青年结直肠黏液腺癌预后列线图的建立与验证

目的利用美国监测、流行病学和最终结果数据库(SEER)建立青年结直肠黏液腺癌(MAC)预后列线图并对其进行验证。方法收集SEER数据库中2004—2015年936例青年结直肠MAC的资料,利用R软件将其随机分为建模组(n=656)和验证组(n=280)。通过COX比例风险回归模型筛选建模组人群的预后因素,并建立列线图。利用一致性指数(C-index)和校准曲线对列线图进行内部验证与外部验证,评估其预测效能。结果建模组的COX回归分析显示,婚姻状态、分化程度、T分期、N分期、M分期、手术是患者预后的独立危险因素,以上因素均用于构建列线图。建模组的C-index为0.813(95%CI 0.788~0.838),验证组的C-index为0.779(95%CI 0.740~0.818)。2组1、3、5年的特异生存率校准曲线图亦显示出良好的一致性。结论研究构建的预后列线图对青年结直肠MAC患者生存具有良好的预测价值,可提高其预测准确度。

Establishment and verification of prognostic nomogram for young colorectal mucinous adenocarcinoma

Objective To establish and validate the prognostic nomogram of colorectal mucinous adenocarcinoma(MAC)in young people by using American surveillance,epidemiology and end results database(SEER).Methods:The data of 936 cases of young colorectal MAC in the SEER database from 2004 to 2015 were collected and randomly divided into modeling group(n=656)and verification group(n=280)using R software.The COX proportional hazard regression model was used to screen the prognostic factors of the modeling group and establish a nomogram.Use the consistency-index(C-index)and the calibration curve to verify the nomogram internally and externally to evaluate its predictive performance.Results The COX regression analysis of the modeling group showed that marital status,degree of differentiation,T staging,N staging,M staging,and surgery are independent risk factors for the prognosis of patients.The above factors are used to construct a nomogram.The C-index of the modeling group was 0.813(95%CI 0.788~0.838),and the C-index of the verification group was 0.779(95%CI 0.740~0.818).The calibration curves of 1-year,3-year,and 5-year specific survival rates of the two groups also showed good agreement.Conclusion The prognostic nomogram constructed in this study has a good predictive value for the survival of young colorectal MAC patients and can improve its prediction accuracy.