| 摘要: |
| ［摘要］ 目的 分析影响胆囊癌(GBC)根治术后患者生存预后的因素，并构建其列线图模型。方法 从SEER数据库（https://seer.cancer.gov/data-software/）提取2006—2015年行GBC根治术患者1 056例临床资料作为训练组。收集2015—2020年在安徽医科大学附属省立医院行GBC根治术患者76例临床资料作为验证组。针对训练组数据资料采用Cox回归分析探讨影响GBC根治术后患者生存预后的因素，并基于此构建列线图模型。通过Bootstrap自抽样1 000次进行内部验证，应用验证组数据进行外部验证。结果 Cox回归分析结果显示，年龄、肿瘤直径、淋巴结清扫数目、TNM分期、T分期、N分期是影响GBC根治术后患者生存期的独立影响因素（P<0.05）。以此构建预测GBC根治术后患者1、2、3年总生存率的列线图。内部验证显示列线图C-index（95%CI）=0.740（0.720～0.760），外部验证显示C-index（95%CI）=0.707（0.627～0.787），校正曲线显示模型预测情况和实际生存情况一致性较高。结论 基于SEER数据库建立的列线图模型在预测GBC根治术后患者1、2、3年总生存率有较高的准确性和稳定性，可用于指导临床工作。 |
| 关键词: 胆囊癌 根治性切除 列线图模型 生存预后 SEER数据库 |
| DOI：10.3969/j.issn.1674-3806.2023.05.09 |
| 分类号:R 735.8 |
| 基金项目:安徽省自然科学基金项目（编号：2008085QH419） |
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| Analysis of influencing factors of prognosis of patients with gallbladder cancer after radical resection and construction and validation of the nomogram for survival prediction |
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WEI Zhen-kang, SHAO Feng, HUANG Qiang
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Department of General Surgery, Anhui Provincial Hospital Affiliated to Anhui Medical University, Hefei 230000, China
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| Abstract: |
| ［Abstract］ Objective To analyze the factors affecting the survival prognosis of the patients with gallbladder cancer(GBC) after radical resection, and to construct a nomogram model for survival prediction. Methods The clinical data of 1 056 patients who underwent GBC radical resection from 2006 to 2015 were extracted from the SEER database(https://seer.cancer.gov/data-software/) as the training group. The clinical data of 76 patients undergoing GBC radical resection in Anhui Provincial Hospital Affiliated to Anhui Medical University from 2015 to 2020 were collected as the validation group. Based on the data of the training group, Cox regression was used to analyze the factors affecting the survival prognosis of the GBC patients after radical resection, and the nomogram model was constructed based on the analysis. The Bootstrap method was used for self sampling 1 000 times to verify the model internally, and then the validation set data was used to verify the model externally. Results The results of Cox regression analysis showed that age, tumor diameter, number of lymph nodes dissected, TNM stage, T stage and N stage were the independent factors affecting the survival of the GBC patients after radical resection(P<0.05). Based on the results, the nomogram model was constructed to predict the 1-year, 2-year, and 3-year overall survival rates of the GBC patients after radical resection. The internal verification showed C-index(95%CI)=0.740(0.720-0.760), and the external verification showed C-index(95%CI)=0.707(0.627-0.787). Correction curve showed high consistency between the model prediction and the actual survival situation. Conclusion The nomogram model constructed based on SEER database has high accuracy and stability in predicting the 1-year, 2-year, and 3-year overall survival rates of the GBC patients after radical resection, which can be used to guide clinical practice. |
| Key words: Gallbladder cancer(GBC) Radical resection Nomogram model Survival prognosis SEER database |
