factors and prognostic factors for pulmonary metastasis of CC and to construct a prognostic prediction model.
We retrieved data on patients diagnosed with CC between 2010 and 2019 from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate logistic regressions were used to identify independent risk factors for developing pulmonary metastases in CC. Then, univariate and multivariate COX regression analyses were used to identify independent risk factors affecting the prognosis of patients with CC. Finally, we constructed a predictive nomogram and assessed the efficacy of the nomogram by receiver operating characteristic (ROC) curves, calibration curves, and decision analysis curves (DCAs).
Independent risk factors for developing pulmonary metastases in CC patients were gender and tissue type. Independent risk factors for the prognosis of CC patients were age, marriage, primary location, liver metastases, lung metastases, and surgical intervention. The results of ROC curves, calibration curves, and DCA in the training and validation groups confirmed that the nomogram could accurately predict the prognosis of CC patients.
Patients with CC are more likely to be young, have a more primary male genital system, have a poor prognosis, and are most likely to be complicated by pulmonary metastasis at initial diagnosis. A novel prediction model to predict the prognosis of CC patients has been constructed to personalize and guide clinical decision-making.
目前,绒毛膜癌(CC)发生肺转移的风险及预后因素仍不明确。本研究旨在探讨CC肺转移的独立危险因素和预后因素,并构建预后预测模型。
我们从监测、流行病学和最终结果(SEER)数据库中检索了2010年至2019年期间诊断为CC的患者数据。采用单因素和多因素逻辑回归分析来确定CC发生肺转移的独立危险因素。然后,采用单因素和多因素COX回归分析来确定影响CC患者预后的独立危险因素。最后,我们构建了预测列线图,并通过受试者操作特征(ROC)曲线、校准曲线和决策分析曲线(DCA)评估列线图的效能。
CC患者发生肺转移的独立危险因素为性别和组织类型。CC患者预后的独立危险因素为年龄、婚姻状况、原发部位、肝转移、肺转移和手术干预。训练组和验证组的ROC曲线、校准曲线和DCA结果证实,列线图能够准确预测CC患者的预后。
CC患者初诊时更易为年轻男性,原发于生殖系统,预后较差,且最易合并肺转移。已构建一种预测CC患者预后的新型预测模型,以实现个性化并指导临床决策。